Tiger Sisters - Skincare & Aesthetics 101: What Actually Works for Your Skin with Stanford-Trained Plastic Surgeon Dr. Sarmela Sunder

Episode Date: September 28, 2026

Thank you to Granola for sponsoring this video. Try it for free at https://www.granola.ai/tigersisters Check out our matcha brand, Sisters Matcha at ⁠https://www.sistersmatcha.com⁠ Sign up for our newsletter here: https://tigersisters.substack.com/ When it comes to skincare and aesthetics, there’s no shortage of advice online. But how do you know what actually works, what’s just marketing, and what might be doing more harm than good? This week, we’re joined by Dr. Sarmela Sunder, a double board-certified facial plastic surgeon in Beverly Hills, to cut through the noise.Tune in for lessons on: ✅ Why some at-home LED masks may be a waste of money ✅ What to look for when choosing an aesthetics provider✅ How much sunscreen you should actually be using✅ The difference between lasers, radio frequency, ultrasound and other aesthetic devices✅ Dr. Sunder’s own “high maintenance to be low maintenance” beauty routine✅ Fact or fiction on collagen supplements, retinol, skincare, “Ozempic face” and moreWhether you’re already deep in the skincare rabbit hole or don’t know your Morpheus from your microneedling, consider this your Skincare & Aesthetics 101.  Quick Disclaimer: This episode is for educational purposes only and is not medical advice. Botox, filler, lasers, surgery, skincare, and other treatments are personal medical decisions that should be discussed with a qualified medical professional. Tiger Sisters is not suggesting that anyone needs aesthetic treatments to look beautiful, age well, or feel confident. 00:00: Cold Open 01:18: Introducing Dr. Sarmela Sunder04:50: Investigating LED technology 08:50: Demystifying Botox in all its forms14:20: Hannah Bener’s Botox mishap 16:33: What should you ask your injector?23:55: All about sunscreen use36:07: Cherie’s Sephora encounter37:25: What shouldn’t you combine in skincare?37:55: The science behind facials 39:24: Breaking down all types of laser treatments 44:17: What should a consumer do with all of these options?52:03: “High maintenance to be low maintenance” routine53:57: Fact or Fiction game 57:29: Closing thoughts🐯👯‍♀️ We’re the Tiger Sisters — your Wall Street & Silicon Valley big sisters Decoding Money • Power • Love✨ New episodes every Monday | Shorts all week ✨💌 Want to partner with us? Sponsorships: [e-mail] trust us?▫️ Cherie Brooke Luo — 100M+ views demystifying tech, finance & MBAs▫️ Jean Luo — ex-Goldman Sachs, ex-Snapchat exec, 50+ AI patents, startup investor▫️ Together: 4 Ivy League degrees • built billion-dollar products • two startups — decoded for youWhat you’ll get (and keep):▫️ 🚀 Ivy League cheat sheets — no $250K tuition▫️ Personal finance playbooks (salary, investing, negotiation)▫️ Networking scripts behind $100M+ deals & job offers▫️ Real conversations with CEOs, operators & investors▫️ Mindset resets — clarity without the pricey coach▫️ Systems for career, money, and long-term growth💛 LET’S CONNECT~ CHERIE ~Instagram — /cherie.brookeTikTok — /cherie.brookeSubstack — cherieluo.substack.comLinkedIn — /cherie-luo~ JEAN ~Instagram — /jeanluo_LinkedIn — /jeanluo👉 Hit Subscribe & tap the 🔔, then leave a ⭐️⭐️⭐️⭐️⭐️ review on Spotify & Apple Podcasts. It takes 10 seconds and makes a massive difference in helping new people discover Tiger Sisters.🛍️ Items:🍵 Sisters Matcha — http://www.sistersmatcha.com🌀 Everything else — https://amzn.to/3z0dx5b 

What is one beauty trend on TikTok that makes you want to scream? Overusing LED mask. Oh, this is a hot tape. Like, if we're staying indoors all day and I'm like, I have no plans to go outside, I'm just working from home. Do I still have to wear sunscreen? Yeah. Is it because of the sun getting into the house or like the fluorescence of the lights?

No, it's the lights themselves. Are you kidding? Yes, that's horrible. I'm going to work in the dark. Factor fiction. Collagen supplements actually work and noticeably improve your skin. Fiction. What?

Yeah. I take it every day. No. What is your high maintenance to be low maintenance routine? Okay, she's already dropping facts. This is already so helpful. Yeah, I had no idea. Okay, you just saved us $2,000.

I'm Cherie. I'm Jean. I'm Sharma. And we're the Tiger Sisters. We are your Wall Street and Silicon Valley Big Sisters. And we're a top 10 business podcast bringing late night sister talk meets boardroom strategy. Hi, Tiger fam. Welcome to skincare and aesthetics 101.

one. Every time I open Instagram, I feel like there's a new hot take on skin care, aesthetic procedures, and aging. It can be super overwhelming because it feels like for every single decision there are hundreds of opinions out there online. Luckily, we are joined today by Dr. Sharma Lassander, who is a double board certified plastic surgeon based in Beverly Hills, who studied at John Hopkins, Cornell, and Stanford. And she is here with us today to separate beauty myths, from science. Today we're demystifying it all, skin care, Botox, microneedling, lasers, and more. We're going to find out today what actually works, what is marketing, and what is right for you. We are so excited for this episode because Dr. Sunders' philosophy is all about helping people

feel more informed and feel like the best version of themselves, not like a different person. So quick note, before we get into it, this episode is educational. We are not saying, and would never say that anyone needs Botox, surgery, or any sort of aesthetic treatment to look beautiful or age well. We are here to help you understand the options, ask better questions, and make informed decisions for yourself. All right, let's get into it. Sharma, welcome to the Tiger Sisters podcast. I'm so excited to be here. Yay!

Yay! Yay! Dr. Sunder, we have some icebreakers and we want to get into some hot, juicy topics. What's the beauty treatment you think people are overdoing, right? now? I think one of the treatments that people are just overdoing is filler. And nicely, I think we're trying to come off of that trend a little bit, but there's still a lot of overdone filler out there. Okay. We're going to get into that later. We have a ton of follow-up questions, but I'm glad we're starting there. Okay. All right. She's setting the scene. She's setting the scene. Okay, filler.

The other thing that I'm seeing a lot of is on the opposite end. There are people that are doing surgery to prematurely. So I think that's the flip side of the coin. And I think a lot of that has to do with messaging on social media. So on one end, you hear a lot of fillers are bad, fillers are bad. So people are swinging completely the other direction going to surgery prematurely. And then you're seeing the flip side of it as well. I'm totally getting all of that content on social media.

Like everything about mini facelifts and how like that's like, the best way to, I guess, stay looking like yourself. And people are saying you should do it as early as in your 40s. I'm like, what? Okay, so we'll get into that too. And so we also want to ask, like, since you brought up social media, we can be quite influenced by the things that we see as we're scrolling. Like, what are some, I guess, guardrails or things that we can tell ourselves as we're

scrolling and we're seeing people talking about these topics? Yeah, I think it's really easy to get stuck in this, like, echo chamber. of information because once you engage with one video, even if you don't necessarily agree with the information in there, you're going to be fed similar information. And then you hear it over and over again. And then your mind kind of starts playing tricks on itself. And you think, well, maybe I do need this surgery

or this procedure. And I think it's really important to level set every once in a while and say, OK, this is just information for me to process and perhaps research and think about whether it's a good fit for me. Yeah. And really break it apart in that way rather than just taking it at face value. Yeah.

I need to stop the doom scroll at like 11 p.m. before bed. And I'm like seeing all these cosmetics procedures. And I'm like, oh, no, I'm spiraling. So it's like good to get out of that. What is one beauty trend on TikTok that makes you want to scream? I would say overusing LED masks. Oh. What?

I was not expecting it. This is a hot take. Yeah. So LED masks, I mean, there's so much I can say about that, but LED technology, a lot of the masks are just a waste of money. They're not effective. And for it to be effective, usually you need a certain number of lights. You need them spaced a certain way. And they need to pulse.

And there's all this metrics that goes into it. So a lot of the at-home devices really aren't effective. Secondarily, even if you had one that's effective, it's not safe on all skin types. So most of these devices aren't tested on skin types five and six. So I'm five and six, or I'm five. So I don't think a lot of people who are skin of color should be using these devices. Because not only are they helpful, but sometimes they can be harmful if you're not the target population. then people that have are that are prone to hyperpigmentation people with melasma should not be

should not be using LED masks so I see a lot of yeah I see in a lot of patients who have melasma and they come in they're like oh my melasma's just gotten worse this year I'm doing the sunscreen I'm trying to stay away from heat and then we'll kind of go down the list of things that they're using and the LED mask will pop up so that is you know I think a lot of people use it it's going to help them. And in a lot of scenarios, it's not only not helping, it's actually hurting you. Oh my gosh.

Okay, so my journey with the LED mask, is that a few years ago, I bought one from the Nordstrom anniversary sale. And I tried it on one time, but it was too heavy. And it was like pulling my face down, so then I returned it. Yeah.

So I never ended up using it. But what about the panels? So the panels. So the panel, so for example, in our office and a lot of medical offices, medical spas, they have these panels that are appropriately calibrated. And those are what a lot of the FDA trials were performed on. And so those are effective. But the at-home ones, especially the really small ones, there just aren't enough LED lights on there to affect the change. I see.

I have a really, really tiny one. It's like a handheld. held and it's like I felt this small. Yeah. And I'm figuring out that probably is in that category where it's so tiny that it's not really doing anything except for maybe guashing my face a little bit. Exactly. But I want to get one of those like larger panels that, okay, this is me also influenced my

social media. But I'm like, I should wake up and sit in front of my large LED light panel for like 10 minutes when I get up in the morning. But it sounds like that might be closer to, you know, the effectiveness that we're looking for rather than the face one. Yeah. Yeah. But then you have to know your own skin.

if you're likely to get melasma or hyperpigmentation, it could do more harm than good. Okay. Yeah. Well, I think you just saved me $500 or however. Yeah. No, those are the thousands. The boughs are expensive. Yeah.

Yeah. Well, the face masks are a little bit more affordable, but if they're not working. Yeah. And, you know, all the studies on these masks or all the studies on LED light really has to do with inflammation and healing. So if you're trying to heal from something, sure. Or if there's inflammation, sure, it'll help. But everyday life, we're not walking around inflamed, right?

Or at least our skin isn't walking around inflamed. And so I don't really know if there's really that much value in it for the amount of money you're spending on it. Yeah. Okay, she's already dropping back. This is already so helpful. Yeah. I had no idea. Okay, you just saved us $2,000.

Here we go. Let's back up a little bit and start from the foundations. We want to talk about Botox. So the first question is what is preventative Botox? Should people in their 20s be considering it or is it just marketing? So preventative Botox in its purest form, what it means is if you are intended to get a line in a certain area, doing Botox to that muscle could prevent that line from developing sooner than it would have originally developed. And so that has more to do with your anatomy than age. So for some people, that line can form in their 20s.

And for other people, it's not going to form until their 50s. So if you were supposed to get that line in your 20s and you start the preventive Botox, maybe you're going to push it to your 30s. If you were supposed to get it in your 50s, starting Botox in your 20s really isn't going to do anything, right? You know, whenever people ask me, when should I start Botox? A good example is I tell people, you know, if it's, if you're worried about your forehead, go ahead and raise your forehead, keep it there for about a minute and then relax. If you have a line in your forehead after you relax it, even for, you know, for five seconds, that means you're eventually going to develop a permanent crease there.

And so now is this time to start doing Botox to prevent that line from becoming permanent. But if you do that and there's no line, you know, even for a few seconds and you don't have to treat it just yet and try again six months later or a year later. And at some point, there will be a line that shows up. So then you can do it to start preventing that line from setting it. Yeah. So for some people, I mean, I've definitely seen patients where they're in their mid-20s and they have creases in their skin. And that could be age-related. It could be lifestyle-related.

It could be history of smoking, vaping, whatever it is. And so for those patients starting in their 20s makes sense. But for the vast majority of people, I think you want to start probably in your 30s. And then I've had patients who, I mean, I saw someone last month who had never done Botox. She was in her late 40s. And I was like, I don't think you really need to start it now. Give it another year or so. So it just really depends on the patient.

Yeah. I feel like the other thing that I've been hearing a lot is the term baby Botox. and that gets conflated with preventative Botox a lot, right? But baby Botox is kind of just, I'm thinking it's kind of just a marketing term for people to be like, I just got baby Botox. Exactly. What is baby Botox? Baby Botox is one amount.

Exactly. It's just a smaller dose. And I think for a lot of people, it makes them feel better that they don't have to do large amounts of Botox. Or it seems like it's an entry dose as opposed to a full-on dose. But I think you should do the dose that that's going to work the best for you. You know, there are people who need 48, 50 units to the upper face, and then there are people that need 50 units for their entire, like, neck and face. And if you under-treat, you're actually not helping things

because you're not really treating the muscle to its fullest extent. So long-term, you might actually be hurting things. So I would say don't get fixated on this. numbered too much, just allow your, as long as you trust your injector, allow your injector to dose you appropriately. Appropriately. Okay. So you just touched upon the other topic that I wanted to bring up, which is that I feel

like historically, Botox used to be really focused on sort of spot treatments. And everyone was like, oh, getting Botox in your forehead to prevent the forehead lines or like the 11s. But now there's a whole new kind of philosophy of treating the whole face, right? And getting Botox is not just for one area. It's to kind of, there's the term facial balancing, I guess. And then there's also the idea. It's not just for wrinkles either.

Exactly. For a holistic application. So can you tell us a little bit more about that? Yeah. So exactly. When Botox first came out, it was actually came out for medical indications, not cosmetic indications. But when it first came out for cosmetic indications,

it was just targeting lines, right? Crow's feet lines and glabella lines, which are the Angry Elevens. And now we use it much more artistically, I would say, so you can actually shape the face using Botox. So people get it in their masseter to slim the face or to make it look a little bit softer. You can also use Botox to impact other muscles that aren't being injected.

For example, you can inject this area and this area. So you can inject in between the brows and around the eyes to allow the forehead muscle to relax. Or you can treat the DAO to keep your lower face from turning into like more of a pulled look or like pre-jowling, things like that. So you can actually weaken a muscle to allow the lifting muscles to get stronger. So you can use it a lot more artistically than we were 20, 30 years. ago. I don't know if you've seen this, but recently a podcast host comedian Hannah Burner from Gigley Squad was injected, I think, in her jawline somewhere, and it like froze her face and she couldn't smile all the way. So there's been like a ton of clips of her like kind of like

this where she's like trying to smile or when she's like laughing. She's like, her and like it's become this whole thing. Yes. So that that's been sent to me a few times. And I think I might not have the facts completely right. But I think she. got masseter Botox and what sounds like happened is there's a muscle called the Rosorius muscle which pulls your lip corners to the side when we smile and that sits right in front of the masseter sometimes it could be a little bit of overlap but it sits right adjacent to the masseter so Botox that's injected into the masseter could drift into the risorius and that then that could impact that muscle from moving so

it can limit how much you smile or how wide your smile is. So it sounds like that's what happened to her. Yeah. And she's just waiting for it to fade now, I think. Yeah. Unfortunately, you know, for fillers, we have a way to reverse it. Botox, there's just no way to reverse it yet. And so you just kind of have to wait it out.

There are things you can do to hasten the process, but for the most part, you just have to wait it out. Yeah. Can you sweat out, Botox? I've heard, maybe it's like exercise a lot. Old white tail sauna. So there is some evidence, and it's not very strong evidence, but heat to the muscle can make the Botox effects go away sooner. And sometimes vibration or friction.

So I've had patients where I've advised them to use like a mechanical, like a buzzer or a, like an electric toothbrush, use the opposite side of it and hold it on to the muscle. And sometimes I can speed up the, the. effects of the Botox. I never knew that. Yeah. If there's you know if there's ever a time when you feel like the Botox is too strong or you want it to come out sooner, those are things you can try like heat to the area or friction vibration. Cool. And so going off the topic of like injectors and people who maybe are injecting the Botox are there things that we should look out for? Like for example if we go to a med spa like should there be questions that we have ready to ask them to suss out whether the injector is qualified or someone that we

would trust with our face. Yeah. So now in the U.S., and depending on the state, there are different types of professionals that can inject. So in California, yeah, in California, a physician, MDDO, and that could be, you know, a dermatologist, a plastic surgeon. It doesn't even have to be someone that's trained in aesthetic, so it can be. a gynecologist, it could be a medical doctor. A dentist? A dentist, yes. So, and then nurses,

physician associates, really anyone can inject as long as you have one of those degrees. And so that means that if someone got their degree on Friday, like their nursing degree on Friday, they can theoretically start injecting Monday without having any proper training. or instruction on the muscles and what their interplay is like. For example, the Rosorius Masseter thing, I bet if you asked a lot of injectors, they wouldn't know that relationship. They wouldn't be able to tell you where the Rosarius is relative to the Masseter. And so I don't think, and that goes for MDs,

there might be nurses that know that relationship, and there might be MDs that don't know that relationship, right? And so I think it has more to do with experience and their level of training within the field more than their degree. So there are a lot of great nurse injectors. There are a lot of great PA injectors. And I think what's more important than anything is who the PAs and nurses are working, which company they're working is part of. So I think the ones that are affiliated with a plastic surgeon, I'm biased, right? So I'm a facial plastic surgeon.

So the nurses in our practice really, really know their anatomy. They know the limits. And I think that's really important because knowing when to say no is so important in our field. And I think that's why you see so many crazy looking faces out there because there are a lot of providers that don't know how to say no. are uncomfortable saying no. And so knowing your limits is really important. And I think when you work within a plastic surgery practice or you're working within a dermatology practice,

I think those standards are established. And there are a lot of good medspas, but I would say a lot of the medspas are not as critical in the thinking as some of these physician-led practices. But that's a generalization, right? So there are, like I said, there are some great med spas where they have routine training and continued medical education. And so they're great. So it's just really hard to tell, you know, as a patient who to go with.

But I think the experience is really important and seeing who they're affiliated with. That's a good starting point. And also, like, maybe if there's like a consultation or some sort of conversation you can have ahead of time, I think the point that I'm really latching on to is like, do they know their limits? Yeah. Or like when to stop too. Exactly. Or like if someone comes in like wanting to do a lot of things, like at what point is it the provider's responsibility to say no?

Yeah. I see patients all the time where they come in and they say, oh, you know, I wasn't happy with this injector because they wouldn't do this. And I know you guys do that. I always tell them, that's wonderful that your provider knew their limits and wouldn't do it because they didn't feel comfortable doing it. On the flip side, I've seen so many patients whose faces haven't ruined by someone that didn't know that this was inappropriate to do and went ahead and did it anyways because they were asked to do that. So I think it's always better to have a provider say, I don't know how to do this or this is not a good idea. Go see someone else. Yeah.

And here's a referral to someone. that's comfortable doing this. Yeah. And when you see those patients, have they had procedures done to them that are irreversible? Or what, like, what are some examples? Yes. So because our practice is both surgical and non-surgical, we see the gamut. So we've definitely seen irreversible treatments, for example, with a lot of these devices,

these heat devices, these radio frequency devices, ultrasound devices, we've seen fat loss. And so that's irreversible in the sense that your body's not going to produce the fat. There are ways to, you know, with fat transfer or sculptor, there are treatments to try to fix it. It won't be back to 100%, but there are ways to fix it. And then there's reversible treatments, for example, filler scenarios where someone looks crazy or it was placed inappropriately. and we can reverse it and address it. Well, I don't know if you remember this, but I used to write for the school newspaper,

and I actually had an interview column in the Dartmouth, which was our daily newspaper, and I would interview students where every time I interviewed them, I would audio record the whole interview and then play it back and manually transcribe the whole interview out for myself. Oh my God.

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Okay, so before we get even deeper into aesthetic treatments, we were thinking, let's take it back to even more basics. So we start with, let's start with like skincare. Yeah, so we wanted to ask you a little bit more about sunscreen because everyone says you have to wear sunscreen. But what does that actually mean? Like SPF 30 versus 50, mineral versus chemical. How much should we be putting it on our face and reapplying? That's a great question. So the most important thing with sunscreen is consistency.

Okay. And secondarily, more important than the number is the amount. So the number is important, but if you're doing SPF 30 and just doing a small smear of it, you might as well just not be using anything. So the appropriate amount is, I think it's two grams per centimeter square. So what that works out to is about half a teaspoon for your face and extend down to your neck. So what this is really fascinating when I learned this is that the protection goes down exponentially if it's less than that. So if you're doing SPF 50, which is what I usually recommend, and you're doing half a teaspoon, then you're getting SPF 50.

But if you're using a quarter of a teaspoon of SBF 50, you go down to like SPF7. Oh, okay. So the amount really matters. And I think a lot of people just put it a little bit on. And they are like, okay, I'm good for the day. And that's just not cutting it. So I prefer SPF 50 because I feel like most people are under treating anyways. You need at least SPF 30.

And SPF 30 gives you 97% protection. and SPF 50 gives you 98% protection. So it's just 1%. But if you're not using the amount that you really need to of the 30, then you're just putting water on your face at that point, right? So I feel like if you can bump it up to SPF 50, then you're giving yourself a little bit more protection, but then you really want to make sure you're doing that half a teaspoon on your face and neck.

Is SPF 100 100% protection? No. So that's like 99. Okay. Yeah. So you're still not a, you don't ever really get to 100%. You're never protected. You're never protected.

And then the other thing, I just thought people knew, but I've been understanding that people don't really know is tinted sunscreen is really important for skin of color, for melasma, because it offers indoor light protection, which can trigger melasma and can trigger hyperpigms. or worse in hyperpigmentation on skin of color. So anyone that's not of Northern European descent or European descent is technically skin of color. So we're all skin of color, right? And so tinted sunscreen is really important for us.

Wow. I've actually heard, so correct me if this is right or wrong or just, you know, in the ether, but I've heard that tinted sunscreen can actually start to help reverse skin damage or it can actually improve your skin as opposed to just preventing further damage. What's the level of truth? I don't know if it can improve the skin,

but in the sense that if you are preventing further damage, you're protecting your skin so that it has the chance to heal from the previous damage. So, you know, through that mechanism, it could be doing that. And there are certain sunscreens that have. antioxidants built into them. So ISDN is a brand that I really like and it has what are called DNA repair zones and so there are certain factors in it that can help reverse some of the sun damage and it comes in a tinted form. Yeah. And when you say indoor light, like if we're staying indoors all day and I'm like I have no plans to go outside, I'm just working from home,

do I still have to wear sunscreen? Yeah. Why? Tinted suns cream. Tinted suns cream. Tended suns skin of color. Yeah. If you're prone to hyperpigmentation and then if you have molasma. Is it because of the sun getting into the house or like the fluorescence of the lights? No, it's the lights themselves. Are you kidding? The fluorescence of the lights? That's horrible.

I'm going to work in the dark. Obviously, it's not as strong or as impactful as solar UV, but it still has some sort of effects to it. So my patients who have melasma or the ones that are really trying to work on reversing, melasma, you could be doing all the things, but if you're not wearing that tinted sunscreen, you're just throwing away thousands of dollars, you know? So for people that have pigment concerns, it's really important to wear sunscreen indoors. How do you know if you're prone to malasma? How can you tell? Well, I mean, you don't really know until it shows up. And it shows up, It shows up more commonly in skin of color.

Okay. It usually shows up on your cheeks, on the sides of your cheeks. It can show up as like a darkening of your upper lip so it can look like a shadow almost or like a little mustache, if you will, and then it can show up along the periphery of your forehead also. Is it kind of like freckles for people of color? It can look like freckles, but usually freckles are sun damage. Oh, okay. but it can look like freckles in some people,

but it's more, it's more coalesced than, yeah, more splotchy, exactly. Wow. Exactly. And it's, it can correlate with your period. So it's hormonally mediated. So oftentimes it used to be called like the mask of pregnancy because when your hormones are elevated during pregnancy,

it really shows up. Wow. Skin of color and pregnant women can't catch a break. Ever, ever. Watch out for those indoor lights. Hey Tiger fam, take five seconds to subscribe to the Tiger Sisters podcast. When you subscribe, you are notified every single time a new episode drops. And if you're listening on Spotify or Apple Podcasts, please rate us five stars and leave a comment about this podcast because it really helps people discover our content and it helps us to continue to make the show for you.

If you're listening to this on Spotify right now, take this opportunity to turn on the video. Thanks. to the show. So the next thing I want to talk to you about is skincare routine. And I'm going to kind of talk about mine. So I'm really into skincare, but I am not overly specific about my products. So usually I will use some sort of serum, a moisturizer, tinted SPF, and what else? Oh, and then some sort of Korean skin wipes with active ingredients. And my philosophy in general is that I think that Korean skin care and Japanese skin care is generally better than the skin care you can get in the U.S. because, and this is just my theory, but I think that the competition is

higher in those countries. So you have to have better product for cheaper prices to stay in the market. And I also think they have higher like FDA equivalent regulations. So for me, I'll just kind of by whatever Korean skincare and not be super discriminating. And is that true? Okay, fine. Let's stop there. Is that true? What do you think?

I think the logic makes sense because Korean skincare is like 10 years ahead. Yeah. Yeah. So I do think a lot of the skincare there is better than a lot of the skincare here. However, we have some really great products here. So it might be, you know, five, 10 percent. of our products are comparable to 90% of Korean products maybe. The other thing is what is highlighted in Korean skincare products is different than what's highlighted

here. So pigmentation is number one priority in Korean skincare, right? And that end and skin texture, which is not necessarily, or until recently was not necessarily a priority for Americans or American skincare. And I think for, you know, you have Asian skin. So it will play, it'll play well with your skin type. Whereas someone, which Asian skin tends to be a little bit more sebaceous, not as dry in general, right? Whereas Caucasian skin is not that, right?

It's not as sebaceous usually. So I think you do need to be a little individual in picking skin care. And so I can see how it would work well for you. And I think that logic completely makes sense, but it doesn't apply to everyone. Okay. But it would apply to Asians. Yeah. And I think, and I think.

Well, I'll sell my Asians out there. But also for Caucasians that have pigment concerns and textural concerns. And they're incorporating a lot of ingredients that we haven't really started thinking about yet. So, for example, PDRN or even snail mucin was, or actually, Allentoyne was, I remember, like, 20 years ago when I was in Asia picking up this product, like snail mucin and being like, it was so popular there. And no one had heard of it in the U.S. And then, like, 10 years later, it worked its way over here.

And so there's a lot of like TXA in Asian products. What does that mean? TXA is tranexamic acid, which is a good component for pigmentation. That is just starting to show up. up in American skin care. Interesting. And I feel like also niacinamide. Yeah.

It affects like the pigment pathway. Yeah. Yeah. Gene is definitely way more advanced than I am in her skincare routine. I'm really into skin care. I love it. Well, you know, when you were asking about what's a TikTok beauty trend that drives you nuts, that that is actually my number one issue is kids who are who do not need to be using anti-aging products

who are using a ton of skin care. That, I think that is my number one issue. Because it's just too young. It's too young. It's not, there's no need for it. And a lot of kids are damaging their skincare barrier by using these products that are way too strong. So I hear that term a lot.

What does it actually mean to damage your skin barrier? So. People are always trying to repair their skin barrier. Yeah. So when we were, I think we're going to talk about retinoles or retin. retinodes, right? And so that is something that happens commonly with retinoid is when you use too much of it, you're actually breaking down the, so the barrier is basically, you know, like the fabric of the skin and you're breaking down the surface layers of it and creating little cracks in the initial layer of the

skin. And that's what causes redness. That's what causes that stinging sensation. And so, so your body needs to go through a process of healing all that before you can introduce retinodes again. And so a lot of, it's really funny. I'll see these influencers with super shiny skin. And it's meant to be perceived as healthy skin, but oftentimes it's really them like, really aggressively weakening their barrier. And so the skin is just trying to heal itself and it looks really shiny.

and it's not healthy skin. So it's a different type of shine on healthy skin versus damaged skin. How can you tell visually? There's, I mean, I think it's just gotten because I've gotten used to seeing what that looks like, but it's just different. It's not like you've got this glowy skin and it looks plump and glowy, which is different than the irritated shiny. Yeah, I was an expert eye.

Yeah. I was at Sephora a few months ago and I was buying some makeup there and was online and these two young girls were next to me online. And in my head I was like, where are your parents? Number one. Number two, I like engaged with them. I was like, hi girls. They're like one of them's like 10 or 12. And I asked them like, how old are you guys?

She's like, I'm 12. I'm nine. Wait, no, I'm 10. And I'm like, what are you buying? And they're like, lotion and stuff. And they had like drunk elephant. And I was like, how are you affording this? Right.

And also I'm like, in my mind. mind, I was just like, wow, they were really young. I'm like 20 years older than them and we're like in the same line at Sephora. Yeah. So I thought that was pretty insane. And I wasn't going to be like, where's your parent? But I was just like, she was about to though. I was engaging with them. I was like, hey girls. Dang. It was so crazy. Yeah. I mean, at that age, you really just need SPF and then maybe a moisturizer, but that's, you don't really need much more than that at 10 and, you know, 10, 11, 12. Yeah. And in our practice, we've definitely seen young patients where they've, I had a patient who basically burned her skin with using a retinoid and a salicylic acid cleanser, which she, and usually

that would be our recommendation for someone that has acne. She never had acne. She just saw someone doing it. Yeah. And so really traumatized her skin and basically gave herself a chemical peel doing that combination. Yeah. Yeah. Because there There are definitely some things you should never, you shouldn't combine. Yeah. Like, I know if you're doing a retinol, like at night, like you probably shouldn't do vitamin C in the morning or, no, you can do vitamin C in the morning, but you don't want to do too many acids altogether.

Okay. Yeah. Okay, back to me. Okay, my other question is that I, well, so both Shereen and I recently started doing facials. So we started getting facials monthly and I really think it makes a difference. And I love it. But I guess what is the science behind it? Is it just that it's helping to like cleanse your skin? And then is there it just, it just seems funny in my mind because you're putting on just lots of layers of things to treat the skin. So is it scientifically helpful? So facial is like a very broad term, right? It's an umbrella term. So it depends on the type of facial that you're getting. So if it's just a,

a basic facial, I think the only way that it's helping is it's probably just cleansing your skin to a deeper level. But as part of the facial, you can also incorporate certain ingredients. So if someone's not using vitamin C routinely incorporating the vitamin C as part of the facial may help. Or a lot of facials have certain enzymes that exfoliate your skin and a lot of people don't exfoliate regularly. And so this is an opportunity to have that exfoliation. But then there are more advanced facials also. Like there's hydrophacial.

There are facials where you're using different types of AHA, BHA acids that are really improving or increasing cell turnover. So that's more of a true treatment. And so it depends on what kind of facials you're getting. And so I can definitely see it being impactful if it's one of the ones that are incorporating these acids and higher active ingredients. Okay, Dr. Sundar, let's talk lasers. I feel like lasers are such a broad category and I'm not sure if they include all of these things. So radio frequency, ultrasound, all therapy, morphias, surf, softwave, thermo, CO2, pico laser. They're all, I think they're all

totally different modalities, but they all get bucketed under the same bucket. So can you tell us a little bit more about that and how do you figure out what is right for you? Yeah. So those are all what we consider devices. Lasers are actually very specific. So IPL is a laser. CO2 technically is in a laser radio frequency ultrasound. Those aren't really lasers. Those are all devices. And they all tackle different problems. So usually ultrasound is for tightening and toning. So all therapy, softwave, those are ultrasound devices. Then there are radio frequency devices. They can also tighten and tone, but they can be combined with microneedling like Morpheus, Viva, Potenza, Vivachi, all those are microneedling radio frequency treatments. So those can help with texture

and tone as well as a little bit of tightening. The issue with the radio frequency and some of the ultrasound devices is that depending on the energy level and depth of penetration, it can lead to fat loss in some cases. And so when we were talking about experience level of the provider and, you know, choosing a medspa versus choosing a physician's practice, I think that's where some of that is really important because when these device companies give you, you know, when you buy the device. They tell you standard settings. And, you know, just between the three of us, your skin depth is different than your skin depth is different than mine. And so it really needs to be a provider that can tell based off of what we look like and based off of examination, how to adjust that setting.

Because if you just did standard settings on everyone or you cranked up the settings trying to achieve tightening, then you could run into trouble with fat loss. And we've seen that a lot with patients that are referred into us who've had fat loss or other complications. So in our practice, we really understand how the technology works and we know how to adjust it so that you can achieve great results without really crank the energy. So rather than doing one treatment at the highest setting, you do three treatments at one-third the setting maybe and ultimately get to the same result. Okay.

So there's risk even for radio frequency? Yes. Oh, wow. Yeah. Yeah. Now, it's not a very high percentage. I think this is another scenario where social media is really blown it out of proportion where I have patients come in.

And if I'm recommending a radio frequency treatment, they're like, oh, no, no, I can't. I don't want to have fat loss. Oh, okay. So it's not that any time you get radio frequency, you're going to have fat loss. But if it's used inappropriately or if it's used to lift, there's a chance that you can have fat loss with it because the settings required for lifting heat up the tissue so much that you could inadvertently get fat loss. Okay. So radio frequency is not really intended for lifting. It is. Oh. It is. So there are some radio frequency devices that you use for lifting.

And what are they called? I mean, all of them. So Morpheus, you can use it for lifting. Okay. But if you use it at that setting, you're usually going to get fat loss. So when I have a patient come in and say I want to have a certain level, you know, a certain result. We have that discussion. And I say, well, if we do it at this setting to give you the level of lifting that you're hoping to achieve, the unintended side effect will be fat loss.

And so I don't want you to have. And there are lots of people who say, oh, I feel like I have a full face. I'm fine with losing a little bit of fat. You don't want to lose fat because that's the subcutaneous fat, especially the fat that is right under your skin kind of nourishes your skin. It's what gives the skin its plump quality. Okay. So if you lose that fat, that will inadvertently age your skin faster.

I think with all of these technologies, and devices for someone like me who is not as advanced in it, it can feel really intimidating, like with all these names. Like how do you suggest that someone, a consumer, go research it? Like what should we be looking up or is it just talking to a provider? It's talking to the provider because there's just so much information and it can get very confusing and it's not very black or white, right? So like I said, radio frequency can cause fat loss.

it doesn't most of the time. And in most practices where they do it in a way that's thoughtful, it's not going to happen. And so I think the information, especially on the internet, it's not fact-based, right? There's always, if you're reading it off of someone's website, there's some level of subjective anecdotes involved, right? And so I think it goes back to identifying a provider that you trust, that's ethical, that's going to be honest with you, that can help guide you. And really, the other thing is I think it's really important for the patient to not push the provider either.

Because I think in general, most of us want to help our patients achieve whatever their goal is, right? And so if a patient is saying, oh, I really want to do this, I really want to do this, but I don't want to do surgery, but I really want lifting. And so the provider is going to be tempted to, okay, let me turn up the energy to give them that lift. And they're thinking about short-term benefit, which is lifting. But long-term loss is the fat loss, which over the course of five years, 10 years, is actually going to do the patient and disservice.

Yeah. I think maybe a good question to ask as a follow-up to a provider is like what are the long-term effects of this treatment. What are the long-term effects? But also, I think a lot of patients now are open to surgery. The question should be asked, how will this impact future surgery? If I'm thinking about having a face lift in five years, how will this impact it? Okay. And I have heard that some of these devices can impact.

Yeah. Because it can create scar tissue. No. Yeah, it creates scar tissue. So the dissection plane. are not as easy to identify. It's not impossible to do, but it makes it more challenging. So it's definitely something that you want to disclose to your surgeon.

And I usually have a time frame. So if someone has had any of these heat devices within a year of surgery, I usually ask the patients to wait. And not necessarily because of the scar tissue, but because of the inflammation. So when you have a treatment, it can take a full year for your brain. body to reset and for the full healing process, the collagen simulation process to complete. And so if you go in three months after a treatment when there's some low level of inflammation, you're actually going to aggravate the tissues and there could be potential complications

from the surgery. So if it's beyond a year, it's not as problematic, but it's good for the surgeon to know there's going to be scar tissue. So the surgery may need to be. be a little bit longer. We may want to do certain things as part of the surgery to improve healing, whether it's PRP or hyperbaric oxygen or exosom, different different modalities to help improve healing. So I think it'll help formulate a game plan better for the surgeon to have that information. And is that a general, I guess, rule of thumb that you have for each of these, what do you call them like all therapy and these other? All these heat-based devices. devices? Yeah. Is that your rule of thumb that you should wait a year between? Yeah. That's my personal

rule. Different surgeons have different rules about it, but my personal rule is you want to wait a year. Because your skin is still inflamed and still healing over the course of that year. Yeah. And it depends on the depth. So for example, Morpheus, if you're doing it at a superficial setting and you're having a deep plane lift, it doesn't. You don't have to wait a full year. But all therapy, which goes deeper and it can affect healing of the skin that I would wait a year. In between those, even like all therapy to all therapy? No, that depends. Okay.

Yeah. Sometimes you can do it at six months, yeah, depending on the settings. I know we talked about filler very early in this episode, but I just want to ask you, do you have any words of wisdom or advice when people are thinking about fillers. So going back to the provider and listening to the provider is really important because I see it time and time again with filler. Patients will come in and they're the most conservative patient. They're like, I don't want to do too much. I'm so scared of it. I just want to do a little bit and we do it. And then they're back three to six months later, wanting more in the

same area because our minds play tricks on us. So the initial delta is so significant. The change in what you see is so significant that once that change starts going away, you think it's all gone. So three months, six months later, when some of it's going away, patients want to come back in and do another full syringe to that area because they don't, they forget where they started off. And so that's where it's really important to have a provider that says, no, look at your photos from three months ago or six months ago. there's still some filler there you're not ready for more yeah you might be ready for more but chances are you're probably not ready for more especially in the lips right and so i think not overdoing it is important so volume matters and frequency matters and that's when you get a lot of these migration issues especially with the lip is when you're doing too much in an area that can't handle

that volume and so it has to go somewhere so it's following the path of least resistance So if there's no way for the filler to come forward with the lip, it has to go up into the white, the mustache area of the lip. So I think volume is really important. Frequency is really important. And so to prevent migration, it's just like don't overfill. Don't overfill. Yeah. Yeah.

And it sounds like documentation is really important. Yeah. Having a clear idea of what you looked like before and after the first treatment that you can refer back to together with your provider. Exactly. Hey guys. It came to my attention that some of you don't know, we have a matcha brand. What? A matcha brand?

Yes. Like, some of my friends were talking to me. Like, wait, you guys have a matcha brand and it's called Sisters Macha. Gene and I started it in October 2024. And it's something that means a lot to us because I lived and worked on the farm where we source the matcha from. This Macha brand is our baby. And we are so passionate about it.

And we really love everything that has gone into it. there's just so much love and passion that goes into our company, and we want to share it with you guys. We source from a small family farm just an hour and a half outside of Kyoto called Wazuka is the name of the town, and it's absolutely incredible. We've visited the farm. We've worked on the farm, and we're so excited to bring it to you. So you can find out more at sisters matcha.com. That's sisters matcha.com. All righty. Now back to the show. Okay, so one question I've been dying to ask you, Dr. Sunder, is as someone, who has unlimited access to every single treatment in the world. What do you do?

Like, what is your high maintenance to be low maintenance routine? Yeah, that's great. I love, we have a proprietary peel that we customize to patients. And so I try to do that once every two years or once a year just to remove any sun damage that has accrued throughout the year. So I think that has been really helpful. The other thing that I like is fractionated radio frequency. So that helps with skin quality, skin tone.

And so I do that actually once a year. And that way, I'm not the best when it comes to skin care. And so I feel like that really is a great foundation for me. Botox is the other thing. I think that's, and I do it for preventative reasons. And I think it's worked really well. for me. I was on board to have really, really deep 11 lines and I've really been able to reverse that pretty well. So I think Botox and then Sculptra. So yeah. So I think Sculptra, especially in like the chin area

for me has been helpful just because I'm postmenopausal. So postmenopausal women or women in general will start losing bone in their jawline. And so that's expedited in the post-menopausal. menopausal phase and so that i think has been helpful in supporting my jawline oh and then one quick question about sculptra sculptor sculpture it's not a filler right it's not a filler okay no it's a collagen so it's an injection but it's stimulating your own collagen rather than putting a gel into the face so it's a different category it's a different category yeah cool i love it thank you so much thank you for having me this is great we have one one last section called fact or fiction, which is a rapid fire.

We give you a statement and you say whether it's fact or fiction or a quick clarification. Okay. Number one, filler always migrates. Fiction. Yeah, actually. That one's tough. That one's tough because it can migrate if it's placed improperly or in a different layer or if it's in an area that moves a lot.

So around the eyes, it can move. It can migrate a little. But I think the way people think of migration, that's not accurate. So I've had patients who come in where we're wanting to do chin filler and they're worried that it's going to migrate up to their cheek. And that's not how it happens. So from that respect, it's fiction. Okay.

Fact or fiction, Botox prevents wrinkles. Fact. Drinking more water automatically gives you glowing hydrated skin. Fiction. I'm horrible about drinking water And I feel like my skin looks pretty good Because of the other things that I do to compensate for it Yeah, that makes me feel better

Okay, factor fiction, everyone needs retinal Fiction Factor Fiction Expensive skincare is always better Fiction Okay, factor fiction If a skincare product burns or tingles, that means it's working. Fiction

Fact or fiction. OZemPEC ages your face. That needs a clarification. So it can age the face if you lose too much fat or lose too much volume in the face. But I think for a lot of people, or for most people, OZMPIC is an anti-inflammatory. And so a lot of people carry inflammation in their face. And so decreasing that inflammation. can actually make someone look younger, more importantly, healthier.

Oh. So I think, yeah, yeah. So I think it can do both. Okay. Everything in moderate. Yeah, it depends on the person. Depends on the person and everything in moderation. Okay, factor fiction.

Collagen supplements actually work and noticeably improve your skin. Fiction. What? I take it every day. No. Are you sure? Yes. This is actually, there's like,

Evidence to, yeah. Right now, all the products on the market, there's no way that, so your body breaks down these collagen supplements, right? Into like individual amino acids. It can't target specifically the skin or the hair. So if you're seeing a benefit, it's usually the other products that are, it's usually compounded with certain vitamins and other supplements that have a benefit to some. skin and hair anyway. So collagen itself, the molecules are just too big right now.

There's, they're just, they're just not doing what I think they're doing. But if it's working, I mean, if it's working for you, I wouldn't say to discontinue. I think it's a protein boost for gene. Yeah. Yeah. Other health benefits. Yeah. Yeah.

Exactly. Exactly. Last one. Factor fiction. It's too late to start taking care of your skin after 50. No. Fiction. Absolute fiction.

Awesome. All right. Thank you so much. Thank you so much, Dr. Sunder. This was so informative. I'm so glad. It was so fun. Thank you for having me. Where can people find you online? So I'm on Instagram and on TikTok at Dr. Sharma L-S-A-S-U-N-E-R. So it's D-R-S-A-R-S-U-N-D-E-R. Awesome. Thanks, Tiger Fam. We'll see you next time. Bye.