Well with Arielle Lorre - 135: Prejuvination, Surgery Trends & Consumer Restraint with Dr. Lara Devgan

Episode Date: October 20, 2021

In this episode I’m talking to Dr. Lara Devgan, a Yale-educated, Johns Hopkins Medical School-instructed, and Columbia/ New York Presbyterian Hospital-trained plastic & reconstructive surgeon. We discuss why restraint is so important when it comes to cosmetic surgery or minimally invasive interventions; where she thinks beauty standards and surgery trends are headed; the concept of “pre-juvenation” and doing procedures younger to avoid more complex surgery in the future; why doing surgery too young can be a mistake; what specific things to do in 20’s and 30’s to age gracefully; the beauty of aging and so much more.    www.Headspace.com/BLONDE for a free month trial of the full meditation library. www.Curology.com/BLONDE for your free 30 day trial, you just pay $5 for shipping. www.Justthrivehealth.com with code Blonde to save 15% site-wide. www.helloned.com/BLONDE for 15% off plus a free De-Stress Blend Sample on every order over $40.   Produced by Dear MediaSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

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without your re-sadviseur or sunnycars. The following podcast is a dear media production. Hey, welcome to the Blonde Files podcast. I'm your host, Ariel Lori, and I'm here to talk all things wellness. From how to achieve optimal health and well-being to the best beauty tips and everything in between, no topic is off limits. I know there is so much information out there, so I'm here to help you

navigate it all and live your best life. Thanks for listening. Let's get into it. Hi, everybody, welcome to the show. Okay, so I know I've hit you with a lot of aesthetic, cosmetic surgery, beauty intervention type episodes. But this one is a must listen because my guest, Dr. Laura Devkin, really breaks down how to be restrained when it comes to this stuff. And then she shares details on best lifestyle and preventative practices, when to start what skin care musts. And then we, of course, discuss surgical and non-invasive interventions and who is doing what and why and so much more. And I really enjoyed hearing her perspective. And I think being a female plastic surgeon, she just has a bit of a different approach from male surgeons.

And it's really interesting to hear that come through a little bit in the episode. And she's just great. I know you will love this convo. So a little bit about her. Dr. Lara Devgan, of course, is a board certified, Yale educated, Johns Hopkins Medical School instructed and Columbia, New York Presbyterian Hospital-trained plastic and reconstructive surgeon. Her special interests are cosmetic surgery of the face and body and reconstructive surgery for breast cancer, skin care, and facial injuries. Dr. Devkin is also an attending plastic surgeon at multiple hospitals. She teaches plastic surgery, residents, and fellows.

She is also the CEO of Dr. Devkin Scientific Beauty, and she is a medical expert for ABC News and an editorial consultant. She is a nationally and internationally invited lecture on surgical topics. She's an advisor on plastic surgery issues and so much more. I could go on and on. Basically, this is all to say she knows her stuff. So without further ado, please enjoy Dr. Devkin. Okay, welcome Dr. Devgan.

I'm so excited to talk to you. I'm so happy to speak with you also. Thank you so much for having me. Of course. So I'm sure my listeners know that beauty and cosmetic procedures is probably my favorite thing to talk about. And full disclosure, everybody who listens to this podcast knows this, but I've had a number of procedures over the years. I've had rhinoplastie. I had a browlift. I had an upper blephoroplasty. I had a lip lift. And I had fat grafting. So I've done a lot of things over the course of almost a decade. decade and I just always love learning from the experts like yourself. So to start, why don't you just introduce yourself to the listeners and tell them who you are and what you do and how you came to

do it. All right. Well, I'm so excited to speak with you and your listeners. My name is Dr. Lara Devkin. I'm a board certified plastic surgeon in New York City and the founder and CEO of Dr. Lara DeVagan Scientific Beauty, medical grade skin care line retailing worldwide. And the focus of my practice is the tiny little meticulous details in plastic and reconstructive surgery. And I'm best known for the concept of facial optimization, which is a combination of surgical and non-surgical procedures to bring the facial

features into better harmony. And that can include things like facelift, eyelid surgery, rhinoplasty, lip, lift, but also more novel procedures like non-surgical rhinoplasti, cheekbone and jawline contouring with injectable fillers, buckle fat-pad excision, the use of suture suspensions, laser resurfacing, micro-infusion, microneedling, skin care modalities like that. I also do a lot of body procedures, including non-surgical buttock augmentation, small volume, breast augmentation, and very finessex procedures. And to me, the thing that ties together all of the procedural-based things in my work is that I'm very drawn to anything that is about the tiny little millimeter level details.

So I love stuff that involves fine, fine measurements and where every little thing counts. I think with plastic surgery, you see it all. And when I think about my patients, their bodies and faces are going to bear the signs of my hands forever. And so it's a very high stakes job, but a really special and artistic one. And then more broadly, you know, in my role as a skincare founder and CEO, I think about how to bring a little bit of the magic of that to people's bathroom mirrors. And then on top of that, I also love art and culture. And I am the mother of six young children. And I love being in New York City. I love restaurants and museums and stuff like that. I love this idea of facial optimization because I think that especially now,

and I really want to talk to you about beauty standards, but I feel like there's this kind of like universal look. And I think that we are getting kind of conditioned to all see this one look and between public figures and filters on ourselves. And we're kind of moving in this direction of, I don't know, I think it's been called like Instagram face before, you know, with like the really high brow lift and the lips and the buckle fat and all of that. So what is facial optimization to you? Because to me, it sounds like you're really focusing on somebody's individual anatomy and just kind of working with that to like emphasize their features. Yes. I mean, you really hit on it because we are in this era of the Instagram face. And why are we doing that? You know, 2021 more than anything else is a time of

globalization. And our cell phones and social media and the internet. brought us in contact with people from all over the world. And there are so many people who have backgrounds that are from many different cultural and ethnic heritages. And I think more people than ever are celebrating their uniqueness. And so when I think of facial optimization, what I'm not trying to do is make everyone a cookie cutter of a high arched brow, a prominent cheekbone, a pillowy upper lip that's averted out, a hollow mid-cheek sulcus.

a classic Instagram reality TV face. What I'm trying to do instead is allow people to lean into their own idea of beauty, whatever that means to you, and kind of identify the beautiful, unique features in each face and help let those features shine. And so, you know, when I think about life as a plastic surgeon, what I do in my relationship with patients, it's almost like when you hire a plastic surgeon to do something for you,

almost like commissioning an artist to make a very beautiful and very high stakes painting for you. And it's not just like, okay, make me a Mona Lisa. It's, this is what I want. This is my vision. What can you do? What's possible? What kind of paints do you have? And it's a collaborative effort. And so facial optimization is just a term that I coined that's since been like, you know, repurposed and borrowed by everybody else. But we're just fine. Feel free to steal it if you want. I think the idea of it is that we want to lean into not only identity and beauty, but also specificity and customization. Everything that we do in plastic surgery should be bespoke.

And every face is different. So every procedure is different. With the stresses of this last year, it's more important than ever to practice living healthier and happier lives. So what if a few minutes was all it took to change your relationship? with stress and anxiety, transforming your life for the better. Well, that is the power of meditation, and Headspace makes meditation really easy. So Headspace is your convenient dose of meditation, mindfulness, and sleep exercises to relieve stress and anxiety and help you get a good night's

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best. Get your gut in order with Just Thrive Probiotic. Just go to Just Thrive Health.com and use the promo code blonde for 15% off. Again, that's Just Thrivehealth.com and the promo code is Blonde, B-L-O-N-D-E for 15% off. So I'm curious where you think we are headed right now. I mean, I know that like we were saying, I know there have been studies about like the Instagram face and kind of this dysmorphia that we're all having. Do you think that we are going to move further down that road? Or do you think that people are going to kind of embrace like your approach and really focus on individuality? I think in the long run, people are going to lean into what I'm saying. But I do think like so many things, you know, you have to hit rock bottom before you start climbing back.

So I do wonder, you know, anyone who goes to restaurants in New York or L.A. sees examples of faces that are overfilled and overstretched from a facelift vector that is too tight and not aesthetic. Or, you know, filler that is really burdening the tissues and creating a duckiness or a puffiness, an undesirable and almost abnormal looking contour. So I think there is an exaggeration that's happening right now that I do believe is in vogue. But I think the trend in the future is going to definitely be leaning away from that. Especially post-COVID, it's been a very bad year and a half for the entire world for all of us. I mean, I think personally, professionally, I'm sure for you and your listeners, we all know people who have suffered immense. as a result of COVID-19 and, you know, people who have died, gotten ill, lost their jobs,

had their lives fall apart. And it's been, as we pick up the pieces and we're not even through it yet, people are kind of re-emerging into the world of aesthetics and feeling better about themselves, but in a more restrained way. And it's less about puffing out your peacock feathers and how big can you make your breast implants. And it's more about let me feel confident. Let me present my best self to the world and let me just be more kind and accepting of myself and figure out who I really am. And I think that at its heart, plastic surgery is about confidence. It's not about looking like the cover of a magazine or swallowing a beauty identity that some corporation has shoved down your throat. It's about feeling like the best version of yourself and like you feel good, you know,

doing whatever little thing you do, putting on your lipstick. in the morning or working on your abs at the gym or coloring your gray hair, whatever the things you do are, you feel good about yourself. So I think we're headed in a more restrained direction. And I think that that's a good thing because like everything, like food, alcohol, you know, fun, television, everything is good in moderation, including interventions like what I do. I can relate to that a lot because every procedure, that I've done has been very subtle to the point where like my extended family didn't even notice. And I've always said that like, I just want to look like myself, but refreshed. And I had

insecurities that, you know, I had very hooded eyes. And after I turned 30, it started to droop and Botox wasn't helping because I had the excess skin on my eyelids. And when I did the browlift and blephoroplasty combination, like I said before, it was, it was like you said, very restructed. drained to the point where people just said that I looked kind of refreshed and more awake. I'm curious, though, back to what you were saying about like being in New York and L.A. and seeing these kind of overpulled, overstuffed faces. I'm curious if you see like a variation in trends in different places. So I live primarily in L.A., but I'm in New York too and I kind of go back and forth. And I feel like there's a little bit of a different aesthetic. I feel like in L.A.

there is this paralyzing fear of aging. And you see women of all ages, you know, just really like doing everything between facelifts, like overlifting, like you were saying, and overfilling. I feel like New York is a little bit less so. I feel like you see people kind of looking their age, but more refined. So do you notice that at all? I do. And I grew up in L.A., actually.

I grew up in Malibu and Santa Monica and I love L.A. and I go back a lot. My family's there. But on some level, I wondered if I could professionally have the same kind of career there because it is a different ethos. And I think that my professional identity and the kinds of work that I find more beautiful are types of outcomes that are more restrained. and you know, you never, you want to be careful when you've generalized because they're like 10 million people at a time you're putting in a bucket. So it's never really going to be a good generalization. But I think generally speaking, and don't kill me, you guys who are listening, but generally speaking in LA, the ethos culturally is a little bit more exaggerated. It's a little bit more dramatic. You can kind of see it from a little further away. And there is a

major emphasis on the elimination of imperfections, whereas in New York, patients are much more willing to tolerate imperfections in the interest of global facial beauty. And interestingly, I write about this a lot when I'm captioning my Instagram posts, which is like my major form of creative writing these days. That's a separate topic. But I think that sometimes tolerating minor imperfections, in the interest of global facial beauty is actually what can give you a believable and realistic and elegant looking outcome. So, for example, the nasalabial fold, which is this line that goes from the nose to the mouth, this like kind of curved smile line, or a little bit of a crinkle by the eye when you smile in the crow's feet area. Some of these wrinkles can be completely

eliminated, filled or Botoxed, but keeping them can make a face look slightly more appealing in conversation and in real life. And these are some of the conversations I have with my celebrity and professional actor patients about how to appear on screen in a way that doesn't look like they even know me. But also for just private citizens walking around on the street, I think there's a little bit more of that acceptance. I also think in New York, people like the idea of a more, there's sort of some very specific characteristics, but I think are so interesting.

So in New York, people like a more chiseled-looking cheekbone. In L.A., people tend to like a more full apple of the cheek-looking cheek bone. So people like more Malar eminence, which is right here in Los Angeles, whereas in New York, people like more zygomatic prominence, which is more chiseled over here. In Los Angeles,

patients tend to like more of a high-arched eyebrow, like this, in New York, patients tend to like more of a lower fuller brow, which is interesting. Also, a high arched brows associated with more femininity. A lower arched brow is associated with more youthfulness. So I think in New York, more angularity of the face is emphasized. In Los Angeles, more softness and youthfulness is emphasized in the shape of the face. In New York, a thinner lip with more structure and definition of the cupids bow is more in vogue in LA, a fuller lip with a little bit less cupid's bow definition and more lateral fullness and lower lip fullness tends to be more emphasized. So those are little quirks. And you may not fit into this. If you're listening to this

podcast, you may not personally identify it with this, but those are sort of regional trends that I see. That's so interesting. So I'm curious, what are, the procedures that are kind of trending right now that you're doing a lot of? So I'm doing a very high volume of face and necklifts in younger patients. So facelifts in your 40s and kind of almost the prejuvenation preventative aging. So the people who want to age like J-Lo and basically look the same from age 30 to 60. And the way you achieve a look like that is you have the interventions a few years before you truly desperately. need them. And so the advantage of doing procedures at an earlier age, like a little

facelift or necklift, when you're just beginning to see signs of necklaxe or jowling, those advantages include a smaller incision, a shorter scar, a faster healing propensity, and a more discreet before and after where other people can't really tell what happened. Like, did she or didn't she? So facelifts in your 40s and, you know, other types of little procedures, kind of like your procedure, a blephroplasty at a young age where you don't totally notice what's going on. That's a huge, huge trend. So younger procedures at an earlier age. A second big trend is for the entire upper third of the face. And I think that perhaps this is because of compulsory mask wearing that people are really looking at the upper third of the face. So the eye area and the eyebrow

area. So I'm doing a lot of blephroplasty surgery, which is to make the eyes look bigger, brighter, or less hooded and less tired underneath. And temporal brow lift surgery to improve the arch and lift of the brow. Also a ton of suture suspension brow lift and mid-face lift, which is the modern generation of threadlifting. And that's kind of an intermediate procedure that's a little bit more than Botoxin fillers, but a little less than surgery. It lasts for about a year.

And you see that in some of the young of the moment models who are having a bit more of an high arched brow and a little bit more of an almond-shaped eye look. I think that that's having a bit of a moment. And a lot of injectables tear trough augmentation, Botox, temporal hollow filler for the upper third of the face. And then I think the third big trend is small volume breast augmentation. So patients now are still interested in having their body contouring, looking beautiful and having a shapely physique, but very, very small volume implants. So kind of like a fashion figure where you would still fit in sample size clothing. People would barely notice that your breasts or body look different, but it just fills out a little bit better. And when you're nude, the shape is perfect. And so those are

some of the big trends. And then I would say the final trend I wanted to call out is the use of poly lactic acid, which is a collagen biostimulating injectable for non-surgical body contouring. And this is a very, very popular procedure. So I recently wrote the largest paper about the use of this medicine called Sculptra for building and smoothing the contour of the buttocks, hips, and posterior thighs. And Sculptra can be safely used to boost collagen in these areas. is and I'm not paid by the company or anything like that. It's just something that I find interesting because patients have become very interested in having a shapely physique. And so this is a very popular procedure because if you want to stay in the same size genes but have a smoother,

less cellulitic appearance of the buttocks or a perkyer shape, this is a really nice way to achieve that. And it's a nice alternative to like a traditional BBL where you're doing fat grafting from your body into your bottom. Totally. And I completely stopped doing BBLs, actually, because Brazilian butt lift or autologous fat grafting to the buttox has a one in 3,000 risk of death, which is truly crazy. And I think more people should know about that because it's a very popular procedure.

I get that the look of an hourglass figure is appealing to many people. And I totally appreciate that aesthetically. but, you know, is it worth dying for? I don't think so. It is fall, and for me at least, cooler weather and less sun exposure means one thing. It's tretanoin time. I bet you are not expecting that. Yes, I am back on my personalized curology formula with 0.07% trinan, niacinamide, and azaleic acid. So tretanone is one of the most effective ingredients at targeting fine lines. Niasinamide is an antioxidant that reduces wrinkles, brightens the skin and helps with elasticity, and azalec acid improves texture and lightens dark spots.

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And you can also cancel any time. I have been going through some health stuff the last few weeks, possibly relating to what I was going through last year with my hearing issue, which has never gone away, but I have just gotten used to. But now it has developed into a whole host of other issues with my eye, my balance, muscle movements, and more. And it's been pretty scary and frustrating. But while I work things out with my doctors, I have been leaning heavily on my tools in my toolbox. So some of those are meditation and breathwork and movement. And then some of those are from Ned. Ned has the absolute highest quality CBD on the market, which is obviously so important when it comes to something that you are

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with the issues that I've been having. So anyway, if you want to try the new de-stress blend from Ned, a brand that I love and trust, they have a special offer for my audience. So for every order over $40. You qualify for 15% off plus a free de-stress blend sample. So go to www.com slash blonde or enter blonde at checkout to take advantage of this offer. That's h-E-l-l-l-O-N-E-D.com slash BLO-N-D-E to get 15% off plus a free de-stress blend sample on any order over $40. So I have a couple questions based on what you were saying first going back to the doing more invasive procedures at a younger age to prevent having to do a whole overhaul down the road and also for some continuity, right,

so that it's not so noticeable when you do something. There is a point where you're too young, right, where if you did a necklift before you need it, there's going to be too much tension on that you're going to get scarring and all of that. I have a friend who's a surgeon down in Florida and he gets a lot of revision cases from patients in L.A. who had necklifts and facelifts in their 20s. So can you talk about some of the kind of adverse effects that can happen if you do it too young? Yes. You know, your 20s are when you're coasting on the magic of youth, with the exception of some people who have certain genetic specific situations. So for the vast majority of people, that's very young. And obviously, anatomy is the number one dictator rather than calendar age. But you don't want to

do anything that is too invasive at too early of an age. And the basic guiding principle of my practice is to think of plastic surgery as a ladder. And that's the advice that I would give anyone who's listening to this, that you want to climb the ladder as slowly as possible, and you want to do the least invasive thing possible to make you happy. And if you can be made happy with a little Botox to give you a brow lift, then do that for as long as it makes you happy. And when you graduate from that and you get so much brow descent that it's no longer lifting properly, then that's when you start thinking about surgery. You don't jump right into surgery just because you think that surgery is going to be better and, you know, surgery is possible

and it's a thing and you want to consume as much as you can. It's not like, you know, opting for the, you know, super luxx option. It's something where there's an expression in plastic surgery, discretion is the better part of valor, which basically just means that restraint is important. You want to hold yourself back. So to answer your question, the dangers and the downside of doing things too early are that you're going to develop scar tissue, which can make further procedures more difficult. Number one, number two, you're going to undergo the experience, of healing tissue trauma, expense and recovery when you don't really need it. And every intervention is not only an opportunity to help someone, but also a possible chance of problems that are

related or not even related to the surgery. So you want to minimize risk as much as possible. And then number three, sometimes things are not exactly what you intend for them to be. So we always want to think about when someone in their 20s is asking for a procedure like a facelift, with the rare exception of a person who has a collagen vascular disease like Ehlers Danlos or a syndrome like progeria. And these are rare, rare syndromes where someone would have genetically premature aging. So I'm putting people with a special situation as an exception. But so let's say you're a healthy person with no medical conditions and you're in your 20s and you're asking for a facelift. As plastic surgeons, a board certified plastic surgeon who's responsible should be really taking the time to try to figure out, is this appropriate?

Does this patient need me or does this patient need to be screened for potential body dysmorphia? Can we put them into a program for potential weight loss or diet management? Is this an issue of excess fat distribution? It's very uncommon for a healthy, otherwise medically stable, 20-something to have enough tissue laxity to really require a necklift or a facelift. So this raises red flags for me more for the surgeon than for the patient, to be honest, because it's normal, you know, I thought a lot of things that were wrong when I was in my 20s. It's not the patient's fault.

But as surgeons, we go through 20-something years of education and training to be able to help people make good decisions. And the most important decision a surgeon can make is when to say no to someone and how to say no kindly, compassionately, appropriately, how to redirect, how to be there for them when they do need you. but you've got to be able to be a human being before you're a surgeon. And you can't just cut everybody open who comes and knocks it in your door. Right. To that point, though, and kind of what you were saying before about like maybe doing some threading for like that arched brow or the elongated brow,

we do know that some of the younger models and younger celebrities are opting for more permanent interventions, I guess, like an end of, brow lift, the endoscopic facelift. I won't like name the doctor or the name of it. But do you find that some people, especially in the public eye, would prefer to do something permanent, you know, just so that they don't have to continually do like less invasive treatments and also to have kind of like a consistency in their look? Yes and no. I think with surgical interventions, we're resetting the clock, but we're not stopping it from ticking. So even the people who are doing a more permanent intervention are basically resetting

their anatomic baseline. So let's say you do an endoscopic browlift to create a more permanent position of the lateral eyebrow arch. You know, unfortunately, the reality of human facial aging is that every year you get a little bit of collagen degradation and a tiny bit of muscle. at a little bit of tissue descent. And so after some time, you're going to have a little bit of re-descent of the tissues. So if you'd like to be a working model from age 25 to 35 and you've done an endoscopic brow lift and you want to look exactly the same at age 25 and 28, you're going to

need to do procedures during that window. So it's a false concept that people do a procedure at 25 and then do it again at 35. They do it at 25 and then they maintain it. It's almost like, you know, getting your car fully detailed, but then you go in and you get it like waxed and washed and you change the oil and all of that every four or five months. So people will do a procedure to reset where they are and change their baseline appearance. And that's surgery. And that's capable of getting you to like a little bit of a more dramatic different look. And then the main maintenance of that, let's say the endoscopic browlift that we're talking about would be, you know, maintaining neuromodulator, aka a Botox browlift and a little bit of suture suspension to

give you a little bit of yearly support. Otherwise, the photos you take when you're 27 are going to look a little different than the ones that you take when you're 25. Right. Yeah, that makes sense. I can think of even with like a lip lift, people ask me all the time, oh, so you got a lip lift so you don't need filler. And I say, well, no, they're different things. The lip lift changed. the shape of the upper lip and gave me a little bit of height and all that. But if I want to have any kind of volume or projection or anything like that, I get a little bit of filler, just a tiny bit. I mean, it did make it so that I need much less. But yeah, and same thing with brow lift. And same thing, even with the fat transfer. You know, I did that at the beginning of this year. And I did

my cheeks, my under eyes and my temples. And people said, oh, so you don't need filler anymore. And for the most part, I don't. I mean, I lost a lot of. of volume. I'm in my mid-30s just over the last like two, three years. And so it really restored that. But, you know, if I want like a little bit of a pop or a little bit of a, you know, cheekbone kind of definition, yeah, you still can do a little bit of filler. And I still do Botox in my brows. So that totally makes sense that you're kind of changing the baseline and then doing things to maintain it along the way. Yeah. It's like if you're at a restaurant, you know, you've got your glass of water at the restaurant, the nicer the. The nicer the.

restaurant, the more your glass of water is always at the very top. If you're at like a very super casual diner, you finish your glass of water and it's like empty and you're waving your hand trying to get someone's attention for a refill. And if you're at the nicest white linen tablecloth restaurant in town, somebody's there refilling your water glass every five seconds. And so that's sort of like an analogy for the maintenance of facial aging and appearance. That's kind of the reality of if our existence on earth. And I think people have to also get a little bit more realistic and comfortable with the fact that you don't look the same over time.

You change. And there's actually a beauty in aging. I think that it can be really pretty and beautiful to age. Like, I think that there are a lot of people who look better as they age because they get a little bit more definition and contour in their face. And some of their features come out in a different way. You know, the nose can look slimmer with a little bit.

bit of fat loss. The eyes can look a little bit bigger. Like I personally like my cheekbones better. I used to be the chubbyest faced kid, like so round, like a little basketball-faced kid. And I was like so pleased to finally enter my 30s and get a little definition in my face. So, you know, we shouldn't be afraid of aging, but at the same time, if you want to have like the white linen tablecloth experience of facial aging, like some of the celebrities who grace the covers of magazines when they're well into their 50s, then you need to have the approach of like the person at the restaurant who's refilling the glass of water every five seconds. Right. Yeah, I love that. That's a great analogy. Okay, so let's go over like best things to do maybe in your 20s preventatively, what to start

doing for your skin so that as you do age, you're in kind of a good, position. Yes. So important. So the best things to do when you're in your 20s are established good lifestyle habits. So you want to make sure that you're being rational. So some of the stuff is free and easy. So you don't have to be intimidated if you don't want to see a doctor. So the basic stuff is try to maintain some regular exercise routine, try to have a healthy diet. You want to try to limit your simple sugars. Alcohol is not good for you. So you really want to try to limit that as much as you can. Same with tobacco. Vaping is really terrible. I think people sort of forget about vaping a little bit. And a lot of times my patients will forget that vaping counts when they're filling out their

forms. That's also something like the 20s or a time when you're trying to establish who you are as an adult for the whole rest of the 80 years or 100 years that come next. So don't get into a bad cycle with the habits. That's the super basic stuff. And that also includes a regular sleep rhythm, try to do things like sleeping on your back, normal stuff so that you don't get into a really terrible position. Once you've got the basics mastered, a very basic approach to medical grade skincare would be to make sure that you're using incredibly basic and greedy. that have been demonstrated in the scientific literature time and again. So I won't bore you or go into too much detail,

so I'm going to focus on the most basic ingredients. But my recommendation, if you're a super minimalist, would be a mixed molecular weight halaronic acid and a peptide-based eye cream and face cream in the morning, followed by an SPF. and the SPF should contain zinc and titanium as physical blocks. So that's like your basic essentials for the morning. And then any makeup or whatever you want to put on top is up to you.

And then at night, after cleansing your face, a vitamin CBE ferulic acid serum and a retinal Bucuccio. And the reasoning for those products are that, you know, the halaronic acid is going to boost collagen production and hydration of the skin. And that's for the morning. Epid-based eye cream is going to help you with rejuvenation of the most delicate tissue on the face, which is in the eye area. The peri-orbital skin is the skin that shows your age the fastest,

so you want to pay extra special attention to it. And then the SPF, you know, sun damage is not only terrible for you, it gives you hyperpigmentation, makes you look older, but also skin cancer is the most common cancer and a very preventable one. So besides making you look older, it's also going to, you know, harm your health and life. So you want to avoid that. And then at night, the vitamin CBE ferulic acid serum is an antioxidant that is really nice for scavenging free radical damage of the skin.

It's also going to help fight hyperpigmentation. So people start accumulating little brown spots and freckling and irregularity of the color of the skin. And that's one of the things that makes a young face look very different from an older face. If you look at someone in their teens or 20s, it's like a milky, smooth, creamy complexion. It's all one color. It's like a pantone color. And then you look at someone in their 30s or 40s or 50s, and it's like not a pantone color anymore. It's all speckily.

And so you can stop that with a great vitamin C.B. Fureolic acid serum. And then a retinal Buccio serum is a very important. product because retinoles will increase the rate of skin cell turnover. And that helps reduce fine lines, improve poor size, decrease blemishes. So pimples and blackheads, white heads, and also improve overall texture and trigger of the skin. And then Bacuchio is an ingredient that is derived from red wine. It's also an antioxidant that makes retinol more tolerable because sometimes people get a little redness and irritation from a retinal, so it's kind of mixed together.

So these are, you know, in my skincare line, what I really focus on is using evidence-backed medicine in order to create products that actually work because I am a practicing plastic surgeon, and I do the full spectrum of everything from lasers, skin care, micronealing, injectables, Botox, fillers, suture suspension, and surgery in the operating room. so fully vertically integrated. And I need my patients to have nice skin and products that are actually working. So it's all evidence-backed stuff. And I think that the goal of your 20s should be to use super basic evidence-backed stuff.

And then I would just say a final piece for your 20s. And you don't have to do this if you're not into interventions. But if you are beginning to think about interventions, I think that preventative Botox is indeed a thing. You want to begin to think about that when you have the skin quality you'd like to maintain. So I personally started doing Botox when I was 27. You don't have to do that. And for people who are not into it, I think that it's very empowering to be your own kind of beautiful

and to say no to stuff that doesn't feel good to you. So please don't feel like you're being pressured to do something that doesn't feel right. You never want to feel that about anything. But if that's something that's of interest to you, Botox, Ziamin, Juvo, and Disport are the four FDA-approved neuromodulators in the United States. And people use the term Botox generically for the entire category because that's just like it's become the Kleenex or in the Coca-Cola of the world. Basically, Botox slightly reduces the function of muscles in order to smooth the skin. and you can have natural movement and a little bit of prettiness like a brow lift, a wider eye.

You can have reduction in wrinkles and furrows. And your 20s or your late 20s can be an appropriate age for some people to start thinking about this. Yeah, I started doing it as well when I was like 27, 28. However, I actually got sober then. And I had totally treated my body like a dumpster. I mean, I was smoking a pack a day, doing drugs, drinking, never sleeping, eating terribly. And I'm so envious of like Gen Z right now because when I was younger, I'm making myself sound really old. But I'm a millennial.

It was cool to be like the tannist person in the room. Like we would have competitions in high school, you know, spring break, who can get the most tan. We're in the tanning beds all the time. And it's kind of frustrating because you see. say to a teenager or a 20 year old, you know, use SPF. And at that time, you think like, yeah, yeah, whatever. Like, it's not going to happen to me. And then you turn 30, 31, 32, whatever. And it starts to kind of start showing up on your skin. So when I turned, when I was around 27, 28, I got sober and I always talk about this. I looked in the mirror and I was like, who is this person?

I mean, I had really like accelerated the aging process in my skin because of all of those things. And, you know, thankfully, I wasn't like beyond repair and Botox and some lasers and stuff that was, you know, that was able to kind of erase some of that. But moving into your 30s, when are things like lasers and microneedling? When is all of that appropriate? It's really appropriate depending on what you're seeing on yourself and kind of exactly what you were saying. different people see different things. So if you've had a little bit more exposure to the elements, you can think about stuff like lasers even sooner. So lasers, microneedling, even things like injectable fillers can be done whenever you feel the need for them. And so that could be in your 20s.

It could be in your 30s. You know, one thing that's interesting is that it used to be that Botox was the entry point into plastic surgery. And one of my predictions for this coming decade is, I think, think that fillers are now going to be the entry point into plastic surgery. And I'm seeing that in my practice. So more and more of my younger patients are coming in for the very first time. And instead of asking for baby Botox, they are having conversations with me about cheekbone augmentation or profile balancing, non-surgical rhinoplasti, you know, maybe a little facial optimization and, you know, lip augmentation. So I think that it's really more about what you want in your anatomy than it is about your age. And it kind of depends whether you're thinking about this through an anti-aging

lens or whether you're thinking about this from a pro beautification lens. And I think that that's one of the coolest, most interesting things to me that's happening in the world of plastic surgery. and one of the things that I am really trying to be on the forefront of changing the way we think about plastic surgery, that it's not all about like whack-a-mole, like I see a wrinkle, I see a gray hair, I see oldness, like bad, bad, bad, make it go away. It's more about how do we make you feel amazing and how do we make you feel confident at any age that you want, wherever you want to be. You can think about how to achieve your own goals. And I think, you know, plastic surgery is a very complicated field because it's portrayed in the media in really the most salacious and annoying way. And truly, it's a very academic and intellectual field.

And it's really complex and nuanced. And people who do what I do think about it a lot in an intelligent, sophisticated way. But you would never know that because you turn on e-entertainment television and it's like, you know, enormous breasts and vast, flashy cars and ostentatious displays of wealth and, like, big lips. And it's like crazy. And you feel soulless. You feel like you feel terrible about yourself. And I remember growing up in the 90s in L.A. And I felt terrible about myself digesting those images.

And I had to leave L.A. as soon as I could for college. And it's not like that, though. And I think that that's sort of the way I think about my work in this field is that plastic surgery is about being your own kind of beautiful, on your own terms, whatever that means to you. And if you choose to be interested in an intervention, there's a safe and medically responsible way to do it. You don't want to go into one of these crazy back alley hotel room situations with an unlicensed practitioner and get yourself in trouble or get yourself dead. because that's where people have very bad things happen to them. And that happens because there's so much stigma associated with talking about this stuff and doing stuff like this.

Because for whatever reason, society decided that you either have to be born, beautiful, and genetically blessed, or you're screwed. And that itself is another problem. Yeah, it really is so stigmatized. And, you know, I chose to be open about it. just because I do have, you know, the platform that I have. And I just wanted people to be informed and know what's out there and share my experience and then bring experts like you on. But I get so much trolling about it. And I'm sure that you get people on your page as well. But, you know,

people, it's kind of low-hanging fruit, but there is this idea that like there's something wrong with you if you want plastic surgery. But I think that everybody should go to your page and, you know, look at the work that you do because it is so incredible. And people, do look like themselves. And I think that you and others like you in your profession are really helping to kind of steer the ship when it comes to this road that we're going down, like what we were talking about in the beginning, where, you know, there was this uniform look. And I think that your work is helping show people that there's another way and that we're all, you know, individually beautiful. And we can embrace that and do procedures. And there is nothing wrong with that. So I would love

for you to just tell everybody where they can find you, where they can find your skin care, all of that. Yes. Well, thank you. You can find me on Instagram at Lara Devkin, MD. And through there, basically everything else. But, you know, my skincare is at Dr. Lara Devgan. And you can link from there to my website, TikTok, e-commerce, and the skincare is all over the place.

Sephora, Neta Porte, worldwide. And I guess probably just going to my Instagram, we'll show you the best, broadest everything. So that's Lara Devkin, MD. And it's been so fun to talk to you. I think you're amazing and you're doing a really amazing, wonderful job of just bringing really interesting topics to the forefront.

And I think it's very cool. Thank you. I really appreciate that. And we'll link everything in show notes that people can just go down on their phone and link to your Instagram and all of that. And thank you so much again for coming on. We'll have to do a part two down the road. I hope you enjoyed that episode. If you liked it, and if you like the show in general, please take a second to rate, review, and subscribe. It goes a long way, and it's actually the best way to support the show. Also, if you want to see more about each episode,

you can head over to The Blonde Files podcast on Instagram. I'm always posting about each episode there or over on my personal page at Ariel Lorry.