Well with Arielle Lorre - 301: How to Get the Most Out of Injectables, Lasers, and What Not to Do with Anush Movsesian

Episode Date: March 13, 2024

Anush Movsesian, MSN & FNP-C, is an aesthetic practitioner and among the most sought-after skin rejuvenation experts in Los Angeles. Anush joins me to talk about realistic (and unrealistic) expectations in the world of injectables. We discuss common injectable mistakes, what makes a good candidate for certain procedures (including Morpheus, fillers, threads, etc.), and less invasive options for results. We also go into the mental health aspect of aesthetics, from procedure addiction to face dysmorphia to treating young patients and the ever-changing beauty standards. We also go into the exact skincare routine she suggests for her high-profile clients and anyone who wants to elevate their aesthetics.This episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct, or indirect financial interest in products, or services referred to in this episode.Get Arielle's complete skincare breakdown: https://ariellelorre.com/a-complete-breakdown-of-my-skincare-routine/Go to TryArmra.com/blonde or use the clode BLONDE for 15% off your first order Check out M by Maidenform at Maidenform.com and use the code BLONDEFILES20 for 20% off your first purchase.Go to JustThriveHealth.com and use the code BLONDE20 for for 20% off a bottle of Just Thrive Probiotic and Just CalmGo to HelloNed.com/blonde for 15% off BonCharge: Go to boncharge.com/BLONDE and use coupon code BLONDE to save 15%.Go to VEGAMOUR.com/blonde and use code blonde at checkout to get 20% off your first subscription order.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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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's so much information out there, so I'm bringing on expert guests and sharing my own experiences to help you sift through all the wellness stuff without the BS. Enjoy the show. Hi, everybody. Welcome to the show. I have an incredible episode. for you today. I am obsessed with my guest, Anush Mubessian, also known as Skins and Needles on Instagram. I'm sure a lot of you follow her. She is just my absolute girl crush. I had so much fun talking to her. We have followed each other on Instagram for a while and DM'd back and forth a

little bit. And you never really know how somebody is going to be in person when you meet them. And She is better in person than she is on social media and she's very entertaining on social media. So that is saying a lot. But she is just really smart. She's really real. She's really funny in a dry way. And what you see is what you get with her. There's no pretense.

And I always appreciate people like that. So she is an aesthetic practitioner. She is one of the most sought after skin rejuvenation experts in Los Angeles. In fact, I think that she is booked out until the end of the year. be even next year. So many celebrities go to her. She has her own practice called routine here in LA. And you can definitely see why in her results. And also in this conversation, you can hear why she is one of the best. So we talk about beauty expectations in the world of aesthetics. I thought it was such an interesting part of the conversation to hear what people are requesting when they come in.

And she was talking about how people used to bring in pictures of celebrities that they wanted to look like. And now people bring in filtered pictures of themselves. And we talk about just how beauty has become really unrealistic. We also talk about common injectable mistakes, which I think is really important for everybody to hear if these are procedures that you are doing or thinking about doing. We talk about who is a good candidate for certain things like morphias, fillers, threads. etc. We talk about less invasive options for maximum results. And we also go into the mental health aspect of aesthetics from procedure addiction to dysmorphia to treating young patients and just, again, the ever-changing beauty standards. We also get into skincare routines that she suggests

for her high-profile clients and anybody who wants to elevate their aesthetics. So I know you guys are going to love this episode. You know I could talk about beauty. hours and I feel like I met my match in Anush. So please enjoy Anoussacian. Welcome. Thank you. Very happy to be here. Very excited to have you here. I feel like we've already been talking about so much good stuff before we started recording and I was saying to you like I could talk about this stuff for days. All day. All day. It's so hard for me to keep these episodes short. I think we've been following each other for a while and I am just really excited to talk to you today. about all things. So excited to be here. Beauty and aesthetics. Thank you. It's my pleasure. So something I wanted to

ask you to start out is about your aesthetic philosophy. I feel like everybody has kind of a different approach. And I see providers almost as like designers. I remember Dr. Ben Talley said this once. He's like surgeons are kind of like designers. Like you're going to get a different style depending who you go to. And I think that goes for aesthetic providers as well. So what is your approach? I think my number one approach and I think that does reflect upon my style is honesty. And then I would say less is more, a more natural approach. But honesty is my number one. I want to call it style because I refuse to treat a patient with anything that is not going to really give them benefit or a true change, the change that they're looking for. I won't just do something to do it. And I think, and I think,

think unfortunately in my field, that's way too common. Yes. And I feel like when people think of things like Botox and fillers and some of these less invasive treatments, they think of the stereotype, right, which is like completely frozen face, which nothing wrong with that. I missed my frozen face. But yes, over-injected. I think a lot of people, you know, use things like filler, maybe for the wrong reasons. They use filler to like lift or provide a lot of volume, you know, instead of just like shadows and kind of that nuance. And I think also like Botox, you can go way overboard as well. What do you think are some of the kind of common mistakes that people make when it comes to their injectables? Big, big mistake is the idea of lifting with fillers because the average female.

So maybe you and I, because we know so much about the industry, when we think of a lot of, lift, it's millimeters. But when we say lift, the average female or male listening on the other side is imagining a actual physical lift. And then when they come into my clinic, that's what they're expecting. And so I literally get TMJ pain all day just talking about, and Kelsey knows a dry throat. And neck pain simply talking about the fact that you cannot get a physical lift with fillers. The amount of filler that I would have to put in someone's cheekbone to get a lift is insane. And so that's one of the number one mistakes. And then now, just unfortunately, because social media does play a big role in our lives, and it affects, I think,

almost every feel that you work in. It affects us a lot because the expectations that people come in with because of either filters or things they've seen on social media and then me having to talk them through and out of it. And sometimes I think that the average patient might think, well, you don't really know what you're talking about because look, I see on social media, this is attainable. And then the rest of my consult is given to things like, well, no, that's a filter. If you close up, you'll see that no one really has poorless skin like this unless you're blessed. But yeah, I think that a lot of social media can really negatively impact what we do for a living. Yeah, I've heard you talk about that before. And I heard you say

something interesting, which is that people aren't really bringing in pictures of models or celebrities anymore. They're bringing in filtered photos of themselves, which is crazy. I would imagine that kind of started with Snapchat. Like I remember those filters. And it was like, whoa, I mean, I never used Snapchat except for the filter. And I was like my jaw, my chin was a little smaller. My nose was a little smaller. My eyes were a little bigger. I mean, it was like uncanny, you know.

Yeah. But I think that, and I remember hearing this from plastic surgeons too, like saying that people are bringing in filtered pictures of themselves. Yeah. It's unfortunate because, and again, you know, I go to so many like teachings and conventions and trainings. I was just in Switzerland for a training in Miami after that. Were you at Julie Horn? I was. I flew all the way to Norway for her. My friend went to that too. No way. I went to a one-on-one with her. Okay. Yeah, that's what she did too. That was just a dream come true. I really look up to her. Oh, you got to do my lips now.

My pleasure. But it's definitely sad because years ago, because the industry is really infiltrated now. I think seven years ago when I began, it wasn't that infiltrated because I remember I was the only student in my cohort and there was 150 students in my cohort. that when you were asked to introduce yourself at what you're going to do with your nursing degree at the time I was studying to be an RN, I was the only one that raised my hand and said, I want to be in plastic surgery in Beverly Hills because that world interested me so much. Everyone else had an amazing story about helping sick people. And I was so judged for just being like, I want to be in plastic surgery. Yeah. So back then it wasn't as, you know, I read somewhere that back then seven years ago, there was just there was 26,000 injectors just in Los Angeles. That is insane. Wow, that's staggering. But years ago, we were showed pictures of a celebrity,

you know, but now it's just a filtered photo. What they want is just so unrealistic. And some of the words used like, you know, want to be snatched. And I just don't even know what that looks like. It's just, you know, like this wooden jawline that doesn't exist. And we're just coming actually from like a really good medical office and we were just talking about that how it's portrayed so incorrectly. And I think that as injectors, as medical professionals, doctors, nurse practitioners, we really have to be aware of the words that we use when we are talking about certain treatments that we're doing. A machine like Morpheus, which is a wonderful machine for skin rejuvenation, right? It's microneedling with radio frequency, you know, causing thermal injury and trauma with

needle to really improve the skin. Fine lines, wrinkles, minimal lifting, tightening of the skin. It's literally now like a facelift in a machine. That's what it's looked at. And it's just so unrealistic. I recently had a patient that was concerned about submental fat and asked me if Morpheus would get rid of it. And I said, no, you know, maybe if you have a little bit and it's dense fat, I said, you really, in my opinion, and I've worked in plastics long enough, side by side with a surgeon, to let you know that I think a little bit of liposuction and possibly a lower necklift. She didn't listen to me. She went to somebody else, paid $3,000, had Morpheus done.

And then six months later came back to routine, my med spa and said, you know, I did it. And I spent three grand and I didn't see results. I said, do you know how easy it was for me to tell you to do Morpheus and just rob you of $3,000? is so easy. And that's what I mean by honestly. Like I would, I just won't do it. Because the last thing I want to hear is you took my money and I don't see results. My ego is just too big to hear that on it. Because I do what I do because I love it. I don't have to do it. And the worst thing to do is just take someone's money. I had a patient come to me recently and said, she went to another med spa. And someone told her, it's about to change your life, the treatment. And then to hear these patients and say it didn't change their life, you really. learned to not to not do that. Realistic expectations. It seems like every year there's something that's kind of trendy and marketed as like the panacea for every issue. And I feel like Morpheus was kind of one of those where people think, oh, it's going to lift my face. And I've had so many providers on my show who have said like, yeah, it's great technology on the right person because it largely

depends on your body's own ability to produce collagen and heal and everybody's different. I have thin white girl's skin. Like I have to be really careful with radio frequency. But for other people, it can be amazing for the right concern. It's not just like a... Right concern, right patient, right skin. I tell my patients, new patients in consult all the time. I can have 10 patients and I can do Morpheus on all 10. Six might say to me, oh my God, Anush, everyone's asking me what did I do to my skin? My husband says, what did you do? You look so good. And the other four might say, I wasted my money. I don't see any results. And that applies to almost every treatment in aesthetics.

You know, the body, everyone's body reacts different, everyone's skin. So, for example, I don't do PTO threads. I don't really, I just don't do them. I've never really seen great results from them. But I'll always say that there are certain patients in certain areas with a certain skin type that might benefit greatly. But overall threads, no one's walking. around after you pulling those babies up. They settle into your skin, fat, and muscle. And, you know, I'm not into threads, but that's just such a great example. Maybe that's what I need right now is

threads and somebody just holding my bowtops up and my crows feet. Just follow, yes. Listeners are like, what? Just even crows feed Botox is such a great example because, you know, someone might have such a strong, nice pull at the tail of their auricularis. You do a little bit of Botox and they get the nicest lift. Yeah. And then someone will see that and, you know, oh, Anush gave me that lift. And then they'll come to me and I'll ask them to squint and there's such minimal muscle activity. You're not going to get the same lift that Mary just got, you know, because your muscles are different. What about mine? Oh, I would, I'm like looking at, I would love to do about 12 units per gross

speed. Twelve per. Yes. I know. That's what I used to get. 12 or like 15 per. Yeah. Got to start small. they're so bad. We'll do four units at a time and see what happens. Would four do anything? Just see what you're going to. I'm just holding it like to see how you're going to react. I'm scared. I am traveling right now and I have to say that my one wellness thing that I truly miss

when I am traveling is my infrared sauna blanket. So you guys probably have seen me post about this on Instagram. It is my absolute favorite wellness habit that I incorporated into my routine. last year and now it is something that I truly crave and truly miss when I am not doing it. So the sauna blanket that I use is from Bon Charge and the way that it works is that it raises your heart rate to that of physical exercise. So you burn calories while you are relaxing. In fact, you can burn up to 600 calories in just one session. And of course, the sweating helps flush heavy metals and other toxins out of our systems, the infrared heat and the elevating of the heart rate

while you're relaxing releases endorphins, which helps me to feel euphoric after my sessions. I like to do it at the end of the day, not too close to bed because I like to hydrate after, but I'll do it in the evening at some point and it definitely helps me to relax and sleep. And my favorite thing about using the infrared sauna blanket is that by using infrared light, it heats your body directly rather than heating the air around you like a traditional sauna. So this means that you get the same benefits at a lower heat. You also don't have to have your head in the heat like a traditional sauna. I've been doing a traditional sauna while I have been traveling. And not only have I noticed things like drying of my eyes and my skin, but I also just can't do it for a lot of.

long as I do the sauna blanket because my head is so hot and I'm breathing in hot air and it's just not the most enjoyable experience for me. So Bon Charge has just incredible products that are founded on science inspired by nature. All of Boncharges products adopt ancestral ways of living in our modern day world. So they have an extensive range of premium wellness products that can help you sleep better, perform better, have more energy, recover faster, balance hormones, reduce. inflammation, the list is endless, from blue light glasses to red light therapy, to EMF management, and circadian-friendly lighting. Bond charge products help you naturally address the issues of our modern day way of life

effortlessly and with maximum impact. So definitely check them out, and I'm so happy that I have a code for this for you guys, because when I first posted about it on Instagram, there was such an overwhelming response, and I feel like this is just such a good wellness hack and habit that has such a far-reaching impact on overall health. So go to bondcharge.com slash blonde and use the coupon code blonde to save 15% off. That's B-O-N-C-H-A-R-G-E dot com slash blonde and use the code blonde to save 15%. When it comes to supplements, I definitely have a less-as-more approach, but there are are a few things that I incorporated into my daily routine that have been an absolute game changer

for me. And one of those is magnesium, specifically mellow magnesium from Ned. So a little backstory, 75% of American adults are deficient in magnesium, which is a mineral that's essential to hundreds of functions in the body. I think a lot of times people just think of magnesium for things like anxiety, stress response, maybe stomach issues. There are different kinds of magnesium, but it literally is an essential mineral for over 300 processes in the body. So Ned's Mellow magnesium was designed to address the fundamental imbalances that come with our modern lives and that come with being deficient in magnesium. So it's a powerful daily super blend that contains three forms of magnesium. It has GABA, my favorite, L-theonine, my other favorite. It has

amino acids and over 70 trace minerals. So it can improve sleep. It can reduce stress. It can also help to increase energy, elevate mood, boost your gut microbiome and strengthen immunity. I started using Mello years ago, I think, when it was on its first iteration. And I just noticed so much better sleep. I did feel so much more relaxed at night. I felt better rested. But I also have said this many times on the podcast before. I felt like it was kind of this missing puzzle piece to my overall well-being. And I just feel way more balanced when I take it. And they also are so convenient for traveling. So I'm traveling now. And you can get mellow in individual packs. So it's so easy to pack. They also have some amazing new flavors. I love.

the lemon. It's so good. They also have a flavorless one if that's your jam. They have pomegranate now, which is so good. So definitely check them out and become the best version of yourself. You can get 15% off Ned products with the code blonde. Go to hello ned.com slash blonde or enter the code blonde at checkout. That's H-E-L-L-O-N-E-D dot com slash blonde to get 15% off. Wait, would four do anything? I mean, look, if the four, so let's talk about dosing for Botox. So let's talk about dosing because that's another funny thing, me and another provider earlier, we're talking about. He said when he sometimes tells patients how many units they need, they'll be so surprised.

And he's like, oh, I didn't know you had letters next to your name. Like, is that what you do for living? Sometimes I'll tell a patient, oh, 48 units. And they're like, really? I'm like, oh, was what did you compare, what are you comparing that to? Like, is that a lot to you? Or do you know how counting units? cost. So units work, so we'll assess a patient in person and based on their, you know,

first of all, you look at the area that you're injecting, right? Some people have a bigger forehead than others. Based on how strong the muscle is, based on how large the surface area is that you're injecting, then you'll count units according to that, right? So you might furrow, which is, you know, get mad to show me your 11s. You might have like a very tiny thin muscle and I'll say, oh, you know, that's just 11 units will knock that out. And then someone else might frown, male or female, and it's just a chunky, it's a fat muscle. You can actually physically grab it. That muscle is a stronger muscle. It means it needs more units. But what a lot of people get confused about is they'll say to me, oh, can you do less so I'm less frozen? What a lot of people don't know,

and that's normal is that dose equals duration. The more I do, the longer it lasts. The less I do, the faster it goes away. So if you have a smaller muscle and I do 13 units and I have a little bit stronger, I do 16, you and I are still not going to frown the same exact way. It's not that Anoush has more so I can't frown harder than you. But our globolas are knocked out. We can't frown. So if I do 100 units on you, again, we're not going to frown the same way, but you won't frown for maybe four, five, six, seven months, way longer than me. So the first. The frozen aspect is really it applies to the forehead because it's the placement of your Botox. The higher you put your injection points, the more the eyebrow muscle is still going to be active and you could lift and relax.

Yeah, you're not frozen. Like you have movement, but you don't have lines. But the minute I inject a little closer to the eyebrow, that's when you're either heavy, drooped or fully frozen. And look, some women want absolutely no movement and some women don't. If you're a new patient to Botox, I always inject up higher. I allow the movement because I can always bring that down 14 days later. But if I droop or freeze you, there's no going back. You just have to wait until the Botox wears out.

But that's something. I tend to not do a lot of teaching on my social media. I leave that to just a one-on-one with me and the patient in the consult room. So when it comes to getting a neuromodulator, I think another thing, I mean, you can speak to us more than me, obviously. But I think a lot of people go in and say, I just want to do my crow's feet or I just want to do my forehead. Do you recommend doing the whole face? Because I feel like it looks more obvious if you just don't move your forehead or you just don't have crow's feet, but then there are other areas. Like it really involves balancing. Especially when it comes to the upper third. So your frontalis, your glabella and your orbicular, those three muscles are anatomically woven in together. So when it comes to the upper face, they work harmoniously.

together like a yin and a yank. One is a lifter. The other two are depressors. Imagine if you only do your forehead. I have patients that say, just my forehead lines bother me. Well, that's your only lifting muscle. If I do any neuromodulator there, I am depressing your lifter. And so this is now depressed. This is active. We didn't touch it, which is a depressor. And your orbicularis is a depressor too. Right. So now everything's depressing. So if you are going to inject the forehead, then you want to relax your two depressors to lift them up. And so I always say, do them all together. Now, if I have a 20-year-old and now I'm going to just,

my words aren't going to make a lot of sense now, but if I have a 20-year-old that barely has any crow's feet, I may not touch it. I may just do between the eyebrows, the forehead, and we're done. But now you can be 20 and 18 and frown or squint and have very strong muscles. So sometimes age doesn't play a role. It's genetics, you know? Yeah.

But most of the time you want to address all three because if you knock out one and not the other two or if you knock out two and not the other one, the one that is active will overcompensate. And over time, not just with one treatment, but over multiple treatments, the one that you're not treating will get stronger and you'll have stronger lines there. And so I always say, you know, you don't have to freeze it. You can just sprinkle a little, if it's a light muscle, just soften it up. but still do all three. It's so interesting because I was on a plane and I was watching my best friend's wedding, Cameron Diaz, Julia Roberts.

And I was watching it and both of their foreheads were fully moving, full lines, full crows feet when they were moving their face. They weren't static. They were dynamic. But, you know, I'm sitting there and I'm like, what year was this movie? And then I'm like, how old is Cameron Diaz minus 1994? Like, trying to figure out how old she was. And I'm like, they were in their mid. She was like 24.

Yeah. And Julia Roberts was like 27. And that was 23 years ago. But it's so interesting what has happened between then and now because now like you just don't see that, at least in a place like L.A. And also I was watching like reruns up the hills. I don't know if you remember that show. Of course I didn't. We were just talking about that.

I'm like they, I mean, they're beautiful. They're young. But they had like full crow's feet and full like. full like static lines in their forehead and it's just crazy. So that's interesting to hear that people come in in their early 20s now. Is that just preventative or like you said, genetically, some people just have more movement? I think that this era, the new younger generation, because everything is so just open and out there on social media, everyone's at a very, I have a 13 year old that's into skin care. And that's because of me. She doesn't necessarily have social media. But I think

that over the years I've realized that the younger generation is really getting into it a lot sooner. And look, with some things I disagree with, but other things, and I've said this before, if something is a real insecurity and it's bothering you, right? So if I have an 18-year-old that's brought in by their mother and she has, or he has really thin lips and it's really bothering the kid, who am I to tell them that you shouldn't be doing your lips? Again, I've said this before on many platforms. I'm Middle Eastern. I'm Armenian. And in my culture, rhinoplasty is a very accepted surgery. Right. When you're 16, 17, 8, you know, very young. And that is a whole surgery that's changing your whole face. Fillers are not permanent. They're temporary. They go away. So if a rhinoplasti

is accepted at 16 and 17, why isn't a little bit of lip filler? You know? And I have many family members that a rhinoplastia at a young age. So if it is an insecurity, as long as it is tastefully done, then there's absolutely nothing wrong with doing it. And yes, I do have some 18-year-olds or 19-year-olds that furrow and that muscle is so strong. You know that by the time this kid is 20, 22, 22, 23, it is going to be indented. And so once a year or once every eight, nine months knocking it out just to soften it, there's nothing wrong with that as long as it's done morally and ethically correct. That's my motto. I think that I'm no one to judge. This is the field that I chose and if I'm going to make someone feel better. I turn away women on a daily basis,

no matter what their age. If something is too overdone, I'm either going to say, I won't do it or let me dissolve it because it's not about size. The shape needs to be done beautifully. I will not accept a young patient in my chair telling me make me look snatched. Yeah. Like that, stop. Yeah. We're not going to do that. Yeah.

But certain things, if it's bothering someone, if I can make them feel better by helping, I definitely will. Yeah. And I think it can be so benign like you're saying. I mean, I think that people do, to your point, they do rhinoplasty at 16. I mean, I remember when I was in high school, even people were doing it young. My sister did it in high school. Yeah.

And now people are doing like even like an endoscopic. facelift like Dr. Keo, you know, he's like, this is a beautifying procedure, like a nose job. That's what he compares it to, obviously, way more invasive. But he's doing that on young patients as well. And that's like a whole, you know, intense surgery. So I think like to your point, Botox, filler, things like that can be much more, much less invasive. Much more subtle and much less invasive. And I think that as a good provider, your consultation, you really start to learn the psyche behind. it. When I was a new nurse in plastics, I used to have, you know, the doctor that I worked with had like gorgeous models coming in. And he'd give them the mirror and tell them what's bothering them.

And everything was bothering them. And I was so new to the world of aesthetics. And I didn't really understand much about mental health at the time. And they would complain about so many things. And all I would stand there and say is, but you're so beautiful. And one day I think, I remember he got mad at me. He said, you need to stop saying that because, yes, they are beautiful. And you. And I think, I remember he got mad at me. He said, you need to stop saying that because yes, they are beautiful, but they don't see that when they look at themselves. And by you constantly complimenting them, it's not, you're not helping. You're making them feel bad. Like invalidated. You're invalidating them. And that took me so long to understand. And so as an injector, and I see 20 to 25 patients a day, so much of what I do is therapeutic in that room.

I mean, Kelsey will tell you all. It's, you know, you don't want. want to invalidate them, but you also don't want to feed into it because you don't want to inject something that doesn't look like it needs any more filling. So a lot of it is internal. It's just, you know, I probably have some body dysmorphia. You know, nothing is ever good enough for me. And if I say it out loud, people think I'm fishing for a compliment, but really I don't see it the way they do. And I'm really hard on myself. So a lot of the women that I see on a daily basis, It's a lot of talking and explaining to them. And I know that if I say no, they could easily go down the street to another injector.

But I feel better sleeping at night knowing I didn't do what, you know, because they really didn't need it. Yeah, I know. I see my face on video from like last summer. I was so frozen. I mean, it was amazing. I was so frozen though. Everything from my forehead, my eyes, my bunny lines down here. my neck, like everything was just like. And I remember people at the time were like,

your face is frozen. And I was like, no, it's not. And I was always, I would find something else that, you know, I would be like, oh, but I have this line here. And like, and you start to nitpick. And now, as you know, like having not really had Botox since August, my face, I feel looks completely different. And I have movement and I have lines and everything. And I'm like, God, like, I just have a different perspective now where I was like, yeah, I was. kind of like dysmorphic about that, you know, because you do start striving for perfection. And now I'm just like, I would just be happy if I could just do my eyes. Like that's all I want. I'll take a little bit of crow feet. Yeah, yeah. But it is a slippery slope, I think. And I,

I feel like the most beautiful people that I know are the most critical of themselves. It's like you could do like a chart or something. You know, it's like more attractive you are, the more dissatisfied you are with your appearance, which is so interesting. Yeah, absolutely. I would agree. A lot of my, I think all my patients are beautiful, but the ones that are like super well taken care of are the pickiest. Yeah. And it is a slippery slope.

It becomes an addiction. It's like getting one tattoo and then all of a sudden the whole body's tatted up. But I think that that's when you have to choose the right provider so that when you are sitting in that chair and you are starting to think that your lips have gone down. down, but really they haven't. They're not just going to feed off of, they're not just going to see dollar signs. They're going to let you know that no, they're not. They haven't gone down. Let's look at some before and afters. And I know so many injectors that I've never had my lips on if I sat in front of them. And I said, you know, I just wish they were a little pump. Let's do it. Yeah. But you need to find someone that's not just going to say, let's do it. Look, I love cheek fillers. I have a lot of cheek

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and minerals they need to stay healthy and strong. So again, go to just thrivehealth.com and use the promo code, Blonde 20, for 20% off a 90-day bottle of Just Thrive probiotic and Just Calm. Okay, let's talk about filler because you mentioned earlier, filler goes away. Obviously, we're hearing now, like, filler can actually last for a very long time. How do people go about getting tasteful filler? Like, what is your approach when it comes to that? Because you just mentioned you have filler in your cheeks, but you don't have that typical look. Overdone. And I have a lot. I mean, I'm, I'll be 40 this year in a few

months. I started when I was 30. And I've always had a long, narrow face, but not really like full cheeks. And I like to be skinny, but when I'm skinny, my face, the fat and my face depletes. So I want a little bit of volume in my face. I gain a few pounds. My face looks, but I don't like my body. That's my exact thing. And I got fat in my face. And I was like, I would rather like feed the fat and have that extra five pounds and have my face be plump than be skinnier. But with that being said, you don't want to overfill. So I think, look, back when I started in this industry, I was not an injector. I was assisting a surgeon who injected full time. And I learned, I realized I could be an injector simply by watching what he's doing, I realized I had the eye for it. And it's not just

about being able to hold the needle or just deciding I'm going to be an aesthetic. You really have to have the eye and you learn that really everyone doesn't. You can be very knowledgeable, know the anatomy so well. But if you don't have the eye, you're still not going to, you're going to know where that artery is and you're maybe not be able, you know, you're not going to cause an occlusion or do anything wrong. Yeah. But it still might not be put in the right place. So when you have the eye for it, you make sure you just, I don't know how I'll say. You make sure you don't over-inject. And fillers can stay for years. I know that they've looked at ultrasound fillers from 14 years ago and it's still there. I've done my cheeks multiple times over the past 10 years. I haven't touched them for a year and a half. But if I don't touch them for an even longer time, they will be there because they're layered many times in close increments. I have patients that will come to me and want more lips and I'll be like, well, your lips are already too big

with the proportions of your face. And they'll say, oh, God, I haven't done them in two, three years. Okay, well, how many times have you done them in the past few years? Oh, seven, eight. Okay. Have you used Juvederm? Juvenor ultraplas, yes. Well, there's still filler in there.

I'll be like, no. I'm like, yeah. I can look at it and see there's filler there. And then we'll dissolve it because it's migrated or whatnot and maybe start from scratch. But I just think that overfilling is like the worst thing that you can do. So again, going back to less is more, no matter what area you're injecting, whether it's tear trough or, you know, midface, you don't want to look like filler face, like a pillow face. How do you keep it from migrating in your cheeks?

Not every area migrates. Some of the most common areas that migrate are lips. You're constantly moving them, you know? The eyes can tindle and migrate. My cheeks have never migrated. They're down on bone, you know, voluma, Juvederm voluma. It's a thicker filler. It's never migrated.

My tear troughs, I didn't think they migrated. Recently, I went to Dr. Arthur Swift in Miami. We have a cadaver dissection in Miami I went to. And like my under eyes have been done seven, eight years ago. My second daughter is seven and a half. Gia is almost eight. I did it after she was born. And I'm like, well, I told him, I said, I think my under eyes look great.

And he goes, well, I could see a little bit of sausage filler. Wow. Tindle effect that's come out. Oh my gosh. And back then, Juvederm was used under the eyes. Right. And every year, it's a little thicker. I mean, I still think they look great and I'm not going to dissolve them.

And, you know, sometimes you're chasing the rabbit's tail. Some areas, you just, if it's not broke, don't fix it. You're going to dissolve. You're going to dissolve. You're never going to be happy. Yeah. And I've learned myself, I'm in the field, right? So I do this all day.

It's very easy to get like kind of, oh, God, should I do a little bit? It's been so difficult. I mean, I'm happy with my lip size. I've always had thick lips. But sometimes you look and you're like, oh, I'm almost 40. They've depleted. Should I do it a little? It's very easy to fall into that.

And I've learned, and a lot of it is seeing other patients and how they're not happy with the aging process. I've learned to really accept some things. Not everything can be fixed and you shouldn't hold a mirror this close and say this little line bothers me. some things we have to be happy about and if you can minimize it and age gracefully and it's all very subjective but I think that it's

more healthy to just be okay with a lot of the things because you're never it's never going to be perfect some lines occur with upon movement when you know what dynamic and you don't ever inject based on movement if I tell patients all the time I could do your smile line but the minute you talk

or smile it's going to indent again right so I just think that keeping it more on the subtle natural side is always always better. So when it comes to aging, I would imagine eyes are kind of the first place that we see signs of aging and then maybe like jowls. I know that a lot of, yeah. So let's talk about that. Because I think, you know, that's where a lot of like the radio frequency comes in and threads and filler and using filler to try to lift the jowel. And what are non-invasive or less invasive options? before it's time for surgery.

You have an amazing jawline. I talk about this all day. Thank you. I have both my parents age very well. And I have thin skin. But my dad's 65, no jowls. My mom is 63, barely any jowls. So I think it's my genetics.

My sisters and I all have very strong jaw lines. But there is only so much we can do at a med spa with jowls. I have this conversation all day, every day, until I have dry mouth. And so a lot of it is just we turn to surgery for it. You know, I can pre-gels are starting. We could put minimal filler to just kind of camouflage them, you know, a little bit of, maybe a little bit of radio frequency with microneedling to dissolve a little bit of minimal,

minimal, minimal. But really all we can do is camouflage. We cannot. There is nothing. And I repeat nothing. in a med spa that is going to physically pick up your skin and lift it. I don't care what anyone tells you. It's not going to happen.

So there is a point where you just have to turn to surgery. And that can be like Ben does his weekend lift. I have three patients that I refer to him to go do it. Young in their mid-40s looks phenomenal. But a patient that's 46 in fluted Gicono in New York and had it. It looks phenomenal. because I have an 18-year-old, she's 46. But it needs to be, you know, all this, this whole facelift with Botox, neck lift with Botox,

the Nefertiti lift. Yes, if you have, certain individuals have very strong platisma bands. You do it. They'll get a minimal lift. It looks nice. But it is a realistic lift. You are not going to, if only all providers were on the same page. And we just all stopped saying you're going to get a facelift with Botox because they're not.

And yes, one of your patients might have had a great result because they had stronger bands and you minimize, you know, you relax them with Botox and they got a nice lift. But it does not apply to everyone, especially if it's sagging skin and it's not just the muscle pulling down. I think that, and I don't want to toot my own hair, but because of the fact that I had four years of experience with a surgeon who did surgery in the mornings and injected nine to five. And I was able to hear him do consultations all day. I really understood what can be, what needs to be fixed with surgery and what can be improved with filler. And it's not just here, I have a syringe in my hand and I can just fix it all with filling your face. Right. Like when all you have is a hammer or when all you have is a hammer. I know. If all you have is a hammer, then everything is a nail. Or the other way around. Or something like that. But that's everything is a nail. Everything is a nail when all you have is a hammer.

And all you have is a needle, then everything is. Yeah. And that's not true. And I think that being honest and telling someone, listen, you don't want to spend $1,000 on a syringe right now and get, look, if money came easy to you and you don't care about that $1,000 and even a 20% improvement is going to help, let's do a little bit. But you're really not going to get that wow factor. And it's just, it's a stab at my ego if anyone looks in the mirror afterwards. and they're like, oh, this was it? So a lot of it has to do with the consultation. You just have to set realistic expectations. So how does somebody know, like, if it comes to their brows, for example,

how much can a Botox browlift achieve and when is it time for something like an endoscopic browlift? And the same could be, you know, said for under eyes. When can you use filler versus when is it time for a blephoroplasty? So with the under eyes, it's very easy. And again, if you have a knowledge of injector, they can, they can show you very easily hold the mirror and they'll show you if you have fat pockets, it's herniated fat because the muscle wall is weak and the fat is pushing through. That needs to be lower blephroplasty needs to be done. The fat pockets need to be burned. Because if you add filler, that's, that's just going to make it worse. You're going to have swelling. If you don't sleep all the night before, you eat salty or spicy food, you can be swollen.

It is, that's not, that's just like a quick fix. And so I always, tell my patients, really the issue is the fat pads and you need surgery. And if my patient tells me, listen, I'm not going to do the surgery for another year or two, I still won't inject because if I inject and they spend money with me, they go to a good surgeon, Parsa, Groth, Taban, under eye, that doctor is going to dissolve every ounce of the filler that I did. So now we're going to ask back, which you're going to pay that doctor, you paid me, you're going to dissolve it all. So I consider all of that. Like just as a human, you have to consider all that.

Don't make that person pay you to do something that's going to be reversed later on. So if they have hollowed, I had hollows under my eyes, so I benefited from filler. Right. But if you have fat pockets, you're not going to excess skin, you know, that also is you're not going, you can fill it all you want. But if the skin, laxity is not there. If anything, it's going to show through, then you're not a filler candidate. And when it comes to Botox, you know, you. You know, you get a minimal lift, and that again has a lot to do with how strong your muscle is.

If you squint and it pulls down a lot, it wrinkles a lot. Just a little bit of Botox will give you a minimal. So if I have a patient that asks for this, yeah, you need like a cantalplex. You need surgery. You guys have probably heard about colostrum and seen this new superfood and Armra all over the internet. It almost seems too good to be true. but I asked a lot of my friends who are in the nutrition and wellness and medical communities, and they all actually said that it is incredible for a number of things. So it's really helpful

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trends out there on social media, but I stick to what is tried and true for me. And for me, that is vagamore. So I've been using vagamore for almost a year. and sticking to a healthy hair routine has never been easier and I've seen such amazing results. So vagamore products are 100% cruelty free and are never formulated with potentially harmful chemicals like paraben's or hormones. This is huge because I feel like when it comes to clean hair care, unfortunately, oftentimes the clean products are not effective. But vagamore is amazing. So I started by using the grow hair serum. I heard so much about this. And it really helped my scalp. So good hair health starts at the scalp. And then I started using the shampoo and conditioner. I also love the dry shampoo, everything from Vagmore. I am obsessed with. My hair feels so strong. It looks amazing. And I feel like I really started seeing results about three months in. So definitely be consistent. I have a monthly subscription of the

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Skin care. Thank you. I was just going to say, like your skin is your canvas, right? So all of these things can only look so good if you're not taking care of your skin. I often will get complimented by my patients and they'll be like, well, you don't need anything. First of all, I'm turning 40. And I'm like, well, I don't need anything because I do it all. Like, you don't see the behind the scenes. Like, I'll stay after work and or come early and do my own CO2 or do my own micronealing or, you know, Botox and all that stuff. I don't have the luxury of all that time often. But my skin care, and that's why I gravitated to you so much, much, your nine-step skincare kills me. But it is so important. It's like, imagine, I'll have patients come in and want to do CO2 or want to do micronatalinks, spent $850 on CO2, a thousand dollars micronataling

with PR, PR-PRX chromosomes. And I'd be like, oh, do you wear SPF? No. Well, then don't waste your money with me. Go buy $35, L-TAMD, you know. Don't go ass backwards. The homework that you do every day at home is more important than the hundreds or thousands that you're going to spend with me. Because if you do a CO2 but you're not using your SPF, guess what? You're going to go. You're going to make your hyperpigmentation worse, your sunspots, and then we're going to go through the handholding process. So it is so important. It's not just about filling and filling your face, but taking care of your skin. And again, I have patients with great skin, but there's no complexion. It's dull.

My sister, my older sister has flawless, and she makes fun of me all the time because I've spent so much money and time on my skin. She's like, I wash my face with a bar of soap and put Medicare butt cream on my face. I'm like, yeah, but you're genetically blessed. But there came a point where I'm like, Anna, you need to resurface your skin. Yes, you don't have scarring and yes, you don't have acne or dark spots, but your skin is dull. It doesn't have that glow and complexion. So until I got her to start using peel pads.

and retinol and vitamin C. And then a year in, she's like, oh, my. And what a lot of women also don't know is it takes six to eight months of using an active in order to even see a difference in your skin. So once she started using it, she's like, oh, my God, I can't believe I had such dull, dead skin on my face. So, so actives. Look, you can use, I ask patients, are you using good skincare?

Yeah, Lamar. I mean, are you using actives, your vitamin C, your age is, you. your BHA is your retinol. Those are really the three and your SPF, four of the most important ingredients that you need to use. Using some cream that came from a squirrel's butthole from like, I don't know, antalcentia. Isn't going to do anything. Yeah, that's fun. Yeah. It sounds fun. But, you know, retinol, vitamin A, it has like the most amount of clinical trials reverses photo aging and all that. So, I mean, I spent all of COVID on my social media teaching women how to wash their face properly and applying skincare.

So I'm huge on that. Give us a minimal skincare routine. Morning vitamin C, my antaxin and I apply it during the day. Moistrise SPF. That's morning. Okay. Retinal, depending on whether or not you're a retinal user and your age or your skin condition, three times a week retinol followed by moisturizer.

And then once a week or twice a week, depending on how sensitive your skin is, you want to exfoliate with peel pads. Moistrised go to bed. The other nights, moisturized, go to bed. Like, that is probably minimal. You and I were, I'm like, ooh, we're unique. The nine-st-old. Yeah.

I love it, though. You got me onto that Jan Marini glycolic. That cleanser changed the game for me. I had Kelsey go pick it up for me. Do you love it? Yeah. Yeah. Use it every day.

It's amazing. Yeah. Do you really? Yeah. I had very sensitive, dull skin before. Your skin is glowing. Thank you. It's very dry and dehydrated because traveling. I was in Vegas. I saw. But yeah, I mean, it totally changed my skin because I wasn't using. It was so sensitive to the point that I kept taking things out. So I wasn't really using actives. And I would have like, when I washed my face every day, like my skin would pill because there was so much dead skin. And then I wasn't moisturizing. I was just using serene. Like it was just bad. So when Candace put me on Jan Marini, I was like, whoa, this is like a lot of actives. I'm throwing a lot at my face. But it. just like changed it.

Your skin's amazing. Thank you. As long as you know what you're doing, you know, there's people that'll mock like a really long skincare routine. But as long as you're educated and you know what you're doing. And I've learned that the average female does not want to do that, you know. So when I have like a rep come tell me about the TNS from Skin Medica and I'm like, do you know how difficult it is to get the average female to do vitamin C, moisturizer,

and SPF during the day? Oh my God, so many steps. Now, try getting them to do an essence and your retinol and this and that. It's the average female does not do what we do. And everyone's not into it. But I'm really big on skin care. Yeah. Yeah.

For me, it's like my self-care time. But I've gotten it down to three minutes. I'm like boom, boom. It can be down so quickly. Yeah. When people tell me, how long does it take you to get ready? Quick. Yeah.

I love my self-care. Yeah. I really have kids. It's a hectic in the morning. So I wake up. super early 5, 530, do my thing, have my coffee with the birds. People make fun of me for it. But it really calms me because I have such a big day ahead of me, you know, treating and talking to and injecting 20 different personalities is a lot. Sounds exhausting. Oh my God. My husband makes fun of me

when I get home. My ears start to burn. My neck hurts. My throat hurts. My TMJ hurts and my head So he says I touch every part of my upper body. I love you. You're hilarious. We're like the same person. That's how I am. If I do like back to back to back podcasts, I'm like, I need to go sit in a dark room alone, not talk to anybody. I'll come home, lock my door.

My 13 year old and my seven year old will walk after me. And I'm like, the babysitter is mom. Oh my God. Do not even say my name. Yeah. I'll put my hatch, like the white noise. Yeah. And I just, I've, I've been on the closet floor.

I fell asleep ones on the closet floor. I asked my husband, why didn't you come looking for me? He said I did. You were sound asleep. I didn't want to bother you. What? Self care, baby. Yeah.

With kids and a career. Yeah. And you try to manage a social life in that. And then I love this world too. It's a lot. Yeah. Well, you do it so well. Thank you so much for coming on.

It's so fun. We could keep going, I'm sure, for hours. But tell everybody, where they can find you. So I opened my own medspa in Studio City. It's called Routine by Anushmof Sessian. And then you can find me on Instagram at Skins and Needles underscore NP. Thank you. Thank you. I hope you enjoyed that episode. And 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 have to

head over to The Blonde Files podcast on Instagram. You can go to Arial Lori.com. And I'm always posting about each episode over on my personal page at Arial Lori. Please note that this episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct or indirect financial interest in products or services referred to in this episode.