Well with Arielle Lorre - 373: How to Look Natural with Injectables, Biggest Botox and Filler Mistakes, Face Tape & What Celebs Get Wrong with Dr. Justin Harper, MD

Episode Date: February 5, 2025

Dr. Justin Harper, MD is a cosmetic medicine specialist, clinical researcher, national trainer and founder of Juvly Aesthetics. He joins the show to bring you the most compressive guide to facial aging and injectables, treatments like microneedling and skincare ingredients everybody should be using. We discuss why our self image is distorted, the common treatment that he would ban, the 2 most prominent signs of facial aging, botox and filler mistakes, why younger people look old, the single most transformative skincare ingredient people can use and how to vet your providers.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.Visit Puori.com/BLONDE for 20% off. Visit boncharge.com/BLONDE and use coupon code BLONDE to save 15%. Go to drinklmnt.com/WELL to get a free sample pack. Go to ZOE.com and use code WELL10 to get 10% off. Go to www.YNAB.com/well for an exclusive three-month free trial with no credit card required.Go to Quince.com/blonde for 365-day returns, plus free shipping on your 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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or sunnycars. The following podcast is a dear media production. In a world of ever-changing wellness trends and information, what does it mean to truly be well? I'm Ariel Lurie and I'm going to explore this with you. I am bringing you candid conversations that will equip you with everything you need to live your best life and look good doing it. Think of well as your go-to resource for all of the latest in wellness and me as your internet bestie. Well, let's get into it. Hi, everybody.

Welcome to the show. I know that I've done quite a few episodes on beauty and aesthetics. I've had lots of experts in various parts of the field, whether they are injectors, plastic surgeons, dermatologists, but I have to say today's episode to me is the most comprehensive and the most fascinating episode, I think, that I have done on the face, aging, beauty, injectables, all of the things. So I'm talking to Justin Harper. He is a cosmetic medicine specialist. He's a clinical researcher. He is a national trainer in things like injectables. And he's the founder of Juvli aesthetics. So we are really delving into things today, starting with a really interesting conversation around self-image

and why all of our self-images are distorted. Men and women, nobody is immune to this. We also talk about why we fixate on certain things and how it's never one thing that is the tipping point for whether somebody looks attractive or not. So we all hyper-focused on specific things on our face, but really it's the whole composition that other people see. So we also talk beauty myths. We get into a little debate about face tape and why it is working for me and who it may or may not be good for. We talk about the one treatment that he would ban. This is shocking to me because everybody that I know does this particular treatment on this area of the face. We talk the two most prominent signs of aging also really fascinating because they're not the areas of the face that we

would typically think of. We talk why younger people are looking old mistakes that people are making with filler and Botox, why celebrities sometimes end up looking the way that they do. We talk how to vet and actually how to kind of test your injector or your provider. I thought that this was really insightful too. And we talk a little bit about skincare, the things that he wishes people would stop doing. It is such a fascinating episode. I learned so much from this conversation. And I look at my face and other people's faces and facial aging and facial maintenance as a whole so differently and with such a deeper understanding coming away from this episode. So I really hope you guys love it. Please enjoy Dr. Justin Harper. Welcome, Dr. Harper. Thank you.

Thank you for having me. Thank you for being here. I'm really looking forward to talking to you. I think to start, I want to know what your beauty and aesthetic philosophy is. My beauty and aesthetic philosophy is you should be able to do whatever you want without compromise in a long lasting fashion where you're not choosing between looking old or looking strange. So a bit extreme. But for me, I got into the industry because, I felt like it's a fantastic thing, right? Making people feel better, helping them look like they think they look or remember how they look and the confidence they get is always really inspiring. I didn't like when I was doing my training that you had to choose and everybody progressively got a little stranger and stranger over time. So my goal was to be able to, one, make it accessible, cut to like crazy wait times in rooms and then to be able to make sure people looked,

that they were happy how they looked 10 years from when they started. started not in one year from when they started. Yeah, I think that there is this distortion that we commonly see happen where I think a lot of us will speak for myself, go to get an aesthetic treatment done, and I'm not thinking 10 years down the line. I'm thinking right now. I'm an instant gratification kind of person, and we want to see the results that we want to see in that chair, right, or shortly thereafter. And then what happens is when you're continually doing that, however many times a year or once a year, things start to look a little bit funky. And that's a trap that I think so many people fall into. And it's so important to zoom out, right? And look at the big picture.

I think it's challenging, though, to be honest. So I often tell my patients that 100% of humans are delusional. It's just to varying degrees. I don't believe that our minds can actually remember how we looked one week ago. So whether you're losing weight or whatever your goal is, I think that's a why photos are essential. When I first started, I had a very good memory. So I could remember treating people. I would take a picture. They would come back and they're like, you gave me this or this happened. And I was a little confused. I'm like, wait a minute, that's not possible. And so then I was like, does everybody lie or does everybody not remember how they looked? And so even in something as short as Botox, right, a common topic here, it's hard to remember

what we looked like before. And then if we look at ourselves over time, like three months down the road, there's zero people, I believe, in the world who can remember where they started. And I think that drift, that exactly what you described is 100% true. That gradual distortion of our own self image gets us so far down the road and we never see it in ourselves, never ever. So do you think that our self image is better or worse? So if somebody comes in and they have forgotten how they looked three months ago. Do they think that they looked better? It depends. Okay. So I don't know if you ever saw that commercial that Dove did. Or was it Dove? Anyway, they had

people described themselves and they had a forensic artist draw the picture. And especially the women universally described themselves uglier. And so the forensic artist, they looked like distorted almost when they would close the curtains. Really, from a commercial perspective, very powerful. Then they had their partners describe them. And the picture is always more beautiful. So I think as a general rule, a lot of people are delusional. We think they're overly confident, whatever. And that's probably true to a degree.

But self-image, I would say, usually underestimates the way people look. Yeah. We are absolutely our own worst critics. 100%. And I don't think anybody is spared that men or women. Maybe it's a little more. Yes. Yeah.

unfairly so, but the standards are different. But you're 100% right. Nobody's stirred at all. Yeah. Yeah. I mean, I have things that I'm self-conscious about, especially since I stopped doing Botox, which has been a journey of acceptance and highs and lows. I'll be totally honest.

But when I talk about the things that I don't like, other people are like, oh, see, I don't even really notice that. Like, I look at you and I don't see that. And I have been podcasting all day with other women who are beautiful, and they were telling me what they feel insecure about. And I'm like, I don't notice that at all. And my best friend and I always say to each other, we need to trade eyes. I wish that I could see myself through your eyes and vice versa,

because we are so harsh when it comes to ourselves. I constantly remind my patients of that, and I remind them, I tell them there's not a detail on, there's not a single detail on anyone's face that makes them unattractive. So it's the composite always. And so I always say, it's my job to know better. And it's my job to, I tell them, I will happily fix things, but I'm never going to let have mess up the picture. And oftentimes I think, you know, you're famous now for the not doing Botox. But I would agree. So if I would remove something from a regimen, it's never a tiny wrinkle that makes somebody look unattractive. There's something always that's a bigger component to that transformation. And that's usually not it. I think it's fantastic for maintenance, but it's never

the like tipping point to somebody being unattractive or attractive. I don't think of, I don't think that's the thing. Yeah. And I agree. and I have to remind myself of that and I talk about it here as well but I think about whenever I have an encounter with someone and I come away from that encounter and I visualize what they look like or I think of them and I

have an image of them in my head it's never like oh their crow's feet were so bad to your point we're thinking of big picture and more of like an energy thing like oh I like that person because they were so interesting or they were really interested in what we were talking

about whatever it was like you come away from that with a feeling about the interaction and about that person more so than an evaluation of all of their flaws. Yeah, there's a really quick exercise that I do with my patients actually is I make them close their eyes before they... Can I do it? Yeah, go for it. Close your eyes. And then tell me about a single detail you notice on somebody's face. A wrinkle, an uneven brow, a lip line. Can you think of a single tiny detail on somebody's face today? No. But you can tell me whether you've seen men or women, young or old, attractive or not. So we don't even see details in others. But when you look at you, when you're asked to describe yourself, you're going to tell me,

I have this flaw, I have this brow that's lower, this side's flatter than the other. Are you talking about me? Because you're naming all my, the same issues we all have. All of the insecurities. We all have the same thing. I have a higher brow on the right. This one's lower. I have some crow's feet going on. So everyone has some. And the side is flatter. Yep. So I describe it.

Every single person has those things. Yeah. So I always say everybody has a flat side and a round side. Everybody has one brow that's higher or lower than the other. Yeah, mine are distant cousins. Yeah. One eye that's a little smaller. But we don't ever give, even in our friends, people we see all the time or family members.

We rarely notice those details in them. There was, I don't know if you saw that. I think it was on TikTok, a filter that was going around. It was a mirror of your face. And then it would show what you would look like with two right sides, right sides and two left sides. And then, you know, ultimately what you look like as you are with asymmetries, which everybody has, to your point. And I remember doing that. And when I had perfect symmetry, I was like, oh, God, who is that person?

I don't know who started that myth, right? The symmetry is beauty. Yeah. But it's so inaccurate. And you can look at it. Classically, you know, probably six, seven years ago, I always used Jessica Alba as the example. Very, very asymmetric. But nobody would argue she's unattractive.

Marilyn Monroe, they did early beauty studies a long, long time ago. And they came to the same conclusion. And so one of my favorite things are one of the things I enjoy it, but I also have to do it. I kind of call it the truth in the trend. So I do a weekly training with all my clinical staff in all my offices. And a big portion of that is, okay, what is the current trend? What is the thing you're hearing? And I assume nothing is right or wrong.

But let's look for what is true about it versus what is it. And to your credit, your face taping came up. So if it becomes big enough that patients are walking into our clinics and saying, tell me about this or I'm doing that, then I address it. I'm like, okay, this is what's true about it. These are the people that will work for versus these. These are the people it won't. And I think that's one of the challenges of this industry.

Not only do we compare our image to one another, we compare somebody else's journey to another one. You know, somebody has brows that are not very dynamic, somebody who has brows that are hyper dynamic. And so you go, or somebody has oily skin, and they're trying to do the same skincare regimen as somebody with dry skin. And so that's something I find a lot of enjoyment in just like, okay, where's the truth to it? What's accurate about it? Yeah. You guys know that I often start my day with either a protein yogurt bowl or a protein oat bowl. And I always get so many questions about what protein powder I like.

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and so much more. A few years ago, I was diagnosed with chronic Lyme disease and the healing journey I embarked on at that time set me on the path to radical awakening. Let's just say I had no choice but to change my energy and that opened me up to the most beautiful healing of my life. On my show, you can expect to feel like you're sitting in my living room chatting with old friends. Tune in every Wednesday to connect and hang on the balanced bond soul on fire. I want to talk to you about this. Let's get into it. And I very much agree with you. I mean, I, I, I, I am not an expert, so I only know what works for me. And I have been called out by various people on the internet because I do have a history

of past Botox. And I have had surgery, although I always say, show me the surgery that makes your skin better because you know, you would see a lot different outcomes than we're seeing and sign me up because I'll do it. But yeah, I've been very open in the past about all of the cosmetic, aesthetic things that I have done. And I think that absolutely got me to a place where at 39 years old, I really don't have static lines. I'm also not a very expressive person, to your point. I mean, I'm more of like a razor, but I just don't. It's not how I am. I smile. And when I smile, I have lines around.

And that's kind of my area that I have some self-consciousness about. But for all of those reasons, I think the tape and the skincare that I'm doing has gotten me pretty far in, you know, the past 15, months of not doing Botox. I always say like the Botox to facetap pipeline was not something that I expected to be on ever in my life. I was like Botox is number one fan and I'm still not anti and there may be a day when I try it again, you know, when my health stuff clears up and and all of that. But yeah, but the taping for me is something that has really worked because I do express in my sleep. I do notice that. I'll wake up with my brows raised. And some people will wake up for scowling.

I have no, I've never been a furrower. I can't even furrow my brows. I'm like, is that, I don't know why. But some people have more of, you know, the 11s and more movement there. And some people have more movement vertically like I do, I think. And some people are more in the eye area. So all of that is to say when I tape my face a few times a week and I've tried all of the different kinds and there's only one that I have found to be beneficial. And I'm not affiliated in any way, like I'm not making money from it. I wake up and it looks like I have fresh Botox. It's crazy. I haven't done it in a few weeks and I've been traveling and my skin is dehydrated and all of those things are factors as well. But I have found it to be an effective modality in this

season of my life. We can do that one as an example. We can break it down like I like to do. So I think people should think about the skin as a scale, like a balancing of the scale. And I always say your skin bank is full when you're young. Little by little, every time you express and to address your thing, we get a type of stress, right? Nobody is immune to stress. So some people are razors, exactly right. Some people are scowlers. Some people are clenchers.

I do that too. I'm a clencher. Some people are the hold the tension and grind your teeth. You're probably a teeth grinder category. Can you tell for my chin? Chin and cheek. like just shapes. But everybody has one of them. And so some people are lucky enough that they don't almost express at all here. Right. So they're not really consuming their skin bank, essentially.

I didn't get treated in your honor. So you could see. Oh, thanks. But I like the movement. Yeah. So but I'm more dynamic. But I have enough movement that if I don't get treated, I get really deep static lines. So because and I and because I have dry skin and light skin, those age the worst, whether it is what it is. Right? So the drier your skin, the lighter your skin, the faster you're going to age probably by maybe at least a decade. Right. And so if I didn't save it early enough, right, I didn't start doing this stuff until I was in my 30s.

And so I had lines in my 20s, static lines in my 20s. That's very different from some of my clients when they're like, hey, when is it time to start? They're in their mid 40s. They don't have any lines at rest. I'm like, maybe not yet. So the way I describe it is the day before you get your first static line. But what you're doing now is you did correct it, right? You did the treatment, you restored your bank.

And now you have grace for quite a while. And the more you do to repair, right, the more you do to constantly regenerate your skin, which occlusion, holding it still, all your great skin care that you're doing, protecting it like the way you are, all of that is going to slow down the rate that you take withdrawals. And even if you're really, really good and you do enough, then you might actually never have your balance go lower in your skin bank account. Oh my God. So it could last longer and longer. The more weeks you take off where you're traveling and you're not doing that kind of stuff, the faster you're going to deplete that. And so then you're going to get it back. Now, because you don't

have really hyper-dynamic brows, you're not going to burn through your skin as fast as somebody else. So I think it's, I always say you have to decide, right? You decide exactly when you start getting a lot of static lines, whether those lines bother you or not. I wouldn't, these don't bother me at all for you, right? So I don't think, I don't, everything is a personal decision. If I were making a choice, I wouldn't mess with these. They make you look happy, right? That's not a bad thing. I think they make me look old. Not at all. Okay.

And so I think that that's where there is truth to it. So people can use that if they have deep set nasal legial folds. If I could ban people treating those on women, I would. Like one day to the next, zero times. But if you have a nasal... Why? Say more about that. It masculinizes a feminine face. Treating it with like filler.

Filler. Okay. Yeah. Yeah. And we change the name every few years because we know it's not good, but we still want to do it. And patients still complain about it. So it used to be nasal labial folds. That's how all fillers are approved.

And then now it's periform aperture they're talking about. It's the same thing, just different names. But when I do work in masculinizing or feminizing faces, there's nothing that masculinizes the face faster than right here. Right. So any flatness there, and you can do this test on your own, just find any attractive men and women, cover up their face. All women are narrow here.

All men are flat. We have more bone here. And so you can treat this in men, absolutely. Women, absolutely not. Interesting. I get so much feedback from my audience whenever I do Q&As or just people are DMing me and they ask how to get rid of nasolabial folds. It's such a hyper insecurity for women.

And I don't know if that's because we're seeing everybody filtered where they just do kind of look more flat. And I think that that has kind of seeped into our psyche. We've forgotten what real people look like. But that's a really good question and you're 100% correct when I stopped doing nasalabial folds this was in 2015 and people thought I was a crazy person because the industry as a whole still did them it was like it was a who's who of who could do them the best after I did them for about a month I said the person was so happy they were a tearful that the line was gone but then

when I took the step back like but they don't look better right they're like they're line is gone, but objectively they're not more attractive. You could argue they were less. And I think of it, we get, and this is where it's hard to be a aesthetic practitioner sometimes, is we need to not, I tell my patients I hear really well, but I don't listen very well. Because I'm going to hear their complaint, and I'm going to translate that into what the actual problem is. And, you know, there are plenty of places that we are really aging, and there is real volume being lost that can be restored and even with filler that might migrate or whatever and still have no long-term consequences in a fantastic look. But this is the symptoms of aging. So I always say if

you just took a little snapshot of the corner of your mouth and you looked at us at 29, 39, 39, 49, gradually turns down little by little. These gradually get deeper. And so if I'm looking at a mirror and I'm looking at myself because we can't judge ourselves well, I know that I don't want to age, right in general. And so anything that I can see as a hint that I'm aging makes me stressed. So you're completely right. It's even worse now with filters because now you can age and still not have the evidence of aging, which makes no sense. And so you're right. And I say it's just like if you go to the emergency room with a cough. If they just give you a cough drop every time, they're not a very good physician. They should be smart enough to say, okay, the cough means that you're aging here.

right so the chin getting these lines here means the chin the horizontal ones oh i have a huge do you mean this indentation that one that we all get some of us it means this bone goes away oh god and these are the nice thing is finally we have solutions for most of them you know and i always say i would tell patients that there's an answer for this thing right i don't have it the industry doesn't have it yet so i'm not going to do it because there's no good answer Now we're getting to a point where there's a good answer for most things. But if I were to number them, right? Number of aging first to last, most important.

Number one is temple aging. That's the number one volume aging on the whole face. There's probably more volume lost in the temple alone than... Are my temples. Good, good. Not too concave. Not too concave. Okay, we'll cover them back.

It's number one. Number two is here. Well, if you don't notice that we lose probably a full inch of bone over our life there. And you see that when I was in my training, we would fix facial fractures. And so when you'd fix a bone like this, the mandible, and a 20-year-old, the bone's really tall. You can put plates on it. You can fix it. Perfect.

If an 80-year-old fell and came in, there's not enough room to put a plate. The whole bone is gone. Wow. And so I think if we just undo what's going away, you can look natural. but you're getting back to the point that you mentioned is people hyper fixate on what they what tells them that they're aging because they don't see the big picture in themselves. And I think a problem with that is that so many people will go in with their hyper fixation that may not be the actual thing that is causing them to look the way that they don't want to look

and they go to a provider who isn't educated or trained enough or the way that they practice is they just say, okay, great. You know, you feel like your cheeks are not full enough, even though it may be a temple thing and a lower face thing, and they just put a bunch of cheek filler in. And then that's how you end up looking really distorted, right? 100% right.

It couldn't be more accurate. And I don't think that, in my opinion, I would hope that would have gotten better in the last decade, and I'm not sure it has. I think the industry has gotten smarter into having a cheek indication, one before it didn't. Now recently you can treat temples on label. But every time we get a new area, just like cheeks, they get so overdone because people get excited about it that pretty soon we all look like maleficent, right? We see plenty of that walking around.

And you'll know this from social media. People often ask me, this is a 20-year-old attractive woman. why do they look 40 or 50 or 60? Yeah. And our eyes are smart, right? You can't trick our eyes. Even if you're not sophisticated enough from a training perspective to know how to name the filler or the area or whatever, your eyes know something's wrong. And anytime we have a discrepancy that we see between our temples and our cheeks, our cheekbones, our eyes tell us that's older.

And so when we build these crazy cheeks on 25-year-olds, and then we see a big concavity here, and a big protuberance here, the only logical thing your mind can see is age. And so we see these, and then we see these people who don't look quite right. They've been super feminine, beautiful faces with very masculine midface. It's a contrast. Our mind's like, I don't know what's wrong, but something is. Interesting. So how do people go about getting these treatments then or vetting, does it come down to vetting the provider?

That's a really hard question because I wish it had an easier answer. answer. And I'll just give you a quick story. I had a patient who've been seeing me for a while generally okay with the idea, right? It's always a negotiation and it's always an education as to I don't like this line and I'm going to trust you that this is better, right? And there's some level of trust and confidence that you have to have in the provider to be able to do that if you, because people feel the pressure to be educated, right? There are a lot of consumers of your podcast, lots of consumers of this beauty industry knowledge, and I think it's because people are enthusiastic or passionate about it,

but I also think they're afraid. They want to do it right. They want to do it. They want to do it right. They want to know how. They want to not make mistakes. And I think that's a, I think it's justified. It's 100% valid.

I think that if I were to tell a family member, in a city that I don't know to go out and get there. I would say 50, 50, whether they're going to get treated right. But my patient who trusted me, who I'd been seeing for a long time, she's like, okay, I know I need to do temples, but I don't want to. I really want to do more cheek, and I want to do this line. And so I went through this whole, you know, 45-minute education. Let's revaluate and see, and we look back at pictures.

We can see she's making fantastic progress over time. And at the end, she's like, I just don't care anymore. I just, I want this right here. and I just want my cheeks done and I want this done. And I said, I understand, but I ethically will not do that to you. And she went to somebody else. She left in tears, called back, cursing and everything. And I suspect she went someplace else.

But I think that how do celebrities end up looking wrong? I believe they go to really sophisticated people. And there are a handful of really good ones. I know you know Ben, Tully. Yeah, love him. I know there are a lot of, I know a handful of them. personally well enough to know they do good work consistently. And they probably would tell a celebrity no. Ben has told me no so many times, by the way. And I think that's right. And the problem is,

is that people don't want that from a customer service perspective. Yeah. Well, it goes back to the instant gratification. When you get it in your mind and you have that self-consciousness or insecurity, you just want what you want and you want it in that moment. And it's almost like, fuck the consequences down the line. I'll deal with it then. Like, we have. have this inability to look too far into the future when we just want that thing in that moment. I'm going to try to summarize a handful of things that they can look for. Because I know people want practical things they can apply. So I would say you can actually test them. If they'll treat your nasal labial fold as a woman, I wouldn't go there personally. If they'll treat the marionette

lines here without addressing the chin, the gonial angle or volume up here, I think that it tells me they might be skilled, they might even be famous, they just, they might not have the right eye. And if they don't educate or push back, if you ask for the wrong things, then they might be more interested in just treating anyone rather than saying no occasionally. I say no every day. And I think it's not because I'm intentionally obstructionist. I love doing these treatments. I love doing a lot of these treatments. But I want to minimize how many wrong things people do because I don't want them to have consequences. I don't want them to say in five, years or 10 years, I got off track and I don't look the way I wanted to look.

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percent off. Yeah, I want to talk about the celebrity piece a little bit. We were talking before we started recording. And for as many disasters that we see very publicly, which I do like to always preface this part of the conversation by saying, like, these people are under such intense pressure and scrutiny that I feel for them so much. And I think people are so quick to judge. And, you know, I see comments on pictures of people and just tearing them. apart. And then if they don't do anything, they're torn apart for aging. And so they're in an impossible position. But unfortunately, there are some pretty bad outcomes out there. And then conversely, we're seeing some pretty good outcomes recently. All the videos online are like, who is this new doctor

in town? Because some of these women look incredible. So let's just delve into that, into the good and the bad. So to avoid the scrutiny for like the shaming of celebrities, which I know there's some of that. Yeah. I don't think the celebrities have that burden at all, zero. I would 100% blame the practitioners, right? I think it's our fault as an industry. We should know better. And so I think if you look at, we'll look at Lindsay Lohan as the example recently, she's all over the place. People are showing me your picture like how does this possible. And going back to what I said in terms of the things I would ban, here's a kind of a step-by-step way to break down on a celebrity's face to see what happened, whether it went right or wrong. Look at their temples and you'll watch, and if you

measure the distance, right, from the little corner of the eye out, it should match the width of the eye. That's a simple way to look at it. It's a rule called five eyes. There was a TikTok filter that broke it down into 2020, not too long ago as well. But you can watch, they all get a little bit wider here and that's appropriate. So if you look at young, attractive, like supermodels that have never been touched, they all have width here, 100% without exception. Number two, they got their folds back here. So with Lindsay Lohan, in particular, I remember somebody showed it to me probably within the last week. So it's very fresh on my mind.

They dissolved this filler here. If I have a client, a female client who I'm treating and feminizing and making look themselves again, step one is for me to dissolve all filler here. And it's very stressful for them because even though they trust you, they see exactly what made them afraid and came in. And so there has to be a lot of trust established. And I've learned to not do it all at once. So I do some. And then I also lift and I help. So I ease that impact.

Lift. How do we lift? Yeah. What was that? Up here, up here. That's the temple. The temples and the skin tightening. God, I need that.

It's my favorite. It's my favorite and least favorite. It's kind of uncomfortable. It makes you a little sore. I do a lot with sculptra. And so it's long lasting and it builds your own collagen. Do I need that? I'll answer directly.

I'll put you on the spot. Okay. I can show you. You can be honest. I would say you a bit, a bit. Okay. But here's the risk. People build temples the wrong shape.

So just like we went through this age of Maleficent cheeks, we're going to go through an age of too much temples and two forward. Our rationales are right. They're just not accurate. So there's the big technique in our world that is you treat in a certain place. You want to do it for safety, but also you want to use as few syringes as possible and show a difference. I disagree with that concept in general. I feel like if you're actually aging and the person's not 25 and perfect, you shouldn't see a big difference with one syringe because it tells me you're using it in the wrong place. Anyway, I think that the point is, and the reason why women wear eye makeup and there's the shadowing is there's an natural absence here that's missing.

It's kind of like a C. And then the volume goes back even further. Right now, the new fad is to put filler right up here. It's making people wider, but it's also making them look a little ethnically inappropriate. But yeah, Temples is number one. Getting back to celebrities, we'll go through the, it's look here. Okay, so look for the width and look for the cheek no longer sticking out. So we think we want cheek contour, which is true, we do, but we want flatness here.

We don't want a mound here. And I always say makeup artists get it right more than injectors. So when they put a color here, they're going to put light here and they're going to flatten it and they're going to get light reflection here. I think we got confused. So getting back to the like truth in the trend, it's something and it's just the way my brain works. I love to understand. I don't assume they did it intentionally wrong. I like to understand how did smart people who meant well get it wrong. So how did we go down this nasal labial fold trend, right, ever from the very beginning? If I think it's wrong, how did really smart people do a lot of it? Well, I think it's because

we forgot about the picture and we were just narrowly focused on the eyes. The fullness here, it's 100% attractive when you're smiling. So when you smile, you should have a mound here. So we got confused at static. We shouldn't have a mound there. And so if you have a mound here at rest and then you dynamically smile and you have a bigger mound, we start seeing all these closed eyes. It's one of the things I like to do on stage. If I'm doing a live correction, I love to take this part out and you watch their eyes open up again because there's there it was probably never there. But we are, I think providers without saying it, we have this, it's challenging dealing with patients because they're like, I want to see a difference. I want to see a difference. I hate this. I hate this. And I can only spend this much. And so if I need to make a difference in the nasal legible fold, right? I have to show a difference right away.

and I put filler right here in somebody who was flat always and they haven't aged and I put it in a place that shouldn't have been, they're going to see a big improvement. They're going to see a big change rather, not a big improvement. Going to make the line that they hate look better, but little by little because we know that fillers don't go away, the way we used to say they did, you start to see this accumulate. And then when people smile, there's a lot of scrutiny on celebrities. The eye, I think, you know, a lot of harsh comments about celebrities with, you know, under eye filler or these cheeks that kind of get out of control or the old people who got beat up so much about it. They've almost opted out of all treatments and it ruined their life and all these like very, you know, probably accurate and egregious statements, right? So I think look temples, make sure their cheeks don't stick out too much past. They're temples.

And we don't want cheek contour in the back, which is, I think, another misconception. We do want cheek contour up here in the anterior or the, sorry, the forward part of our cheek, but not all the way to the end. And then we want a smooth contour. We talked a lot about masseter beforehand, the smooth contour between the cheek arch and the angle. And so it's one of those things we sometimes get wrong. If I take the whole masseter down and I get a big drop off back here, and I need confirmation, I need instant gratification when I look in the mirror and I see this drop down.

I see it and it makes me happy. It also makes me look a bit older. And so there's that constant, I joke with a lot of my patients. I say I only have two types of patients, neurotic and super neurotic. And so it's a game of managing that probably as much as understanding how to do the right treatment. Yeah, I have some friends who are plastic surgeons and they say the same. You know, they are dealing with some. Intense personality.

Yeah. It's trying to, searching for the right word. And I think there is a line which we don't talk about enough that is probably unhealthy, right, that we probably shouldn't treat them. And there's a level of delusion that probably needs real help. Up to that line, I think of those people as kind of enthusiastic or just, I feel like a lot of them are very goal-oriented. They just want to look and feel their best. And so I feel like to the extent we can, I want to help them do that. assuming we can follow

protocol that I don't think they're trading something that they wouldn't be happy to trade later. I know that everybody's space is different and everyone's concerns are different but are there any maybe lesser known

or just minor tweaks that do make such a big difference? I mean obviously the temples it sounds like is a big one. You talked about the mouth down turn. I used to do a little Botox there and there or wherever it was and it was like

chef's kiss, such a game changer. A little bit of like, a lip, there were little things. That's the stuff that I miss where I'm like, oh, where I just opened up the face and made everything a little bit lighter. But what are some of those things that maybe people, yeah, the little quick, big impact ones. Big impact, quick, or big impact, and either inexpensive or not painful. So I think you mentioned a handful of them. Everything with Botox is a band-aid, right? So it's never actually correcting something. So if I were to just summarize is one, two, three. I would do Temples, chin, maybe a bit of cheek, but then I would quickly

shift away from fillers to, I think microneedling still to this day is grossly underestimated. I need to do that. I've never done it. Really? Yeah. That's shocking to me. I know. As motivated as you've been, as many people as you talk to, by far and away, and they're different degrees. Yeah. And a practice like I have, we are on the aggressive side of it. So if I have, if I have somebody who's like, oh, I've done micrneedling. I know what I'm to expect. I'm like, no, we need to talk about this. So we're going to give you like a weekend of downtime, right? We're going to make you, it's not going to be painful, but I want to give, I want to maximize how much tightening I get, not just texture. And then I'm not opposed to saying, oh, you can't do it at

home. You only have to come see me. I don't believe in that. I think there are pros and cons with microneedling. It started out with these little stampers, and then we got these rollers, and then we got these pens or devices. And I don't love it at home, not because I want you to come see us, but I think that- Cleanliness and risk of infection. That's it. Every time we're doing it, we're damaging the skin. And we know we're damaging the skin. We're damaging it in a specific way. We're mitigating our risks. And we know we're taking a risk in a moment in time for a big payoff. I think too often, and I've seen a lot of patients come in who've gotten hurt at home, because they're doing it nonstop every single day with the same device.

They're not giving their skin enough time to heal in between. They're probably not cleansing the needles. The needles get dull over time. And the way that microdealing works doesn't cause scarring because you have a sharp needle that creates a perfect puncture as opposed to a tear. As those needles gradually, our skin in another context is kind of like leather. So our dermis is way stronger than we think. And so as we gradually do that, they get dull.

So I'm not a fan not because I don't think it works. I think it absolutely works when it done well. But I want, I would say I would rather you do it all your injury in one moment where we can keep your skin clean, make sure we're not putting the wrong products through your skin and then letting your skin heal. So I would say there are sophisticated versions with energy and all kinds of other fancy things. But at a base level, to answer your question, probably the dollar for dollar, most

over underestimated thing that exists, is micrneedling. Wow. And it's the one thing, in your case, specifically, is doing those taping and you don't love the lines that can help keep your bank restored so that with your taping and your skin care, you might always stay ahead. Yes. I've had it scheduled multiple times. And I tell my team, don't book any podcasts for, you know, if I'm doing it on a Monday,

Tuesday, Wednesday, maybe I'm good by Thursday or something like that. Or let's do it on a Friday. I've had it scheduled so many Fridays. and then something comes up on the weekend. So I just have not had any time to really have downtime where I don't have to wear makeup or be presentable for whatever reason. But I think I'll do it this break. Do it as soon as you can.

Okay. So tomorrow we're doing it, right? Fort Lauderdale. I'm on my way. I can schedule it. I think you'll be shocked. I think it's the number one thing that people regret not doing sooner. It's also horribly branded and needs new marketing.

Right? Microneedling for many. I know that you've done other things in the past. You're not deterred by the discomfort or the like process of it probably not at all. I love it. I have a lot of clients who are like, I don't care at all. I'm like, well, a lot of people do. A lot of people are nervous about the pain.

A lot of people are nervous about the recovery. And it's probably without exception, the only thing that we've ever had that makes us a real impact in all skin types. Almost without any. I mean, there are some things you have to watch out for in little, little risk. that I won't say there are none, but it's the only treatment that actually has a really meaningful impact on all skin types without exception. And so, yeah, that by far is, by far in a way is probably the most important. I would say if somebody's trying to make a quick impact, then they have not done that yet. So restoring the volume in reverse order. So we already talked about that,

temple chin, and then getting skin care right for your skin type. So, and we can, I don't know if we have enough time to cover all these, but all these Korean beauty, like Koreans like glass skin, all these skincare regimens out there. I have a 16-step regimen. I have a 25-step regimen. I probably take people off of skincare as much as I put them on because they're over-injuring themselves. They're doing too much. In that same neurotic, slightly neurotic group, there's a big tendency for more is more. And we're absolutely a pendulum as an industry, right? You've got somebody who goes, as aggressive as possible on skin care.

And then the second they have a bad reaction, then like, oh, I'm all natural and I go to only organic natural things, but then plants cause a lot of allergies. So we cause more problems. And then we swing back to, okay, now I'm on nothing. I'm on water. Now I'm on tallow. So, you know, I think that there's just a dynamic thing.

And I think it's because people, part of my training was on allergy and skin reactions. So I spent a whole more than a year of my life, doing allergy testing to ingredients. And so I know a lot about ingredients and skin care and true allergy versus reactivity and all kinds of stuff. But I see, and I think the timeline of it is frustrating. So you get an exposure. And I think that's why it lends itself to people not be able to figure out on themselves

and getting extraordinarily frustrated, is that you get an exposure and you don't see a reaction for a week. And so by the time you have your reaction like, oh, no, what did I change? You look back in the recent days and you're like, oh, this thing did it, and you completely missed that it was exactly this other thing. But I think getting skincare right, it can make a huge visible difference. It's relatively, I mean, it requires consistency. And to simplify it even further, I would probably do, without being too biased,

I would probably do like a dual acid cleanser. It's something you put in your shower, like an AHA, BHA wash, is probably the simplest, most impactful thing outside of adding a retinol that somebody could do on their own. I do a glycolic cleanser, and I feel like that changed, totally changed the game for me. And glycolic is fantastic. Clockcolic's a little unpredictable. Molecule size is very small. Penetrates really well.

Work trade for pigmentation. I tend to be pretty nerdy when it comes to this stuff, so I'll try to spare everyone that level. But I think you have two phases. Think about it as oil and water. So as we think about our skin microbiome, as we think about our skin surface, we're always trying to work in either the oil layer. or the water layer. And so glycolyc works in one, the others work in the other. So I like to hit both of those. Amazing. Well, I could keep going for hours. I know we're pretty much out of time here. But let's end with what is something that you want people to stop doing? I'm sure that you just see all

of these trends and practices and everything. Is there one universal thing that you're just like, God, I wish that this was not a thing. I'm sure there are multiple. That's a hard question because there are so many. And I've already mentioned them a few times. Like as a woman, I wouldn't allow somebody to treat nasal legible folds, periform aperture, marionette lines, which is crazy because those were all of the original procedures that we specifically designed for women. They were almost universally wrong. I would try to not panic when anything went wrong. So I would avoid the, I would avoid the vacillation. And I see it, you know, we'll talk about that client I mentioned earlier. She got mad at me for something or even if I have a patient with a complication.

I still get bruises. I still get swelling. Those things really happen. But the reaction to it is usually the challenge is that they're so mad at you. They don't trust you. They don't listen to you. They don't let you help them get better. And then they go start bouncing around.

And I feel like whether it's you had a skisht. care product that caused you to have a rash or a reaction. And so you go through this crazy cycle of like buying every skincare product and bouncing all over or you have a bad result with a practitioner. And so you start bouncing to new practitioners and telling your story and trying to find an answer that isn't the answer you didn't want. I wish people would kind of stay a course, assuming they're getting accurate information, which I know was the challenge. I don't want somebody to stay the course in our incorrect path. But I think that vacillations and these hyper, hyper responsive, like, I'm going to go from one extreme to the end, almost universally ends up in people getting hurt or going through pain or suffering, frustration, financial waste, way more than they would have to otherwise. Amazing. Well, this was so helpful and fascinating and fun. You'll have to come back next time I'm here.

There's so much that we can still delve into. Yes, my favorite thing to talk about. So thank you so much for coming and tell everybody where they can find you. So they can find my practice is jubilee aesthetics. Juvely underscore aesthetics on Instagram. It's the most common there. I treat in New York and Florida, but I have a big team. We have 11 offices in six states. So, and everybody in our clinics are trained the same. So they can find us at any of those places. I'm on Instagram with Justin Harper, MD. Admittedly don't do much there. And then I do a conference. It's a big aesthetic conference. The biggest, I think, in the industry that is purely education for practitioners. Because as you have, you heard me say, I disagree with the way a lot of things done. So if you agree to disagree that I should try to make it better. So yeah, all those places. Thank you so much. Thank you. I hope you enjoyed that episode. If you liked the episode and if you liked the show in general, please take a second to rate, review, and subscribe. It goes such a long way in supporting the show. Follow the show over on

Instagram at well.pod. You can also follow my personal Instagram at Ariel Lurie. I'm always sharing great clips from the episodes, and we also have full episodes on YouTube as well if you want to watch in entirety. Thanks for listening. 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.