Well with Arielle Lorre - 468: The New Rules of Aging Well: Botox, Filler & Looking Better for Longer with Dr. Doris Day

Episode Date: July 13, 2026

Dr. Doris Day is a board-certified dermatologist, clinical professor of dermatology at NYU Langone Medical Center, and one of the country’s leading experts on cosmetic dermatology and healthy aging. With decades of experience helping patients age naturally, she’s known for taking a thoughtful, long-term approach to aesthetics that prioritizes harmony over perfection.In this episode, Dr. Day explains why chasing wrinkles isn’t actually the best anti-aging strategy and what to focus on instead if your goal is to look naturally youthful for decades to come. We dive into how facial aging really happens, why so many people get Botox and filler wrong, how to stack treatments for the most natural results, and the biggest mistakes she sees women making in their 30s, 40s, and beyond.We also discuss:Why wrinkle reduction alone won’t make you look youngerThe first signs of facial agingThe difference between being “currently hot” and “lifetime hot”The truth about Botox, filler, and biostimulators like SculptraHow hormones impact the way your face agesWhen to use Sofwave, MOXI, BBL, and other lasersHow to get the best results from aesthetic treatmentsThe most underrated skincare ingredientWhat every woman should start doing in her 40sWhether you’re just starting to think about prevention or looking to refine your current routine, this conversation will help you approach aging with a smarter, more strategic perspective.You can find Dr. Doris Day on all platforms @drdorisday. Visit Sofwave.com to find a provider near you.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.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.

The following podcast is a dear media production. This is Well, a podcast about wellness in all its forms. I'm Ariel Lori, and each week I'm sharing unfiltered conversations with people shaping how we feel, live, and look. Come for the substance, stay for the honesty, and leave with the tools to be well, inside and out. Today, I am talking to Dr. Doris Day, and before I go any further, I definitely recommend checking out the clips either on social media or the full episode on YouTube because she has the most beautiful skin and I was so envious for one specific reason. So she is in her 60s. She has flawless skin, especially on her body. And she said that she never laid in the sun. I think she said that

she laid in the sun for 10 minutes once and she never heard the end of it from her dad. And so she just never did it again. And you can definitely tell. Anyway, she is a board certified dermatologist. She's a clinical professor of dermatology at NYU Langone Medical Center and one of the country's leading experts on cosmetic dermatology and healthy aging. And with decades of experience helping patients age naturally, she is known for taking a thoughtful long-term approach to aesthetics that prioritizes harmony over perfection. And we really get into that in today's episode. Something that I loved so much about this conversation was that she really is not about just chasing wrinkles. In fact, she said that that is not a good anti-aging plan. I think that we have fallen into this trap of

thinking that a wrinkle or movement symbolizes aging when it really doesn't. And there's really so much more going on in our face and in the harmony of how everything works together that needs to be paid attention to. So we discussed that. We talk about what to focus on instead. If you your goal is to look naturally youthful for decades to come. We dive into how facial aging really happens, why so many people get Botoxin filler wrong, how to stack treatments for the most natural results, the biggest mistakes she sees women making in their 30s, 40s, and beyond. What to do in your 20s, we talk about how hormones impact the way your face ages, the truth about biostimulators like Sculptra, the difference between being currently hot and lifetime hot. This is a topic that I'm

passionate about. And then we also talk about treatments like BBL, Moxie. She talks a lot about softwave. She loves it and swears by it. In fact, she does it every six months and said that people think that she's gotten a facelift. So I found that to be intriguing. And it's something that I am considering. You can go to softwave.com and find a provider near you. So I'll keep you guys updated on that. We talk about the most underrated skincare ingredient, what every woman should start doing in her 40s, and so much more. So if you are just starting to think about prevention, even if you're in your 20s, your 70s, wherever you are in life, if you are looking to refine your current routine or just learn more of this conversation is going to help you approach aging with a smarter,

more strategic perspective. So please enjoy the delightful Dr. Doris Day. Welcome. Thanks for having me. I cannot wait to talk to you today. We are going to get into so many different topics all across beauty, aging, aesthetics. But I want to start by doing a quick this or that and lightning round to set the tone a little bit. Let's start with this or that. I was just doing these with Dr. Idris, by the way. And she said, this is not fair. This is like asking me if I like oranges or pants, like completely different. She's so smart. I know. Botox or sculptra. Oh, stop. Can it be Botox, this and that? Yeah. No, you have to pick one. Gun to your head. one, but we can circle back. Oaxil or softwave?

Softwave. Prevention or correction? Prevention. Filler or lasers? Filler. In office treatments or consistency at home? Consistency at home. Red light therapy or migra-needling? Red light. Collagen banking or wrinkle correction? Rinkle correction. Natural movement or perfectly smooth? Natural movement. I feel like that's coming back. That's always been here. Okay. It's always been here. But I feel like we lost the plot a little bit. Maybe more in L.A. than here. I think people lost the plot, but I think there are doctors. I mean, I like to think of myself as one of them, but I've always said, I don't chase wrinkles. I understand them. And then you treat the source and the wrinkles get better. But if you chase a wrinkle, you may achieve your goal of not having a wrinkle, but you defeat the purpose because now you don't look better. Right. The purpose is to look better. Not having a wrinkle doesn't always do that. Talk about treating the source. Treating the source means understanding why that wrinkle is there. The one that I've

done a lot on my social media is talking about the foreheadlines because that's when my 20-year-olds come in and they're like, oh, I'm getting foreheadlines and they hate it. And then the easy thing is just Botox it, right? Using a norm modulator, erase that ability to move. But if you say, well, why are you making forehead lines? Most people make forehead lines because they're contracting their forehead muscle. That's why you make forehead lines. That's not most people. It's everybody. You make it by repetitive motion and collagen breakdown. So sun can break down collagen, repetitive motion, repetitive motion will break down collagen. And then once you have that crease, you keep moving into that crease. That's the weakest area. So every time you move, it's a path of least resistance,

you move into it more. The crease becomes deeper and that's a wrinkle. So to stop the ability to move that is going to defeat the purpose because if you see why it's happening, it's either because the brow is dropping or the lid's getting heavy. It's not an expression. It's a function. People raise their brows, mostly when they're trying to let more light in. So they do that to look alert. If you look at somebody at rest, and I'll tell you very quickly, there's three types of facial expression. There's a resting facial expression. For most people, their face is smooth. If you at rest are doing this, that means your lids or your brows are so heavy that even at rest, you have to use muscles to lift your forehead to keep your eyes open. Then you need a brow lift or you need something

that's going to get the brows up. If you're doing it on natural animation like I just did, it's either a bad habit or it's because your eyes and lids are starting to get heavy, which can start in your 20s, then you do something like softwave that's going to lift the brows and that's going to solve the problem. Or you do a neuromodulator between the eyes that lifts the brows or at the lateral part of the eyes to open the brows, to open the eyes, that's going to lift it. And then I teach people to lift their ears instead of their brows. How do you do that? Okay. Let me show you? I feel like I've seen this on social. Yeah. So this is resting and that's, wait, resting, that's lifting. Wow. Your brain feels that as a lift. The way I try to teach people is if you take a slow, deep breath, breathe all the way out,

relax on the way out. Relax your jaw, relax your eyes, relax your shoulders, and I'll smile really big. Generally, you didn't, but when you smile really big, your ears go back. So it's a component of a smile. And your brain feels that the same way as it feels your brows going up from contracting your forehead muscle. So I've taught myself to pull this way instead of this way. Wow. So you can do that. I feel like you need to practice.

It took me a year. But there are people, if you start doing that and you do it consistently, you'll forget how to raise your forehead. So if you Botox the forehead and you erase the ability to move, then what happens is, happens is your brain is still trying to do it because it's a function. It's not an expression. It's not being expressive. It's that you're letting light in your eyes. So if you fight it by stopping it, one, you weaken that muscle, which is going to drop the brows more, which is going to age you faster. And two, your brain is still trying to do it. So any part of that muscle, and this muscle is a big muscle. Any part of the muscle that can move is now going to hyper move, and you're going to

look weird. So I do Botox in the forehead or any of the neuromodulators to even out browse, but I won't do it to take away all movement. And when you do it correctly, you get less lines, you get better lifted, you get better aging, and you feel better. So another one is when someone has a line here. So this line here usually comes from your masseter being overgrown from grinding or clenching. So instead of filling this line, because what happens is, when this muscle overgrows, you've shortened your face. So when you smile, it pushes forward from here and back from here, and you create this crease. If you relax a masseter and sometimes put a little filler behind it, now you've solved the problem.

The line goes away. Now you don't look like a chipmunk cheek. Your face looks lifted and smoother and you age better. So when you combine fillers, devices, neuromodulators, skincare, very carefully, the line's naturally self-correct. Your movement is natural and authentic. Your trajectory for how you age is better and you feel better. And you look authentic. Yeah.

So when people talk to you, you don't look stiff, you can move, and people know what you're thinking in the right way. It's so interesting because I think that so many people, both patients and providers, look at it as treating an area, right? Like one area specifically, like you go in exactly to your point. You don't like your forehead or you don't like your master's maybe, or you don't like your master's maybe. or you don't like your crow's feet, whatever it is. And they just treat that area specifically and just

knock out the movement, right? That's like the intuitive thing to do, I guess. It's an easy thing to do. Yeah. It might be intuitive to the patient. Yeah. Because we look at ourselves and sort of pick ourselves apart. Yeah. But just think about it. When you look at someone else, do you look at an area or do you look at their face? So I always think of the face as a single aesthetic unit and the neck as well as part of that. and I look at someone when I walk in their room, their initial expression at me tells me a lot. Even if they make eye contact or not tells me a lot, their body posture tells me a lot.

So I sort of take it all in. And when I start talking with a patient, I talk about everything but skin for a few minutes. And just sort of watch their natural animation, is one side higher than the other, which is their stronger side of their face. I just sort of take it in. What do they choose to tell me about themselves?

All of that gives me information that helps me understand what I can do for them that will make a difference. And then we get into the skincare and what they've been doing. But I know so much just from a general conversation. Yeah, I have a really good friend who's a plastic surgeon, and he does that too. And every time I see him and we're having a conversation, he's looking at me, but I know. And I'm like, you're doing it right now. Stop doing it.

I know that he's watching how my face is moving and certain things. And I'm sure when you're in your position and you love what you do, it's hard not to do that and look at the face because it's probably interesting. It's interesting. But I don't look at the face that way. I'm not critiquing. And also when I have someone look at their face, I always kind of catch people off guard because I look at what we love about their face. Like everyone has beauty. So their instinct is to complain, right? Well, they're there to show me things they don't like. But I always like to start with what we love. Like you've gorgeous eyes.

People have beautiful cheekbones. Great features. Even the way their hair frames their face, their skin tone. So we point out their best features. And that helps frame. the whole visit around celebrating and enhancing their beauty as opposed to going from more flawed to less flawed. Because that to me is the most important thing is that we all have beauty. And actually, I think it's kind of a gift to not be genetically blessed by being a supermodel. Because the people that I see who are so beautiful also age. Yeah. And they don't take it well. They come in. They're still more beautiful than everyone else. And they still complain about the same things as every everybody else. I find that the most beautiful people I know are the most hypercritical of themselves as well. Yeah. And I think it's

because they didn't earn it. Yeah. They were born with it. And now they're trying to maintain and enhance it. But if I work for something, I know how I got there. And it's mine. I call it Lifetime Hot. I'm like, I would rather be like what I am than like Lifetime Hot because people I know they're Lifetime Hot. It's not, it's not always a gift. Exactly. Exactly. Some people know how to hone it or, you know, I tell. You appreciate it more. Exactly. So my young patients, like teenagers who come in and they really are gorgeous, I tell them, get all A's in schools. Yeah. And make sure that you have a plan B besides being hot. Yeah. Yeah. Peptides are growth factors. Peptides. SPF or a retinoid? SPF. These are so unfair. I know. What is the first giveaway for aging, neck or eyes?

Eyes. Looking younger or looking refreshed? refreshed. Okay. So now I want to rewind a little bit. What does aging well mean to you now? We were kind of talking before we started. You're how old, if you don't mean saying? 63. Almost 64. Crazy. You have the most beautiful skin I've ever seen. How has your perspective or your view and your approach to beauty and aging changed maybe from when you were 40 to 60? Well, I've been very lucky that I come from a family of doctors. And my dad was my OG longevity guru. And I like to think of myself as a youngest apprentice.

And growing up, he always used to tell me that we all should die young at an old age. And I kind of added later, and he would agree that we should look beautiful doing it. So I've sort of been into longevity for a very, very, very long time. I've been talking about hormone therapy for a long time. I've been doing it myself for almost 15 years. I've been preaching it for like 20. And it's been an uphill battle for the longest time because I feel like medicine has fallen so far behind and sort of stagnated.

And unless doctors stay curious and skeptical, we don't get anywhere. And we end up being in this rut of looking only at evidence-based medicine, which I think is great. But I think with experience, there's something called evidence-informed medicine. So for me, when I look at this whole journey, I think I'm still at the beginning of it. I know that it's mostly lifestyle. I've always exercised. I intermittent fasted when I was younger. I sort of stopped that in the past couple of years because it doesn't work as well once you hit menopause, even if you're doing hormone therapy. So I do it intermittently, but not as routinely as I used to. I've made some adjustments as I've aged, but I worship my sleep schedule. So I'm really, really big

on making sure I get seven to eight hours of sleep in night. And when I go to meetings, I'll sleep rather than go to the parties. I don't enjoy anywhere usually. But aging well as you get older is so doable, but it's just more work. You just have to put more effort into it. You have to really work on the resistance training. You don't get the time off. So your margin is less and less. So when I was 40, I could eat more and then take a week and I get back to where I was.

Now it doesn't work quite that way. If I wanted to lose weight again or if I sort of went on a binge or got lazy, building it back takes a little bit longer. So your margin to recover and to get back to where you were is longer and harder. So you have to be more consistent and work harder in what you're doing. But my mom is 93. And she's perfectly healthy, lives by herself in my building. And I see her every day. I take her breakfast. We chat. She walks me to the lobby, waves goodbye as I go to work. So it's so cute. She's adorable. But she also works out every day. She has a stationary bike at home. She has a stationary bike at home. She walks around the garden. She has her friends. She plays poker with in the community room. But

you have to work harder at it. And that's the thing that I feel, but it's kind of fun. And I study every day. I'm still building. I'm still growing. I don't think of the number so much, but I also do more in terms of, I do hormone therapy. I take more supplements. I focus on quality of the food. I eat more. I see a functional medicine doctor. And I add those things in. So it's work. Yeah. I was just in Greenwich over the weekend for my grandmother's 99th birthday. Aw. It was, I have to say, amazing. She invited 12 of her close friends. Were they all 60?

No, they were like all in their 80s and 90s. Beautiful. And I give her so much credit. And a lot of people ask me like, what's her secret? And oh my God, she looks amazing. What has she done? She's had a little help. She wouldn't mind me saying that externally.

But I always say, I don't think that she ever saw herself as old, maybe until like the last year or so. but she still doesn't identify with that. She never slowed down. She was always social. Yeah. She was always active. She was always stimulated by a lot of different things. But I think that there are, to your point, lifestyle things.

Like, how are you living your life? Exactly. How are you living well that really contribute to longevity? Absolutely. I mean, I'm married 36 years. Still like my husband. My son lives in my building with his wife. My mom is in my building.

My nephew's in my building. My daughter's downtown. I see them all the time. we're super, super close. And yeah, you keep your social circle. I go on a girls trip every year. But what happens as you get older is things that matter rise up and things that don't fall away. And you don't care about things that don't matter as much. Like I don't get caught up and stuff. Like it's just, I don't care what anybody thinks of me. I'm not out to please anybody. I've reached the goals of my life. I have the most beautiful children who are accomplished.

My daughter's going to be a dermatologist. My son is doing amazing work. He's a policy director at a think tank. They're great people. They're contributing to society. I travel. I do all the things I want to do. I love to read.

I'm writing. I'm building. I have a radio show. Like all the things I want in my life. Now I get to still enjoy it and still build and grow. So all the things that build anxiety in somebody who's 20 and 30, I'm already over that. And I can still look back at it and go, oh, God, that was fun. And I still have more.

to go. So yeah, you never let that old person in. You never think about age or a number. You just think, what is, what do I have on this day in front of me? And what is my attitude going to be? And I learn a lot from social media. I started doing this with my grandkids now. When we wake up in the morning, I say the same mantra, today is a great day. Everything is going my way. So I say it with my grandkids when I'm with them. And then I add, and my patients are all happy and beautiful. So you just keep building in your mantras. And what I learned a long time ago, that life is in your head. And the way you choose to see things are the way things are.

Because you could put two people, give them the same situation, and one won't see it the same way as the other. But the situation is what it is. So you get to choose how you look at a situation. And I am doing my best every day to choose to be happy and choose to contribute, choose to make a difference, choose to grow, and live every day like this was it. I love that. Do you think that there are things that women should stop obsessing over when it comes to aging? Yeah, aging. Yeah. Because it's going to happen. Yeah. And we're getting better at it. I think if you're going to

obsess over it, do something. Right. If you're going to obsess say, well, what are you obsessing over? If it's aging itself, then are you using enough sun protection? Are you drinking enough water? Are you taking the right supplements? Are you eating the right foods? Are you giving up sugar and alcohol? Are you sleeping well? Are you managing your stressors? It's not to not have stress. We all have it and we should because that's how you grow. But how do you manage it? Do you manage it as everything is the end of the world or this is a puzzle and I'm going to figure it out? So those are your choices. But if you obsess over things you have no control over, then it's going to age you. But if you obsess and you think, what can I do about it? If I can't do anything, I'll try to let it go. And it's work to do that. And sometimes if you're obsessing over something and depending on how old you are, if it's something that's new, you really might need hormone therapy. You might need some guidance. And that's okay. But I would try to recognize it and make a decision about it. But we have choices. Yeah. When it comes to things like hormones and I'm 40, so I feel like I'm probably in like a little bit of a peri, very menopause situation now. I mean, I'm sweating, like soaking the bed every night. I feel like I have

four good days a month. I tell everybody this. I think it's time for me to explore some kind of HRT, because my hormones were always kind of wonky to be in with. But I feel like 30s into 40s and beyond are kind of this age of like frustration for women, both in how we feel and also aesthetically. Dr. Idris talks about these aging peaks, right? And I think there's one around like 44. Yeah. So things start to change. And we were talking before as well. about like estrogen and what are some of those major changes that start to happen, like 30s to 40s when we start to see some aging around our eyes, some sagging in our jowls, you know, we're losing volume, we're losing bone, we're losing collagen.

Yeah. Our skin is getting thinner. We can't retain as much water. At what point does that usually start and what can we do about it? Well, it starts probably in your 20s. Oh. But then it hits tipping points at the inflection points that Shereen, Dr. Idris talks about. And that's, that's been studied and that's documented and published.

But the reality is that it is different for different people. And around perimenopause, it can be in your 30s to your 50s. So it's a broad range. And I think that makes it really hard because in perimenopause, you're still fertile. And you can still have babies. Less fertile, but still fertile. Yeah. So a lot of women just stay on birth control for that period of time, which I don't really love.

But I think if you. look at coming up with a strategy. Younger, it's simple things like sun protection, things like clear and brilliant, occasional fraxals. I like a CO2 every now and then. I start with softwave in women in their 30s and I tell them do it twice in the first year and then once year after that. Now, I have other devices, but when I have somebody who's young, like in their 20s or 30s, not early 20s, late 20s or 30s, my goal is to do as little, in terms of injectables as possible. It could be some neuromodulator if they need, if they're hyper-moving an area or if I'm evening out something. That's fine. But not what people call preventive because

I don't want to take away movement. I want to redirect it. I want to control it. I want to guide it. I don't want to take it away. So when I have a device like softwave that I know is not going to melt fat or affect muscle or filler or anything that's behind it, it's just going to improve your your skin quality, your skin texture, it's going to tighten and lift. And my daughter is 34, and she's a dermatology resident. We did softwave for her, and she's a skeptic. And she's very science-driven. And she came back and she said, Mom, this really works.

And patients came back consistently, and they tell me, this really works. This is the best thing I've done. Has no downtime. It's not an immediate effect. They have to come back and tell me that they see a difference. I always combine it with skincare. I try to get them motivated. but it's really encouraging for me when I have a device and I can see the science is there behind it,

the data is there, but is it going to work in the world? Are they going to be happy? And they are. And they come back and they send their friends and they do it consistently. That makes me happy. So in your 30s, the goal is understanding that your estrogen is changing, your collagen production is changing. Now you want to protect and repair because you're not making it the way you used to when you were a kid. What is the mechanism of action with softwave? Like how is it different from another, say, RF microneedling or alt therapy or something like that? I usually compare to alt therapy, which I also have. And I do it for some patients, but I've switched over to softwave a lot more because altherapy is lines of energy.

So the energy goes to whatever depth you pick and use an ultrasound to see the depth. Make sure you're not hitting muscle or bone or nerves. We can't see nerves, but muscle or bone. So you're picking your depth. but the line of energy, it goes in, and then at the bottom is where the energy is delivered. And that, if you're in the wrong place, can cause some problems. Softwave is synchronous parallel layers of energy. It only goes a millimeter and a half into the skin.

You don't need to be beyond that. If you're affecting the skin in those synchronous parallel layers, you're going to build collagen, you're going to tighten and lift, and you'll improve skin texture. So it's even FDA cleared for acne scars. It hurts a lot less. It's not that it's, there's no sensation to it, but I call it more discomfort than pain. It's a crescendo. So it's like, I'm okay, I'm okay. And then in some areas, at the heat, and then it drops off. So it's like this and then off. And some areas, it just feels

warm. But what I saw, and I see it in myself, when I do softwave and I religiously do it every six months, because when I started doing it, after my fourth one, patients started asking me if I had a facelift. It's not a facelift. Only a facelift is a facelift. But when patients start asking you, what did you do? And you haven't done anything. And that's the only thing I did. I hadn't done fillers. I only do fillers once a year and very little. I do my Botox. I use Daxify usually or disport. I do it one and a half times a year. Just because that's all I get to. And because I'm controlling my movement and because I'm okay with moving. But I do my softwave every six months. But my neck is where I see the most improvement and around the eyes. But everywhere, my jaw line, it's just,

I'm happy after I do it. And I look in the mirror and I don't want to go, yeah, quite as much. What does it do around the eyes? Like, does it help the crow's feet? Yeah, crow's feet and creepiness. Okay. Okay. Yeah, because I feel like everyone has their area. Mine are my eyes. That they hyper fixate mine as well. I have like, not my under eyes. My under eyes. I mean, I've done things. I did fat transfer in 2021. Smart. And I did a lower skin pinch in 2022. Yeah, I can't do a skin pinch. Because there's a thing. No, it's called a snapback. So when you pull down, how long does it take to go up? Mine goes, oh. Other people go whoop. Yeah. Yeah. So if I do that, I'll be pulled down. So it's, it's unfortunate. But oddly enough,

I don't have genetically great skin quality. But I had a dad who was very, very. smart. And even when I was little, he was like, never go in the sun. Because he had older sisters, and he saw that they aged really poorly. So he recognized that UV rays, not good for the skin for aging. So I was in a library all summer, every summer. You're so lucky. Yeah. In the end. And I sat in the sun once for 10 minutes in college. And he reminded me for the rest of my life, you remember that time? You sat in this sun? And now you are the dermatologist. I told you. you have the most incredible skin. Yeah, I was telling you that's my regret was, you know, then we were all doing it in the early 2000s on the East Coast. Not everybody, but the tanning beds

were a big thing. And this is before spray tans and being as tan as possible was very trendy at the time. And yeah. And my mom was like, don't do it. She was? Yeah. She was. Yeah. She had tanned a lot in her teens and she got very, very tan. But then she stopped. And she still has amazing skin. she's in her early 70s. But she warned me, you know, it looks good now. It's not going to look good later. But again, back to what I was saying, like, you're kind of, you know, young, you're naive, you're arrogant. You don't think that it's ever going to happen. You're immortal. Yeah. Totally. Yeah. Well, I came up with my best line in my whole practice of talking to patients because I keep trying to convey to them why they need to use sun protection. Yeah. So my line finally that I saw like,

patients listen, they went like, I get that. It was, nothing looks more beautiful in your 50s. Now I say 60s than sun protection. in your 20s. Yeah. It's true. See? It's really true. It rings. So I do preach. And I had a patient who came in a couple of weeks ago and her neck was beautiful. And I hadn't seen her in forever. I didn't even know I'd seen her before. I thought she was new. And I said, your neck is pristine. It's so beautiful. She was 40. And she goes, it's because of you. And I was like, me. Thank you. What did I do? She goes, 20 years ago, you told me to do sunscreen on my neck and go in an upward direction. And I listened. And I was like, oh my God, I'm old enough with someone I gave this advice to 20 years ago.

I understand that it worked. That's amazing. Yeah, well, I always say that at my age now is when you can start to differentiate the sun worshippers from the sun protectors. And I mean, thank God for things like IPL and Praxel, which like my chest was so modeled with pigmentation. Now it's totally clear. I did a moxie BBL on my chest. Okay. And then I bought the device. I had a friend do it for me. And it was in one visit, it cleared up so much. I was like, I have to have this. Yeah. I mean, thank God for technology. that, but at a certain point. And you made me pick into this and that. Yeah. So rude. Still remember that. I'd soon that hurt. You mentioned before that when you are using something like a neuromodulator

or when you're treating the face, you like to use something like a soft wave as well to help lift and then use it like strategically. So what, so it can lift. It can tighten. Yep. Improved texture helps with cellulate. Okay. So yeah, it does, it does so many different things. But I find what I like about it too is that I can also do it in areas. So I'll do a whole face, but then I can have them come back and just do eyes or just do brows or just do neck or just along the jaw line. So we can focus areas with it. And we can even do upper lip, which shortens it a little bit because it restores the skin. So instead of getting a lip lip and a cut, we can have a nice impact there. But it helps wrinkles and texture. So I just find that it's such a versatile device, great on all skin tones,

and just doesn't have downtime. So people come in and they're just really happy. They do it. They go. And then that evening, I'll have them do a carboxy mask, a CO2 lift because I think hyperbaric oxygen afterwards amplifies the benefit. So I'm always looking for ways to say, okay, how can I get the most out of this device? I look at the tools in my office as opportunities.

So if I'm doing a CO2 or a fractal or IPL or anything else, I'm always thinking what can I do around it that's going to make it even better. And CO2 now, for example, I don't think of it as the main event. I think of it as an opportunity to deliver actives to the skin. So how can I get more out of this? So I'll do softwave CO2, topical vamp or growth factors, and then home care before and after to maximize the benefits. So if I'm going to do anything to the skin where I'm asking it to produce more, I have to think, how am I going to support the skin to when I stimulate it and I ask more of it that it's going to be able to do it and it's going to be able to do it well at any age?

Because a lot of the devices and treatments are dependent on your body's ability to produce collagen, right? And I don't want to count on that. I want to control it. Is there anybody who it's not appropriate for? I ask because anytime I'm having a dermatologist or anybody in aesthetics on people always ask about softwave. I think Kim Kardashian posted about it, right? Yeah, they keep doing it. And Brian Johnson, I think he even has one. Like he gets it done regularly. He says of the three things he did, does regularly, that's the one that's up there in this top three. That makes me happy too because

I see the value and the benefit that my patients do. But I think if you have silicone in your face, if you had silicone injections, I'd be careful. If you have something like scleriderma or lupus, I'd probably be careful and get talked to the doctor first. But for the most part, no. It's definitely not anything to do with skin tone. So it's good for most patients. But for my patients who've had silicone injections in the past,

and a lot of people won't admit to it, or they'll think it was 30 years ago, it doesn't matter. But the reality is silicone is forever. Or if they have aquamid, there's things that they inject in other countries. So you have to know what's, in somebody's face because if you inject, now this goes only to the skin, right? This isn't going through the skin. So I'm not worried about stimulating something deeper, but silicone can be very reactive. And some fillers that are not in the U.S., I don't know where they're injected in the

skin. So there I'm going to be careful, but otherwise, no. Do you feel like aging is more the structure of the skin or volume loss or is it a combination of both? And does it depend on the person? Well, I think there's commonalities to how we age. So everybody as they age, their skeleton is going to shrink. So I look at people, I think about like all these games people play where you go to a company event and they ask you to send a picture of when you were in high school and you have to guess who it was because you look like a different person. Yeah. So I think as you age, you do look like a different person. And I tell people that once you go through your 50s, 60s, 70s, you do look like a different person. You're not less beautiful. You're just a different beautiful. And I look at some people, I have patients in their 90s to hundreds sometimes, early hundreds,

and we're still doing stuff. And they're beautiful. What are they doing? Fellers, Botox, lasers. We're doing everything. And many of them are still working and they're active and they're out and about. They have the most incredible mindset. It's really inspiring and encouraging. But their skeleton has changed. So the orbit, the bone that surrounds the eye, which is why I said the eyes before the neck, the orbit that surrounds the eye is a bone, and your eye is sitting in a hole.

When that bone shrinks, the hole gets bigger. So the brow can drop and the eye sinks in. And that happens as early as your late 20s, early 30s. It can start. So you start to see that shifting. And then it's asymmetric. So your left and right side are going to be a little bit different. And as that happens, I need to adjust around it.

That's why filling under the eyes is problematic because your eye is sitting in a hole and it's being held there by ligaments and muscles and then superficial and deep fat pads. When you think about it, the anatomy that we're using now is injection anatomy. It's different than surgical anatomy. In surgical anatomy, they don't need to understand the planes of things as much. But in injection anatomy, the ligaments and the superficial and deep fat pads, we've only started to figure this out over the last 15 to 20 years. So we're still in the infancy of knowing how to do these injection techniques, how long these fillers last, how they break down. I was one of the sites for the first filler to get FDA approved in the U.S.

So I've been using, and that was Rest Elaine, I actually created the scale that was used for the FDA studies. And that's still the number one scale used for validation for FDA studies for fillers. And it was always for nasal label folds. So I've been doing this since it existed in this country. And I can tell you we're still figuring it out. Now we know fillers last a lot longer than we thought they did. We have a lot more options of fillers and how to use them. We have to be more careful.

I may use one filler for here, a different filler for here, different filler for here. but there are people who think that one filler could do everything. It can't. So you have to be super, super careful. You have to know what that filler looks like when you put it in, but also how is it going to behave when it starts to break down? And this was a big problem with filler around the eyes because people would put fillers in,

but some of those fillers like duvidarm, when it breaks down, it starts to absorb more water. So you see swelling three, four years later, and that can last 10 to 15 years. I only use wrestling around the eyes because that doesn't happen with wrestling, and I use a tenth of a syringe. I undercorrect, observe, and then we come back and see if we need to add more. But you never correct to 100% around the eyes. So it's just a matter of figuring out, and you don't start with the eyes.

You start with the midface. You start with the temples. Start with the cheeks. Start with everywhere else. Or at least evaluate and know where you need to go. But you almost never start with the area that you see. Again, it's understanding the source, not treating the hole or the line. And then you get the proper correction.

And what we didn't realize about fillers, we think about it with neuromodulators, right? Neurmodulators affect the connection of the nerve to the muscle. But fillers also displace movement. And they change the way your face moves. So if you use too stiff a filler around the mouth, it changes your smile and it changes how you age. So you have to be really, really careful. Around the mouth, I basically only use redensity because it's very soft, very flexible, very stretchy. You never see the filler. It doesn't lump and it looks beautiful. So now I do, and you need so little.

So you just have to pick the right filler. And sometimes you don't need the whole syringe. You're not paying for a syringe. You're getting your money's worth when you look better. It doesn't matter if all of it is used or not. Yeah. I think it's so hard for the layperson and for the consumer to find. a provider who can look at the face that way because exactly what we were talking about in the beginning, not everybody does. And so many people just have one filler and one, you know, technique and that's what you get. And you end up looking not like yourself or you look unnatural. And it's kind of uncanny valley. The uncanny valley. And sometimes you have to hide the filler. So it's you, I find that I'm always pushing out of my comfort zone. And it's hard. You can do things

over and over the same way, but it's not the right way. You always have. You always have. to look at what you get at per result. And the left and right face are completely different in many cases. And now I'm learning too. You learn from your own treatments. When somebody comes back, you're like, oh, that really worked. Or you're doing something like, whoa. I learned like for the marionette lines.

I realized when I was doing it, I inject along the lower part and the upper part gets better. So it's crazy how that fold is from down here. Wow. The fold from here is from up here. It's a mirror. So when I correct along the jaw line, for these lines, I'm always doing the lower part first, and I have to put so little to nothing higher up. I got to tell my girlfriend to go to you because she thinks she needs a facelift.

And I'm like, no, you do not. Softwave, a little filler and no modulator. But it's wild how much it helps and sometimes a little bit going back. So it's so cool. And I'm so lucky. I'm really so lucky that I get to go to all these different places. So I went to Pongy, which is in France, where Voluma is made. I like Volumma for the cheeks.

I think it's really soft. You need so little. It lasts two to four years. I don't love it everywhere else, and I respect it. So I never put a lot in any one spot. And knock on wood, it's worked out. Looking at how that product is made, I was just in Vienna. There's another product that's out now called Magic or Magic, as I like to call it.

And I got to see how that product is made. What's in it? We get to play with it. We talk to the scientists who helped create it. I'm going to Geneva. to see how the redensity is made. It's teoxane in Europe. So getting to talk with the scientists who developed a product, learning about the reology of that product, how stiff is it, how soft it is it, where does it work best, how does it break down, what does it look like in the factory, what's a

process? It's really interesting. And there are a lot of differences in how these products are made, how they're cross-linked, what their properties are that are very nuanced. So getting that inside Scoop gives me a lot of guidance as to where they're best use and how they're used. So it is, it is kind of fun to get to do this stuff I do, but it's just you can't get comfortable. Yeah. I have a couple rapid fire questions. I'll try to be rapid in the case. Most underrated skincare ingredient. Well, now it's going to be Arlix 201 because I helped develop it. Oh yeah. Tell us what that is. So Arlix 201 is a novel molecule. So it didn't exist before. And it's what's called the selective torque 1 inhibitor. So torque 1 is a process that is evolutionarily preserved. It's the same

in yeast and fruit flies and mosquitoes and rabbits and dogs and cats and us. And it does the same thing. So torque 1 is a pathway of cell turnover. And you need that when you're growing and you need it when you're making babies. But what happens with age is that it gets stuck in the on position. So when that's in the on position, you're having constant cell turnover, but you're not having cell repair. So what R-LX-201 does, it's in a product called RECU that just launched, and it's sold through doctor's offices. It has $13 million of research to build this one product, R-E-Dash-Q. It's going to also have a prescription side, a similar molecule, but not quite the same. It's going to be developed eventually, but this is what came out first. So what it does is,

it helps the fibroblast, the cells that are making collagen and elastin and extracellular matrix. that gives your skin that youthful look that makes you look like you're 12 versus someone who's 70, whose skin looks thin and exhausted. And if you do a laser, your skin will recover and look better, although you're saying it's getting a little harder now. When you're 70, I've had women come in and tell me they have a face slip. And while they're there, they do an aggressive CO2 laser while they're out. They have months of recovery. And at the end, their skin doesn't look better because those fibroblasts are completely exhausted and they're less efficient when they're exhausted. So they're not making as collagen or any sometimes. So what RECU does is it helps those fibroblasts have a longer health span.

So when you hyper-stimulate them, they make better collagen. And it's like saying, yeah, go ahead, run a marathon, run another marathon, run another marathon, but we're going to help you recover. We're going to be the ice bath and the massage and the nutrients that you need to get better. So that's what RQU does. It's both this RLX 201, the selective torque one inhibitor that slows down that torque one from the on mode, allows for the recovery, and then it has curcumin and other botanicals in it that support that repair process. And we did something that nobody does anymore. We did third-party placebo-controlled blinded studies with histology, with skin biopsies looking at epigenetics. And we work with Johns Hopkins and the Mayo Clinic with PhDs

who stressed the data and said, well, if you want to say this, show me this. Things you would do for a drug, we did for a cosmaceutical to prove safety and efficacy and results. And besides the basic science research. So the basic science thing that was really cool was we took skin explants, that skin that's been removed, and you put it in culture. And the fibroblasts migrate out of the skin explants into culture. So now we have cultured fibrillasts. So we tweeted it with RLX201 and then a fibroblast stimulator. Not only did they produce better collagen, but the 56-year-old fibroblast reverted to 23-year-old fibroblast. They started behaving younger and healthier.

Then we took 23-year-old fibroblast and compared them, and they looked even better. Wow. And if you took fibroblast and you just did the collagen stimulator without the RLX, the fibroblast produced collagen, but they age faster. So we know now that if you hyperstimulate fibroblasts and you don't help them recover, they'll produce, but they'll get exhausted faster. they'll go into senescence and then your stem cells have to send up reserves and eventually when you hit that age, whatever it is for you, you run out of stem cell reserves and you just

can't build collagen. So we want to preserve the fibroblasts. We want to keep your stem cells in reserve for as long as possible because eventually you're going to need them and keep that health span going longer. That's what beauty and youth means to me. It's maintaining your ability to function and that regenerative capacity for as long as possible. That's what I'm aiming to do. And when I help co-found a company or develop a product, I'm not really interested in just doing something. I want to make a difference.

This product, I think, is going to be revolutionary. And when we look at the science and the data and what we put into it, it's all there. And we're stressing it as much as possible. And Rohul Mehta, who's the CEO of the company, comes from developing products that are very strong science. And my highest compliment is to call someone a nerd, he is the ultimate scientific nerd where he looks at data

and he's very, very particular and very ethical. So it's a really exciting thing to have this. So I do it around treatments. So when I do softwave or CO2 or any other laser, I do this first for two weeks. I do it for everybody every day, once a day, but around a procedure twice a day for a few weeks before. and I find that now I'm going to hyper-stimulate, especially with these stressed situations of

softwave where I'm asking the collagen to produce more or a CO2 where I'm destroying some of it and asking the remaining ones to produce more. The recovery is so much better. The results are better and I'm getting two treatments out of one. So those devices are now tools and I want everything you do to work better. Yeah. So, and then we do the hyperbaric oxygen on the other side, which also promote. it's healing. So now we've built in a real program of making difference. I'm excited to try it next week. I told

you. Yes. So excited. That's amazing. Okay. Best collagen supporting treatment. Softwave. Yeah, for sure. Hands down. One thing women should start doing in their 40s. Sleep. Most common skincare mistake during perimenopause. Using retinolic acid instead of retinoles that are cosmaceuticals. Favorite laser CO2. Okay. Favorite tightening? And device is softwave, yeah. I think I've sort of made that clear. And I don't even work for them. Yeah.

One treatment truly worth the money. I do think it's softwave. And can you do it on your body too? Oh, yeah. Okay. They have a body handpiece too now, so it's bigger, so it goes faster. Okay. Yeah, arms above the knees, thighs, cellulete.

It's FDA cleared for that too, stomach. Amazing. After babies. What do you like to do for the chest? I do moxy BBL. Okay. And that's for texture as well. Yeah.

And then I have one by luminous called. resurfix. That's XPL, which is a higher level of IPL and a resurfix laser. And that also helps with skin texture. And that helps with lines. I'm a side sleeper and I'm like, yeah. Softway helps that though. It does. Yeah. And I sometimes will use hyperdilute radius, but mostly the devices and softwave is up there. Okay. It hurts a little bit more. So we do. That's okay. I have a very high pain tolerance. Me too. Two kids, no drugs. Yeah. Yeah. Wow. That's incredible. I like to brag. Yeah. My kids know I tell them all the time. You should.

And that they owe me kisses for life. Somehow I ended up on like labor TikTok one day. I don't know. And I was like, oh my God, I don't have kids. And I was like, this is wild. I'm one of those who you feel that enjoyed it. So I don't know. Oh my gosh.

Well, thank you so much. This was so fun. Tell everybody where they can find you. Dr. Doris Day, DR Doris Day on everything. And that's also my website. Super easy to find. Thank you. Did you know who Doris Day was?

Yes. Oh, you did. Yeah. What was I talking to? Oh, do you know Dr. Banu Sali. Sure. I think it was him yesterday who was like, oh yeah, I just love like saying like Doris Day.

That's so cute. He's a sweetheart. Yeah. Very sweet. 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.

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