Well with Arielle Lorre - 95: Dr. Paul Jarrod Frank - PRO-Aging and Beauty from the Inside Out

Episode Date: February 3, 2021

In this episode I’m talking to renowned cosmetic dermatologist Dr. Paul Jarrod Frank about all things beauty from the inside out. Dr. Frank discusses his PRO-aging philosophy and how it differs from anti-aging; the intersection of beauty, lifestyle and mindset; how to embrace aging; what lifestyle practices help preserve our youthfulness and joy; how to take care of ourselves and our skin throughout different decades; when various interventions are appropriate; when to use fillers or botox; the various devices available to treat the skin; how to treat aging skin on the body, and so much more.    www.Sakara.com/BLONDEFILES for 20% off your first order www.Organifi.com/BLONDE for 15% off any item in the store www.Curology.com/BLONDE to unlock your free 30-day trial!   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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The following podcast is a dear media production. Hey, welcome to the Blond Files podcast. I'm your host, Ariel Lori, and I'm here to talk all things wellness. From how to achieve optimal health and well-being to the best beauty tips and everything in between, no topic is off limits. I know there is so much information out there, so I'm here to help you navigate it all and live your best life. Thanks for listening. Let's get into it. Hi, everybody. Welcome to the show. Today I'm talking to renowned cosmetic dermatologist, Dr. Paul Jared Frank. He is known as a sculpting and technology guru with particular expertise in minimally invasive fat removal, the use of various injectables, lasers, and other high performance devices for cosmetic

rejuvenation on both the face and body. He has offices in Manhattan, the Hamptons, and Miami. He has a big celebrity clientele. He has a new book, The Pro Aging Playbook, which is amazing, a podcast, the pro aging podcast. And he just has a really refreshing approach to beauty, which you will hear in this episode. So he's a proponent of taking care of ourselves from the inside out. And he believes that how we look is a manifestation of how we treat ourselves. And he talks really openly about the fact that he can do all of the beauty treatments on somebody. And if they're unhappy or surrounding themselves with the wrong people, the wrong influences, not taking care of themselves, not taking care of their minds. They're not going to be happy with what they see, period. And I think

we can all relate to that. So this is a conversation about aging and beauty, but also about living a balanced life and really being mindful of how we're living and focusing on the right things, not just externals. So enjoy. Okay, so welcome Dr. Frank. Thank you so much. for being here. Thank you so much for having me. So excited to chat. I was just saying how much I love your book. And it really is like the holy grail of beauty and of pro aging, which I want to have you talk about. But I mean, I really haven't seen a book that's broken it down so straightforwardly, so concisely. And you cover aspects of aging and beauty and maintenance and all of that that a lot of other you know, cosmetic doctors don't necessarily cover like mindset and meditation and the inner part of

all of this. So definitely want to cover all of that. I'd love to start by just having you tell everybody about your specialty and your practice now. Okay. Well, I'm a dermatologist by training. My advanced training is in aesthetic or cosmetic dermatology. I've been practicing in New York for about 20 years now. And I'd say about... You know, my practice is made up of maybe 40, 50% injectables, and the rest are kind of devices, toys. I do quite a bit of surgical like body sculpting. To mess in liposculpture is a big thing in my practice. And I really have found with the growing kind of, with the development of beauty world,

really integrating what I do into a lifestyle approach. I don't just talk about beauty in terms of what I can do in terms of injections to patients. I really feel like getting the best result has to do with how I help them guide how they live their life as much as the skill that I use over the last 20 years to deliver my practice. I mean, for example, you know, I'm on day four right now of a four-day fast called prolong that I talk about my patients all the time and use on my social media. And these are just like one of the tools talking to them about their nutritional status and how they It could be, you know, work from the inside out.

And this has become part of my vernacular in which is what I really tried to get through on the book. How do you feel? Right now, day four, I'm on my fire today. Really? I slept six hours last night because I didn't need the usual eight hours I need. My mind is clear. Day two and day five are tough. But day four is clear.

And I actually got my COVID vaccine today too. So I was expecting to maybe feel a little not. so well and has to eat a little bit more than normal, but I'm feeling strong. Amazing. Yeah, well, you look very clear and you look very beautiful. It's good lighting. I want your lighting and I want to hear your secrets. So can you tell everybody what pro-aging is, your book, the pro-aging playbook? Can you tell everybody how that differs from maybe anti-aging, which we hear all the time? Well, it's kind of a, it's like a sticking my tongue out at the anti-aging industry.

more than anything else. Because I think, you know, there's always been a misconception that, like, doing things for beauty, for vanity means narcissism. And it's just not that. And to me, being vain and caring about the way you look is kind of a reward for the self-care you do. That's what I've always felt. So, you know, the word pro-aging puts a positive spin on it.

You know, it's, you know, getting old is not a bad thing. We're spoiled in modern day world with medicine and bathrooms and toothpaste and doctors and modern medicine and paradigm that we get to live old. And a lot of people spend time just complaining about it. But it's a blessing. And now we have so many tools to make us live better lives, not just in the needle, but also nutritional science, exercise. You know, belonging to a gym is for everybody now.

50 years ago, you had to be kind of wealthy if you belong to a club. And I think this is true of even Botox, fillers, and lasers. It's not just for, like, Caucasian ladies at lunch anymore. So pro aging to me is a mindset. It's a mojo, an outlook about growing old gracefully. And listen, it ain't easy. It's not, you know, it's not always fun. But I think if we all change our attitude about it, we can embrace it and find the balance

that's right for us because we all deserve to feel good about ourselves as we get older. You guys, I'm very proud of myself. I have really been on a kick with my morning routine, which includes, includes my meditation and journaling and then a 30-minute workout followed by a smoothie, and I feel so good. I've been doing a little frozen fruit, some nut milk, almond butter, and Organify Green Juice, which is a superfood blend of things like Moringa, Chorella, mint, spirulina, wheatgrass, it has aschwaganda to help with stress. It has vitamins,

minerals, and antioxidants, and I just feel so energized. I'm sure. every single one of us can benefit from adding more greens, plants, nutrients, and superfoods into our diets. And honestly, there's no easier way than with Organify Superfood blends. So the green juice is amazing. I also love their red juice. That one is also packed with antioxidants and it's a great caffeine-free afternoon pick-me-up. Kind of tastes like fruit punch, but it only has one gram of sugar. And Organify doesn't compromise quality for taste. They take pride in offering. It's a lot of the best tasting superfood products on the market at a price that works out to be less than $3 a day. You can experience Organify's high-quality superfoods without breaking the bank.

Go to www.organtify.com slash blonde and use the code blonde for 15% off any item in the store. That's O-R-G-A-N-I-F-I-com slash B-L-O-N-D-E and use the code, B-O-O-N-E, and use the code, blonde B-L-O-N-D-E for 15% off any item. From the offices of Create and Cultivate, I'm Jacqueline Johnson. And this is Work Party, a podcast for working women that support each other's successes. In each episode, we bring in leading female powerhouses for career, real talk and BS-free advice. Ready to create and cultivate the career of your dreams? Well, welcome to Work Party, the podcast.

Okay, there's a couple of things there that I want to unpack, but I'm very curious. about the aesthetic in New York because I live in I live primarily in in L.A., but we have a place in New York too. And I always say that when I'm here in L.A. in this bubble, I mean, L.A. is like especially obsessed with youth. And it's like 30 years old, you're done. I mean, this week, I think there's news about like Harry Stiles dating Olivia Munn. She's 36 and people are like, oh, well, he loves older women. And it's like, wait, 30 years old. And that's like the news. And that's like the news. narrative. And then so when I'm here, I'm like, oh, I need to do this. I need to do that. I need this laser, that laser, Botox, X, Y, and Z. And I'm very open. I do anything and everything

anyway. That's just who I am. But then I go to New York and I'm like, all of that pressure kind of dissipates. And it is, people are cognizant of it there too. But I feel like there's different aesthetics. What is, what is like the New York aesthetic? What do people come to see you for what's popular and like the most common there? I think no matter where you go, people are equally concerned and self-judgmental and looking for things to do better. I just think the matter of which people on different coasts or even in Miami or in South America,

there are different ways in which they do it. And of course, how we look at ourselves in the mirror has so much to do with the context of those around us, which is why it's so important to surround yourself with the right influences. Because, you know, I joke about it because I have so many bi coastal patients. And I love L.A. and I love Miami.

But I always say, like, people want to wear, they want to wear their features like the letters on their handbags. They want to show people that they've had the work done, that they bought that bag, that they bought that designer piece. Whereas in New York, they're just as obsessed. Don't get me wrong. But they want to make it look like they rolled out of bed that way. Like New Yorkers are a little bit, like they want to show like the models of the 90s.

Like I don't get out of bed for $15,000 a day. I eat whatever I want. I never exercise. Like that's more the obnoxious attitude of New York rather than like I want to show off my lips in L.A. So I just think it's about the way people represent themselves. I do have a lot of L.A. patients who are like, I come, when I'm ever I'm in New York, I get my injections and my hair done. Yeah. It's funny.

I have a friend who's a plastic surgeon in Miami. and whenever I'm like texting him, I'm like, well, I think it's time for a facel. He's like, it's just because you're in L.A. If you were in Miami, you would be begging me for like a BBL. Like it's, you just need to get out of the bubble. Because everything you do has an impact. And again, everyone, you know,

in most of like New York, L.A. society, if you're not doing Botox by the time you're 40, like, oh my God, that's like 40-year-old version movie. You know what I mean? Right. But, you know, if you go to places in Medical America or third world countries or things, or things like that, like, yeah, you're supposed to have wrinkles at age 40.

So again, I think it's a lot about your context. And we do live in a very global world now. A lot of people live in more than one place. So it can get confusing. Just as you said, this is part of my job is to help get them on a track where they can feel good, not feel pressured, do things for themselves. It's a battle we all face, including myself throughout my years, which is why I think I'm pretty good at it.

And it's one of the things I've learned just by dealing with people for 20 years. So you mentioned earlier that your outward appearance is kind of a reflection of how you take care of yourself. So I definitely want to get into different procedures, treatments, everything that we can do externally. But what are some of the lifestyle modifications or lifestyle practices that can best kind of preserve our youth, I guess? And what are the things that really hurt, you know, our appearance or all of that moving down the line? Well, you know, it's the battle of self-image is the most important. Everything is between your ears and life, happiness, sadness. We know people with beauty and money can be miserable, and people without beauty and poor can be super happy.

But to me, it's lifestyle choices that are going to promote a healthy self. And to me, that's been the most influential for me. It's been meditation practices and choosing my friends and peers and people that I choose to spend time with. I'm not always good with it. I've had bad influences in my life. I've certainly let stress get to me. And it's not a battle you ever win. It's a daily challenge.

And people, you know, you live and learn and you live and yearn to be better. And so to me, it's working those kind of inner explorations that make me feel like a good-looking, successful, happy person most of the time. It's very true. I mean, I think anybody can relate to, you know, if you sit there and you're scrolling through social media and you're on your explore feed and you're looking at whatever the algorithm is feeding you and models and public figures and photoshopping and all of that, you're going to look in the mirror and you're going to feel like shit.

And if you go inward and, you know, meditation is amazing and service and focusing on other people and not that stuff, I always say this, but like I can look in the mirror one day and feel like, you know, a monster. And then the next day I can look the exact same and feel beautiful. So it really, you know, you're spot on with that. Very, very quick story about a patient that I honestly put in my book, who came to me and he came to me every like four to six. months without fail. I did the same thing, injectables, lasers. And although he kept coming back, he was always slightly dissatisfied. Like, why isn't him a little better? I knew that he was doing it because he felt like he had to do it for being professional and being single guy and this and that. And he disappeared for a while, came back. And although I've always spoken to him about meditation and weight loss and all these different things, he got his act together. He lost weight. He changed

something about his job and personal life. And I was so proud of him. I did the injections on him. And he called me up and was like, I don't know what you did last time, Dr. Frank, but that was better than ever. And I said, I didn't do anything. You did it. And obviously, he made that change. And enough people like me put seeds in his head about making changes, you know, just hitting that point. And that's why I think so much about my success and skill as a doctor can only do so much with the needle and the laser. Right.

Right. Yeah. I mean, there comes a point where you're never satisfied. and you know you're always I mean I've been there because I've had different you know I've done small procedures I had a rhinoplasty then I had a browlift and I did this and you know all several years apart and just little tweaks and you know I'm I'm happy with things but you can still like like I was saying before you know you can get in that mindset and you're just nitpicking and you just find the next thing and it's never enough so I love that you focus on that aspect of it and I think I think it's

okay to always be slightly dissatisfied or not content. I always say with my life, because I'm very demanding, personally. I'm demanding my staff, my family, people around me because I do feel like I give a lot and we all want to get back at least what we give. I don't need more. I always say I'm filled with gratitude, but never really satisfied because it means you're always striving for more. And part of that is the way we look. I'm always looking for the better version of myself. But I do have to accept that I am 51. I feel and look pretty good. And I have my health. And, you know, people don't sleep me under the rug all the time.

I love it. Well, you look amazing. I mean, seriously, it's crazy. What kind of meditation do you do? So I do TM. I thought you were going to ask you what procedures. I was about to list all the procedures I do. Because I've been doing it since I was 27.

People thought I was crazy when I was 27. Now, if you make it to 27 without doing cosmetic procedures, they look at you weird. I do transcendental meditation. And I've been doing it for eight years religiously. And I really took it up at a point in my life where, like, everything was going great from the outside success, wonderful, gorgeous family, health, all these things. But I just had this sense of, like, overwhelmed and dissatisfied. And I needed to make a change.

And my wife and I started doing it together. And it just really set a course, just changed the pace of things. I'm a TM evangelist. And that's why I was like, this guy does TM. I can tell. Oh, yeah. It's so funny when. I did it right before I got up.

spoke to you. I just had an eight, nine hour day. I just did 20 minutes. I had a TM teacher on my podcast and she had the analogy, which you've probably heard of doing the laundry, like doing the laundry of your brain. And it's that second meditation that's like so powerful for me. And it's the one that I always skip over because I feel like I just can't do it and I don't have time. So you've inspired me. I'm dying. Have you ever met Bob Roth? No. He is amazing who runs in. In fact, I'm trying to get him on my own. on the pro-aging podcast right now. He's just such an inspirational person and particularly in the COVID crisis.

He's done live meditations on telephone with people, with thousands and thousands of people you get on the phone and we all meditate together. It's such an amazing thing. And he's making such an effort to spread it out around the world because everyone can benefit from it. I am starting school again full time next week. So unfortunately, that means I will not have a lot of time

for cooking, but fortunately, I can rely on Sakara to get me through. Sakara is a wellness company rooted in the transformative power of plant-based food, and they have organic, ready-to-eat meals. The menu is crafted by chefs weekly, so you'll never get bored. And guys, the meals are seriously amazing. This week, they have chia pumpkin bread, wild mushroom pasta, they have a burrito bowl, Thai oatmeal, some amazing salads, cassidias. is my favorite and so, so much more. Seriously, go check it out. You will be drooling. Along with

delicious plant-rich meals, Sakara also offers daily wellness essentials for optimal nutrition. Sakara's supplement packs called the Foundation and their metabolism super powder, deliver support for gut health, energy, immunity, and healthy skin. Sikara is delivered fresh nationwide, and they are offering you guys 20% off your first order. if you go to sacara.com slash blonde files. That's s a-k-a-a-a-com slash B-L-O-N-D-E-F-I-L-E-S or enter blonde files at checkout. Again, saccara.com slash blonde files for 20% off your first order. Well, speaking of meditation and youth, the way that I started a few years ago and my husband and I were at dinner with a couple who he knows who are like in their 80,

one of them might be early 90s, and they are so vibrant, so energetic, so youthful. And I asked when I asked the woman what her secret was, and she said TM, she said she'd been doing it since like the 70s. And I was like, okay, say no more. Well, you know, I think, you know, and I talk about this in the book all the time, everyone has one thing that was a major turning point for them. But, you know, you can't do too much of any one thing. I really believe success in life, in beauty, and love. It's about making small. efforts in many arenas. I'm not going to be an Olympic athlete. I don't want to be the person that only relies on cosmetic procedures. I love to eat well, but I'm just, I can't be a vegan

extreme. I can't be an extremist in anything. So I find doing little things of a lot of different aspects. It seems complicated, but it could be quite simple. And I think it helps provide the homeostasis. Nutrition, meditation, exercise, social life, cosmetic tweaks. It's all part of the Okay, so everybody listening is probably like, let's get to the, let's get to the good stuff. What's the, so let's kind of break it down like 20s, 30s, 40s, 50s beyond. In your 20s, for people listening, what should they be doing now, understanding that different genetics, different people have different issues, but kind of like in general, are there things that people in their 20s should start doing and things that they should stop doing?

Well, first of all, what you do throughout the decades, it's not what you do that changes. It's how you do it, different amounts, different balances. And for people in their 20s, a ounce of prevention is worth a pound of pure. So, you know, I know all dermatologists say the sunscreen thing, but it's true. But the 20s is a good time to start getting involved in topical therapies and serums. You know, if a 60-year-old comes to me and has never invested in quality skincare before, it's not going to really do much for their wrinkles. But a 20-year-old who still actively has good collagen turnover and building up, they can find the right serums, retinoles, like colics or whatever other products that are out there that they could really start the course of healthy aging process for the skin.

Because healthy skin is beautiful skin. They're not different. You know, the functional and the aesthetic portions, they're not separate. So keeping your skin healthy and protected is the best thing you can do in your twin. What about your 30s? I mean, I feel like a lot of people in their 20s, maybe it's more of an LA thing, but they're getting into injectables, they're getting into Botox. Do you think that there's an age when people should start,

or is it just kind of once they start seeing changes? I don't believe in doing things preventative. If people come in, I want preventative Botox. I'm very, I have a third of my new patients now are under the age of 32, 35, under that. So I'm very sensitive to not just selling them. Like I'm not doing the med spot thing where it's just trying to like get numbers. This is an art. It's your health.

And most importantly, what you do in your 20s is going to definitely affect your 40s and 50s. But your late 20s is one of the first aha moments of aging, ground spots, sunspots, scars of acne pimples that don't heal quickly, lines for Botox, dark circles under the eyes. So I certainly start using devices and injector. on people in their 20s. But I'm cautious. I'm very conservative. I don't like making dramatic facial changes.

You know, people want a little extra cheekbone, a little extra chin, change the shape of their nose a little bit, arched their eyebrows. That's okay. But I really try, I try and make them happy with the skin that they're in because I tell them you'll spend the rest of your life wishing you look the way you did right now in your 20s. And it's true. So I'm all for making Twitter. weeks. But again, this is a very important pro-aging thing because, you know, I find so many

patients come to me and they've already beaten up. They've injected and stretched and hyper relaxed and strong. And they've done things that unfortunately we see on social media with some huge influencers out there. And I just think they're going to need a facelift at 3540. I like reflating faces, not inflating faces. I like optimizing facial movement, not freezing it. So it takes a lot of education for that set. Most people go from their late 20s to 40 before they hit the next stage. But they can play around with little things. And little bits go a long way in your 20s and 30s.

You're like, wow, that Botox works so great. Oh, that one fringe did so much. And then you hit that point usually between 40 and 45. 44 was my time. You know, I turned 40. I was like, ah, I still feel like I'm. 32 with the stuff that I do. But really in my mid-40s where I not only felt an aesthetic difference, but a physical difference.

My workouts were different. My nutritional tolerances were different. My stress management was different. And I think for a lot of people in their 40s, they're like, whoa, I'm starting to feel and look old. And it's so important at that point how they live their life that's going to affect how they look and feel. Because injections, lipos, they're not going to be the only thing that's going to

make you feel good about yourself. And a lot of patients say, oh, I wish it was like when I first did Botox 10 years ago, the same effect. And that's when I have to re-educate people, because I do have patients for 20 plus years now. And the same things that worked on them 10 years ago may not work with them. That's where I really start introducing the lifestyle things. It's tough to tell a 27-year-old to not lay in the sun, exercise more, eat less carbs and sugar. People are a little bit more ready to hear in their mid-40s. They've lived long enough. They've seen the bloat. Right, right. And that's really what I just a little minute. So you mentioned the effects of too much filler, too much Botox. I think a lot of people don't know about that. And I think that

people kind of look at filler and Botox as like the panacea. It's going to fix everything. You know, and they look at pictures of like a Bella Hadid or a Kendall Jenner and they say, oh, okay, I just need Botox or I need the eye threads or whatever. What are some of the side effects of too much Botox, too much filler? Because I think a lot of people in their 20s are kind of going down that road. I'm glad you said those influencers names and not me because I don't like to point out. Allegedly. Don't see me. But again, I like to use fillers, injectables, to reflate, not inflate. Once you start creating structure with fillers, which is an artificial product, you know, the highly erotic acid filler will never replace bone structure.

So eventually what you're doing is you're stretching skin. Now, an appropriate amount, on the other hand, people like, I don't want to ever do filler, it's going to stretch my skin and make me worse. Well, that's not true. The right amount of everything is appropriate. In fact, if anything could build tissue for you. But stretching of the skin and over-relaxing of muscles can permanently, change the elasticity of your skin, the shape of your eyebrows, and the muscle strength of your

face that keep normal expression as you age. It's got to remember, as we get older, we don't only sag. Our smiles aren't as strong. Our facial muscles weaken, too. Our smiles are different. The arch of our eyebrows drop, and you can ruin it. Now, you know, if you are a celebrity or Instagram star that is used to doing cosmetic stuff, maybe it's okay if you get a facelift at 40.

But I don't want to put people in that position. And I healthfully warn them about the potential long-term consequences. And I tell everybody, we're in for a long game. You're stuck with me. I think the most frustrating thing when it comes to skincare is trying to navigate what works for me specifically. There is so much out there. And I'm also offered a lot of products to try for work.

And usually I'm left feeling kind of lost and let down. I know I am not the only one in this, so I want to tell you guys about curology. So whether you're dealing with acne, hyperpigmentation, texture issues, fine lines or wrinkles, dryness, redness, oiliness, you name it, curology will customize a prescription formula with three active ingredients to target your specific skincare needs. The whole process could not be easier. You just go to curology's website and answer some questions about your skin, upload a few selfies, and then curology matches you with a licensed dermatology provider who gets to know your skin and makes recommendations for you. So for me, the whole thing took like 15 minutes and now I have a custom

product with 0.07% trinotenoin, niacinamide, and azalec acid. So the trinone is one of the most effective ingredients at targeting fine lines. Niacinamide is an antioxidant. And, and is an antioxidant. that reduces wrinkles, brightens the skin and helps with elasticity, and azalec acid improves texture and lightens dark spots. I also got a cleanser and a moisturizer. So far my skin is really loving the combo of ingredients, so I will keep you guys posted. And if you want to take control of acne, dark spots, breakouts, or whatever your unique concerns may be with a powerful skincare treatment made for you, go to cirology.com slash blonde for for a free 30-day trial.

All you have to do is pay for shipping and handling. That's C-U-R-O-L-O-G-Y.com slash B-L-O-N-D-E to unlock your free 30-day trial. C-Cureology.com for all the details. What are some of the treatments that you might recommend somebody who's maybe in there, like late 20s, early 30s, maybe seeing some changes, but obviously not ready for like, you know, something more invasive.

And you break this down in your book, but I mean, a lot of people asked about things like microneedling, different kinds of lasers. What kind of procedures are good for preserving like the texture and the firmness and all of that? So that's a very good question because, again, understandly, some people are gun-shy and like I said before, ounce of prevention, pound of cure. If I catch someone in their 20s, my number one concern is skin quality. Because if you catch them young enough, before the wrinkles come out, what's the number one cause of aging?

Sun damage. And whether you're a sun worshiper or not, we live our lives. Our faces don't look like the skin on our tushes for a reason. And if I can do resurfacing things, whether it's clear and brilliant, fractal, halo, there are so many different name brands. Things that are going to create that turnover of skin quality are going to remove the old, stimulate the new, get rid of medical and cosenetic sun damage. and minimize the speed of the aging process. Skin quality is the first thing I recommend to a young person. I just did clear and brilliant for the first time,

and it was amazing. I mean, I'm going to do more treatments, but I don't know why I held out for so long, but I definitely noticed a big difference. Yeah, and it's great. I mean, a clear brain is a baby fractal. Right. You know, it's just a light one.

And you may one day move up to a fractal. I mean, of all the things I've done in the, I started when I was 27, I'm 51, and whoever many years that is, the most, the thing that has had the most impact on my skin quality has been the once of your fractal I've done since it come out. I don't get paid by the company, but it's just something, it just repaves the road. And I think it complements everything I do. And I think no matter what age, some level of resurfacing, like you're young, clear and brilliant's appropriate. If a 65-year-old comes into me, I've got to do the fractal repair

where I put you to sleep and you're hiding at home for 10 days. I'm not doing a clear and brilliant on a 55-year-old. And I think this goes to show, which is a very common question, how do you know which device to use on what person? And it's really about matching expectations to results, which is why even if a 60-year-old comes in asking for clear and brilliance, I'd rather say, I'd rather see you do nothing than waste your money on something that may just kick sand off the mountain for you. For someone like yourself, it makes an impactful difference. So how you choose these procedures with a good practitioner is the most important because we live in a world of so much content. People are confused. They don't know what to do. There are so many procedures and Instagram

certainly blows, it makes it look like everything is magic, right? Yeah. Yeah, it's crazy. I mean, I have this conversation with other doctors and experts who come on my show about how misleading it is. And, you know, especially with like the plastic surgeons, it's a real problem, I think, to put up a picture of like a celebrity and, you know, claim that they did X, Y, or Z. And then everybody wants to, it's just, that's a whole other conversation. But. I mean, listen, I even see, I see now the big thing with doctors. I see a bunch of doctors. They're actually photoshopping their own before and actors.

And that too. It's one thing when the person does their own Photoshop. Yeah. But when the doctors are doing it, and I can see it so clearly. I'm like, it's so misleading. And I always tell residents and people that I teach and people that I mentor. Because, of course, everybody wants to do procedures. They want to show before and afters and see more patients.

But I always say the power of no is the best practice builder. It gives confidence to a patient. Because if you say no for one thing, there's so many other things that can be done that can be helpful. So to me, it's a tool that I use so much to gain confidence. and to help patients find things they're going to suit them. Yeah, and you talk about that in your book, The Power of No. Do you ever have people who you say no to, and then they come back, having gone to somebody else? Oh, yes.

And something terrible happens. All the time. So this is very typical of body sculpting. A lot of people come in because I have cool sculpting, sculpture, truth. I have all these non-invasive fat removal devices. And I use them and I like them. But they're for a very specific small group, small pinches of fat. It's not a shaping thing.

And a lot of people come in wanting the non-invasive, and I talked to them about tenescent laser body sculpting liposuction. And, you know, understandably, they're gun-shy. They think liposuction is this terrible thing. They go elsewhere. And then they come back. They've spent three, four grand on pool sculpting already. And I'm not bad-mouthing pool-scolping for the right patient.

It's a great procedure. Right. And now they have scar tissue from the pool-sculpting. It's uneven. It's lumpy. And the liposuction that I now have to do on them is more complicated more expensive, more everything. And this is a very common thing with body sculpting.

And I guess sometimes with, you know, fillers and stuff like that, hey, I've had patients that come to me for like skin tightening all therapy. And I say, listen, I don't think you're a great candidate. I think it's time for a facelift. I don't do them. I could refer you to somebody. They went somewhere else for old therapy. I don't want to take their money because what happens is then if you tell someone to do something

that you know it's not in their job. best interest. They'll never come back for the things that you do help them with. Right. The Botox, the fillers, the lasers. I don't want to lose that patient. And you know what? When they do come back, they come back with strong loyalty. I've had patients in COVID now. I'm seeing so many patients. They were going in other places. They cheated on me. Listen, I'm not the best doctor in the world, but for my patients, I'm the best doctor. And they come back. It's nice to see. It makes me feel good. They're like, I'm not doing that again, I'm not leaving you.

It's so funny. I've done that. I cheated once and I felt so disloyal. And I went back with my tail between my legs. And my doctor was so, do you know Dr. Talley? Yes, yes, yes. He was so funny about it. He was very diplomatic.

He said, well, you know, like surgeons are like artists. Everybody has a different style or like fashion designers. Everyone has a different style. And sometimes you want a different style. And I was like, I know, but look at my thing. It's so true. I mean, listen, there are good doctors and there are bad doctors,

but there are enough people at the highest tier, you know, that there are a lot, and they have their own style, you know, and you really develop a relationship with someone, particularly in the cosmetic dermatology field or any even plastic surgeons who do the non-invasive stuff. You really have to age gracefully with them because as you get older, your face changes, your body changes, there's weight gain, there's sun damage, there's babies. There's a bunch of different things. So it's important people find someone that they feel comfortable with. Right.

Okay. So the two main questions that I got, and you started talking about one of them, but a lot of people want to know about skin tightening on the face, what to do when you're starting to see the development of jowls. I think I have a lot of listeners who are in their late 30s, early 40s. Do you like radio frequency, lasers, microneedling, all of that stuff? What do you do? And when is it time for something more invasive?

Lasers, I really don't put in the skin tight realm that much. They don't go that deep. Maybe the most aggressive of CO2 lasers do superficial tightening. But when people say tightening, they want lifting. That's what they mean. And you're really talking about, I mean, I find ultrasound to go the deepest and this is the strongest. Radio frequency could be an adjunct for areas with thin skin. But all therapy is definitely ultrasound is the most aggressive.

But the problem is that a lot of people, particularly in the 40s, you know, people in their 30s do great with all therapy. because it's just minor tweaks, and also a lot of people in their 40s. But there's just like zone, this niche zone of someone who has a little bit more than what non-invasive can do, but like they're not ready or don't want a facelage. Okay. I call this the Gap procedure. One of the most popular procedures I've been doing in my practice the last year or two is called face tight or acutite.

And it's really a modification of something I've been doing for 20 years, which is microliposuction of the jowl and neck. The problem is, in the past, it used to be that you could remove the fat, but if the person had loose skin, you're still stuck with the loose skin. Some of the newer technologies like face tight and acutite are internal radio frequency. It's an instrument that goes inside. Obviously, you can get more tightening from the inside than you can just rubbing on the outside. So it is a minor surgical procedure, but it's done in an hour in my OR on an awake patient under local anesthesia, it's about equivalent to a dental procedure.

Once the Novocaine is in, you're numb. And I have to say, I see really strong surgical results. We do things like radio frequency, microneedling on top of it after the surgery is finished. And I'm shocked at the results I get. And I think we're going to see more advancements with this type of combination, minimally invasive surgical technologies. And it's really filled that gap for me. Yeah, it's awesome.

before and afters on your page, and they were pretty good. You're great. No Photoshop. Frank tune, not Face tune. But again, I'm getting better at it. We're getting better at it. I'm missing and matching other things. But listen, I'm not putting the plastic surgeons out of business.

In New York, I work with a couple of renowned facial plastic surgeons. And, you know, people are thinking, oh, you must hate plastic surgeons. I love them because when they go for surgery and then they come back, the Botox and the filler works like it did in 2005 for that patient. You know what I mean? So I like working with these people. And I think people should also not be afraid of surgery with the right doctor who knows how to say no also.

But in the 30s, non-invasive ultrasound radio frequency, I do believe the energy delivered micrneedling devices, the deeper ones like morphias and things like that, are very, very helpful. Profound. Do you like profound? Profound. You know, I've used it. I find that technology to be more trauma and downtime relative to the result. It was one of the first technologies.

It's an aggressive injection of heat. It's not my preferred one. But I like Morpheus. I like Vavace. I like when they're done very aggressively. When you inject, you know, if you use topical anesthesia for any of these procedures, you can only go so aggressive, right? It's a pain tolerance thing.

But if you inject local anesthesia into the area, like when I'm doing the face type, you can use radio frequency micrneedling to a level that actually causes significant results. Because if you do it on their topical, people do a series of three or five treatments, it makes a difference, but it's not going to lift. Yeah. I did profound four years ago while I was under. I was getting my nose done and a lip lift. And I was like, well, since I'm under, just go for it. And that time I had a really good result, but I was also like late 20s and my skin was probably very resilient.

And you were under. Yeah, yeah, I was under. I was like, just go as hard as you can. Yeah. A lot of people try and do profound with topical or just some minor local anesthesia. And again, part of getting the good result is not just a good candidate, not just a good doctor. It's getting appropriate anesthesia and comfort. I always say that with old therapy, I'm going to credit it OR here because I do surgery.

So I'm giving like intramuscular demoral, laughing gas medicines. A lot of practices that don't have that setup will be like, here's a valium and a per cent for old therapy. You're not going to get any treatment because then you're not getting the number of pulses, the heat is. So people have to make sure that they're kept comfortable because then the doctor or nurse or PA, whoever's doing it, can't do the job they need to be. So people have to remember that, you know, all therapy in one place is not going to be the same as old therapy in or not.

I think that's a difficult thing with patients because people do think sometimes they're buying the syringe, they're buying the machine, they're buying the laser. And it really has to do with the experience and the way it's delivered. You're just playing an instrument like playing guitar on a band, right? You have 10 different guitarists. They're all going to play it different. That's really important to know. The other main question that I got was about aging skin on the body.

So wrinkles, sun damage, tightening. What procedures are good for that? So in my practice, body is the new face. I mean, definitely, I'm a dermatologist. So I do as much on the body as I do on the face these days. And we utilize the same technologies and things we just do it differently. One of the biggest things in my practice right now is a procedure I really kind of helped developed years ago.

I call it biostim treatments. And what I'm doing is I'm using biostimulatory fillers like radius and sculpture to smooth out cellulite, increase buttock size, fixed dimples. It's now starting to come out in the literature. There are studies being done. And now if you go on Instagram, everyone's injecting sculpture into the butt. But I've been doing it now for, I don't know, five to seven years. regularly and I will now, I'll do it and mix it with heat-based devices like M-tone, M-Sculpt,

exilis radio frequency. And I really can make a significant impact on the quality of skin elsewhere on the body. It does take maintenance. It ain't cheap, but it really makes a huge impact for people. Okay, so now I need to know your routine. What did you start doing in your late 20s. How did it evolve? What do you do now? Yeah. So I started doing Botocs 27. I had the lines here. Started at 27 that Botox was not FDA approved yet for cosmetics. You had to stick in a electro, like something that reads the muscle contraction would take a half hour to 40 minutes to just do Botox in the far end. That's how archaic it was. And when I did it and I said, man, I'm doing this again. It works so well. My peers and my superiors like, you're crazy.

This is going to be one day for like older people. I said, watch. Okay. I probably start doing, once I got into practice in 2000, 2001, I started playing around with lasers and stuff. I have had a little hair restoration to help me out starting in my early 30s, heat me coughed. And really in my early 30s is when I got more into small amounts of pillars, working

in hollows of temples, helping out my natural. I have pretty good sheathones and jaw lines begin with, but just kind of like keeping and maintaining them. You know, I don't treat any one feature of my face, just like my patients. I treat the face. And now I still do little bits in many places every few months. You know, I can't do a whole makeover on myself in one sitting anyway.

I'd pass out. But, you know, like my exercise routine, I'm always doing little things. Well, it definitely shows it works. But back to what we were talking about at the beginning, You know, you seem to kind of embody like this wellness from within, and that shows outwardly. So very, very inspiring. Your book is amazing. Thank you.

I've always worked out. I've always kind of watched what I eat. But definitely in my 40s, I started paying a lot more attention to those things. I say, in your 20s, you don't really have to work out. My 40s, the nutrition and the exercise has been to me such a big part of my overall presentation, which is why. you know, I kind of try and practice where I reach. And you include all of that in the book and you have some really amazing thorough tips and you have other, you know, experts that contribute on things like diet and you cover the

stress component of it. And if anybody is wondering about anything from microneedling to Botox to, you know, any kind of procedure, you really break it down in such an amazing way. So thank you so much for coming on. Thank you so much. I appreciate it. I'm going to come see. when I'm in New York. Can't wait to see you. All right. Good luck with your past. Thanks so much.

Bye. I hope you enjoyed that episode. If you liked it, and if you like the show in general, please take a second to rate, review, and subscribe. It goes a long way and it's actually the best way to support the show. Also, if you want to see more about each episode, you can head over to the Blonde Files podcast on Instagram. I'm always posting about each episode there or over on my personal page at Ariel Lori.