471: Bioregenerative Therapy, Fillers, Facelifts, and "Natural" Skincare in Midlife

What if instead of growing older and your collagen breaking down wrinkles and sagging and laxity, what if we could just keep collagen production going like you were a 30 year old so we can.

Welcome to Midlife Conversations. I'm your host, Natalie Jill and I'm passionate about having amazing conversations that matter to us midlife women. On this podcast, I do what I do best, taking complicated health topics and breaking them down simply so that we can optimize aging together. I share actionable steps to help you thrive in what I believe are our best years to come. Join me as I interview the most inspiring people living their best midlife years and dive into essential topics like hormone changes, health optimization, weight management, blood sugar, emotional well being, relationships, beauty, and so much more. For those of you that have cared about how you look aging, that's what this episode is going to be all about. We're talking about facial stuff. Facial plastic surgery, facial fillers, botox, natural stuff. What do we need to be doing, not be doing? And what are the truths in it all versus what is just stuff you're hearing on social media that's not realistic and not true and not fact based. I thought who better than to have on here than Dr. K because she's a facial plastic surgeon and she's a midlife woman. Woman specifically. I know lots of guy facial plastic surgeons and kudos to them, I'm sure they are also amazing. But I thought I want to have a midlife woman. I want to have somebody who is actually aging with us as a female and knows what we're navigating to ask all these questions. So today on Midlife Conversations, we're opening up the conversation with Dr. K. I've got a lot of questions for her, from filler to Botox to natural to is the sun actually hurting us or helping us and when is it time for a facelift or actual cosmetic surgery? And what's realistic? If we want something like that, what should we be asking? What should we be expecting? So thank you so much for being here.

Dr. Katie oh my gosh, my pleasure. I had so much fun meeting you. It can't be more. And I'm glad the conversation keeps going.

I can't. I have so many questions for you. I wrote them down. I'm probably going to fire hose you a little bit. I hope you don't mind, but I'm going to jump right into questions. But after. But first I want can you give a little bit of your background, like who you are, what you studied, how you became a facial plastic surgeon just so people understand who you are and why you do this?

Sure. Well, so I trained. I'm a fully trained head and neck surgeon and facial plastic surgeon, and I've been in practice for about 20 years. I'm here in Los Angeles. I have an office in Pasadena and also in Beverly Hills. And I just love what I do. I take care of everything from the top of your head to your clavicles, just right in there. So this is just. I don't do boobs or tummy tucks or any of that other stuff. I specialize in rhinoplasty, eyelids, facelift, neck lift, and just anything related to anti aging. This year in my practice, I've really done a lot of work on biorejuvenative therapies, which is turning on your body's ability to reverse its own aging process with kind of a biohacking approach. And yeah, I've trained. I have four kids, one set of twins that I had in my chief year of residency at UCLA. It took me 10 years, but I became chairman of my department of surgery at my local hospital. And now I lecture worldwide on stages and platforms all across the world and have become an expert in facial plastics and biorejuvenation of the face.

Wow. Okay, let's start with that. What does biorejuvenation of the face mean? What is that? I've never even heard that term.

Well, this is the. Your body has within itself the ability to heal. Every time you cut yourself, you're gonna grow some collagen and you're gonna turn on these healing pathways and processes. So what if we could do that? What if instead of growing older and your collagen breaking down, wrinkles and sagging and laxity, what if we could just keep collagen product like you were a 30 year old? So we can, we can do that with bio stimulators. Those are products, like products that turn on your own collagen production. You might have heard of Sculptra or Radiesse. These are excellent products. And then there's polynucleotide salmon sperm. There are, there's new things we're doing, like turning on the body's ability to regrow its own fat. And like, it's just very fascinating what molecular biology and biohacking are bringing into aesthetics.

So all those things you just said, is that all stuff that you would inject in or how surgically put in, or is that like topical stuff that could actually do that?

Right now, some of those are mostly for injection and they're all said to be micro needled into the skin surface. So they are placed superficially, but they get needled in and they penetrate deep down and then they do the work where the work needs to be done at the deeper levels of, you know, the skin, the dermis, the epidermis and they grow like. These are treatments that are helpful for hair, for skin, for like replacing volume that you lose if you've had massive weight loss or just to, you know, change how we age so we don't undergo so much collagen breakdown, especially after menopause and perimenopause. Like the aging trajectory really speeds up for women.

Okay, I'm going to, I'm going to go, I'm trying to think what order I want to go in here. And what I want to do is I'm going to go in the order of asking you. I want to ask a about the more extreme stuff first. And then we'll kind of go to like the less extreme the more. Like the microneedling and some of those things that you're talking about, like salmon sperm, I wanna know what that is. And then I wanna go into like the super non invasive, like what topically can we do? And then also even like natural things that people can do. So that's the order I wanna go in. For those of you listening. Just because I wanna jump right into some of the more extreme things and then bring it back down to natural. I think that's the way that I'm gonna do it in my brain. So I could think, think okay through this. But let's start with the extreme stuff. Like, and I say extreme because it requires surgically surgery. Surgery. When is it time and when do you know someone is a great candidate for more surgical invasive things? And I mean facelift, neck lift, upper eye, lower bleph, forehead lift. When is it the actual time for that? And how do you know a patient's ready for that?

Well, surgery is definitely a tool that we use when tissues need to be tightened and trimmed. So if you have too much skin laxity, if you can pinch more than a centimeter of skin excess, you know, and you're holding back your lower jowls or you feel like there's neck laxity and there's heavy, there's like excessive skin, this is what surgery it is. It's taking that skin, it's trimming, tightening and repositioning. If the fat pads are drooping, etc. Same for the eyelids when your eyelid skin hangs over, if it's touching your lash line. If it's making it difficult to put makeup on and you can just reach up and pinch a little shelf of skin, then pretty much you know that you have tissue that's not going away with any cream. There is no magical thread that's gonna work and no amount of micro needling is gonna fix it. There's just, it's like tailoring, right? The clothes don't fit if everything's hanging way too loose. We've got to trim. We don't ever say, like, we'll just eat more and fill it up. Make your clothes fit that way. So we don't use filler in those instances. We would definitely wanna just tighten and trim. Okay.

Now some people talk about using like gua sha or facial massage. Does that do anything? And can you actually get those surgical results from that?

No, it does not. I mean, sadly, like, I watch those videos too and they're fascinating and I'm just always analyzing. But the one thing that does help is when you have muscle tension. Like, for example, the depressing muscles of the face, the, the muscles that pull down and make your eyelids look heavy, you can massage those up and relax their muscle tension that you. So you do get an appear of a more lifted open brow. You can reduce lymphatic swelling, that's puffiness and water content that's in the wrong locations of the face. So those things can definitely help. But in terms of is that going to change a structure permanently? No, it's not.

Okay.

It's going to last, you know, a day or a few hours and it'll be a feel good thing. It's always going to give you some endorphins and glow to give you like blood flow to the area. And I think those are the benefits of those type of facial exercises.

So it's not hurting anything. It's just not going to actually, actually permanently change the structure of your face. Is that how I'm hearing it correctly?

Yeah, that's correct. And I would say there are some muscles that you can exercise. Like for example, the muscles at the base of the jawline under your neck to avoid that double chinny hanging effect. There are some floor of mouth muscles that you can tighten. People do that exercise called mewing where you push your tongue up to the roof of the mouth. And it does, it does. Those kind of things can help. It's most those messages mainly muscle tone that's not gonna be like extremely sharp definition.

So a patient came to you and they're like, I'm doing This, you're not saying don't do it, you're just saying, that's great, you could do it. It's just not the permanent solution and eventually we might need to address something more.

Exactly.

Okay.

Yeah.

So keeping on that topic of facelift or eye surgery or whatever, or brow lift and all the facial different things that you can get done, when do you feel patients are being realistic? What's not realistic when they want that done?

Well, I think.

Nobody really wants surgery, right. Like, I don't wake up thinking like, oh, I can't wait to have a facelift. I'm like, no, someday I might have to. Maybe it's in my future, possibly. But no one really wants to go into surgery. So I'm a big fan of doing everything you can possibly do to maintain good skin health. And I think this generation of women is actually going to age differently than the last generation of women that's did not have all the tools that we have. So I think, you know, we want to use minimally invasive techniques like collagen stimulators, Botox, mild amount of fillers to, to keep skin hydrated, nourished and like triggered to keep rejuvenating itself until the point where you have too much skin. And then we're going to leave surgery.

Now when somebody comes in and they see somebody, a celebrity, and they're like, well, I want to look the way so and so did, and they, they did a facelift or they did a minimally invasive brow lift or whatever it is. And this is night and day and they're showing you pictures. You had mentioned to me when I started, before I started recording that people are sometimes comparing to filters or face tuned or altered stuff. Can you speak into that?

It's awful because they. I don't think people understand how much certain celebrities control the use of their image. And they literally will not allow their image to be released unless they have lawyers, they have teams that go out there and find, scrounge the Internet for every single image of them and make sure it's only the allowed image. Like, I mean, Kris Jenner is a perfect example. Her facelift looks great, but it's unrealistically photoshopped so that it looks like extremely too perfect. When you look at her in live, you have to analyze people in live movement, like when they're in a video, because it's very hard to filter videos mostly unless you have really complex AI. But you can see there is some natural laxity. Not everything looks perfect. Her hairstyle covers the incision site, which at this point it's like the third facelift. So there's definitely some scarring and there's definitely, if you look closely at any person, the results are not nearly as perfect as they seem to be in social media.

So good to know. Okay, what's.

I think it gives women all kinds of hang ups too because they go into surgery thinking they're going to come out looking like JLO with no problems, no scars, just perfection and no further laxity. But nothing is perfect there. Even after facelift surgery, you're going to have a little small amount of laxity. You're going to have scars that might need work, you're going to have some little imperfections. So super important to go into that surgery understanding that are facelifts and brow.

Lifts and eye surgeries permanent? Like if you do it once, do you ever need to do it again? Or is it, how long does it last?

No. And that's definitely a big misconception. You think like, I'm going to get my facelift, I'm going to pay 100,000, $200,000 or whatever crazy amount from so and so and then I'm done for life? No, it's going to last you about 10 years. A good facelift lasts about 10 years and that's with the best, best skin care and the best maintenance and the best routines. Like if you're hard living person, maybe it's gonna last five or six years. Right. So, but eyelids and facelifts, typically, I'll tell patients it'll give you a good tenure. So I think in anybody's lifetime, I think you only have two good facelifts in your lifetime and you want to space those out so that the timing is right. Like maybe I'm, I don't want to, I don't want people doing a facelift in their late 30s. I think it's terrible idea. And I definitely don't want you to do a facelift till you're at least 50 because we know that in 10 years at 60, you're going to need to do another and then at 70, and then that's probably enough if it gets you to 80, right?

Yeah.

Not that many people that are going to be super beauty achievers that want to have the 80 year old facelift.

But is it because it comes undone or just because you keep aging? So what is, what's happening?

You're going to keep aging around all of that. So everything that got tightened is gonna look good and stay there. Other things will start to droop and sag and even the incision site itself. Remodels so much. Like we've all had surgery scars. You can see how something starts and how it ends. Right. Your appendix scar will like sort of fade away and thin out and flatten and atrophy. Everything has, goes through lots of phases of change.

So the first plastic surgery I ever had was my nose when I was 15. I had a nose job at 15. And what I've noticed over the year, I mean, and I'm 53 now, it's changed, it's still gross. So I'm wondering if that's like the same thing that happens with all facial procedures like you, you just keep, you're going to keep growing and changing. And so it's nothing that you do cosmetic surgery wise, is permanent. Like it doesn't undo it, just you're going to keep growing. Is that accurate?

I think it's like when you build a house and you build it according to these plans and then, and it does look pretty damn good the first, you know, once you're moved in, everything's kind of settled. But in a year, joints and floors and everything starts to settle and little buckles show up in the floor and like, you know, and then definitely in or 10 years, there's so much, even much more remodeling that keeps occurring.

Makes total sense. Okay, what about when someone says deep plain facelift versus a regular one? What does that mean?

No, there's definitely a difference. And I think it's crazy that people think a deep plane facelift is a brand new technique. It's not. It's been around since probably the 1950s and it's been studied and it's been one of these. It is a very important part of what we do as facelift surgeons. It's grasping and grabbing the underground attachments of the muscles and the fascia and pulling everything in an upwards trajectory and securing it. So it's like if you were to make a bed and you did not make the bed sheet under the comforter and you left it all ripply and rolly, you wouldn't have as nice of a result as if you pulled the under sheets really tight to and then secured them. Like almost like, you know, the fitted mattress and then you pull everything up tight against it. So that's a good explanation.

So do most surgeons do that or they don't do that? Like, and why would someone choose deep plane versus the other way?

Depending on when you do your facelift and what your facial concerns are, sometimes we might just Do a skin excision. If you're like, let's say you're going to do a very early 50 year old or late 40 year old person who just has a little bit of jowl excess and barely can pinch like a half centimeter, we can just tighten and trim the skin of the face. It's kind of a mini lift. When it's. I tell patients when you can tighten with one finger just in front of your ear just like that. I don't know if you can see, but what I'm doing right here, you could qualify for a mini lift. And that might just be skin only tightening and some underground sutures to position, reposition things. For patients who have more laxity than that, we're going to want to address some of the deep structures. So taking some of these masks, this mass is kind of this superficial fascia that overlays the muscles and we're going to grab that and tighten and pull up. We can't really sew muscles in place per se because you've got to keep moving your face. Right. So we're going to take kind of this, the stocking encasement of the muscles and tighten that up.

Yeah, because I would imagine if you just did the skin, if you just did the skin part, that's going to really start creating a. It's not going to look amazing in a few years because the muscle keeps falling. But you've tried. So that's what's going to look funny, I would imagine.

Yeah. I think in through the 80s and 90s we had actresses who were doing just like a lot of skin tightening facelifts and they had that kind of wind tunnel type.

Oh, is that what creates that? When they look like that?

That's that. Okay. And that's also just indiscriminately pulling the skin backwards and tightening without. We want upward lift and vectors of support because the mid face and the cheeks need to be upwards.

We kind of want a heart shaped face versus a heavy pyramid of aging where we feel jowly and heavy down below. So that's the concept of doing. You can do a skin only facelift, you can do a skin with a little bit of SMAS tightening, then you can do deep plane which is really getting in deep to where muscular attachments are and grasping the fascia of those and tightening everything underground and a safety point.

Now some people I see they do a facelift and they're like recovering super quick like a couple days later. They look great. They look like. And some people, they look terrible. For about a month. They look like they went through a windshield. What's the difference there? Is that a surgeon technique? Is that just different individuals and how they heal? Why do some people.

It's a little bit of both. I would definitely say the deep plane facelift is going to give you much more downtime because you're disrupting all of those planes of anatomy. You're messing with the lymphatic drainage, and there may be significant amount of more bruising or swelling.

Okay.

And some. Some of us in surgery will use different treatments like growth factors, exosomes, et cetera, which, when applied in the surgical bed, will improve wound healing and make it better and faster. Some of us, like myself, we use hyperbaric oxygen and different treatments after surgery, which will improve wound healing and make you recover faster. So I think some of it's the person, some is the technique.

What about people that do multiple things at one time? Do you suggest that or not? I know, like, when I went and got my eyes, I did upper bleph, lower bleph, CO2 laser, and a fat transfer. And my surgeon suggested that I could consider a brow lift, too. And I didn't like that. To me, I got scared. I'm like, that's going to be too many changes that could change my face. And I asked, can I do that later if I wanted to? And he said, yes, I could. That was my choice. But would you. Do you advise patients to do things at the same time, separate them out? What are your thoughts on that?

I think it's beneficial as much as possible to try get things done in one setting, but with the understanding that it's a longer recovery.

I like your idea of the CO2 laser plus the upper, lower bluffs and fat transfer. That's enough for one setting. As long as your brow is in a good position. I would not want to leave anatomic mis positioning. If you had drooping or brow ptosis, I would have definitely told you to do it all in one go. But your brow is actually great. So I think that's something that was just sort of icing on the cake. In that case, I would say lay it and do it separately. Yeah.

In my case, like, I could see what he was talking about, but I'm like, but it doesn't. I don't. I'm okay looking. Being aging. I'm okay with some aging signs. Like, that was like, just like, I'm okay with little squint lines here. Like, I don't. I think that we all have our different. It's so individual for everybody, right? Like for me, I could not stand that my eyelids were falling on top of my eyes. I felt like I looked tired all the time. They were sticking to my lashes. I hated that. But I never was walking around going, I wish my brow was higher. So that was in my mind, I'm like, well, I wanna fix the thing that was bothering me. Not just try to look, try to make it look perfect. That was how I was thinking. If you've listened to my podcast for any amount of time, you know, there's been lots of guests and lots of talks where we've chatted about what to eat, getting enough protein, eating healthy, the importance of it, why we wanna eat organic. But I wanna share that as we age, it's not just what we eat, it's what we digest. Even if we eat super healthy, clean, organic food, we can still not have the best digestion. You see, our natural ability to digest food declines with age. This is because your body produces fewer enzymes, which are the proteins responsible for digesting food. And when you have fewer enzymes, this means more difficulty digesting our food. So even organic, healthy, or what you think are perfect foods won't provide enough enzymes to properly digest them. So this is especially true if you cook your food, which most of us do, because cooking kills the enzymes. So if you've ever wondered why you might have digestion problems even after having a healthy meal, it's because your body just can't produce enough of the enzymes to get the job done. So this is where supplementing with high quality enzyme supplements can be a huge help. So I personally use and recommend a specific digestive stack from Bio Optimizers which includes their mass Zymes, which is a best in class supplement loaded with full spectrum enzymes for digesting proteins, starches, sugars, fibers and fats. So when you take this enzyme daily, and I personally take them with each meal and replace the enzymes your body is no longer producing, you're able to eat all sorts of things and digest them quickly without the bloating, without the feeling, you know, puffy, without the leaky gut issues, all of that. So when you digest your food properly, you're actually getting all of the nutrients. So I've got an exclusive offer for all of my listeners. If you go to bioptimizers.com forward/nataliejill again bioptimizers.com forward slash natalie jill. You can also use coupon Natalie Jill to save. You'll see my recommended stack which includes the Mask, the HCL and the Probiotic.

Yeah.

I think that, you know, there are some surgeons that want to do like a seven, eight hour surgery. And I look at always the amount of anesthesia time that you'll be under. It's a really critical thing for me. If a normal face liquid will take between four to six hours, and then if you're going to add a bleph and a laser and this and that and a fat transfer and it's going to be 8 or 10 hours of anesthesia time, then I don't really like to do that. I would prefer to do slightly shorter case and do several different sessions and the other way. The other advantage of kind of spacing it apart is you can customize the result better because you can see what you get and you can, you know, then try to add or subtract from there.

Good. Okay. And I always think it looks a little bit more. Even though I share, I like, tell the world what I'm doing. I think a lot of people, they're not sharing, they don't want to tell. So I think it's going to look a lot more natural when you space things out. Because it's a less obvious night and day change, I would imagine.

Exactly. Yeah, yeah. I think it's more subtle. You have the ability to kind of. Yeah, I think the ability to customize and get used to what you look like before you decide to do the next step is very important.

Talk to me about, I'm going to go down the next level. I want to talk about fillers and Botox and when those things are needed and when you recommend them. And I want to kind of talk about nuances of both. So let's start with fillers. I want to understand when you think fillers are a good idea, when are they a bad idea, how safe or unsafe are they, and is it true that they stick around forever and that they can migrate?

Well, I think we have all heard all of the above on social media these days. And fillers are great, great products. They are basically a substitute for facial fat. And when you use them correctly in the right plane, the right depth and the right quantity, there is nothing better. Very predictable, highly reliable. And like, that takes the place of using your own fat, nano fat, which a lot of people don't have enough fat. Sometimes fat transfer can be patchy. It can look good the first two years and then it can really settle down and cause inconsistencies, depressions, and like, areas where it needs to be touched up. Or conversely, it can grow up and be too, too big. If you gain weight, etc. So fat can be somewhat unreliable. So I use filler in our practice and have been using filler for 20 years. And the only time we have problems with filler is when someone else has placed it in the wrong depth in the wrong plane. And in those cases, it can be very visible. It can draw a lot of water content into the skin. It can look puffy or bloaty. So, like, that's, that's definitely a problem because the human eye can see that. You can see when someone looks unnaturally over, like, too much turgor and water pressure in their face, can it migrate?

Is that true? Like, if you put it in someplace, can it move to someplace else?

It certainly can, but that's, again, mainly true if someone's injecting outside of normal facial compartments. If you're within a compartment at this certain depth, plane or layer, it really shouldn't migrate too much.

What about. I've heard people say they have to dissolve their filler before a surgery. Is that accurate and why?

Well, so I think if you're doing surgery and you're under the eyes and you've had previous under eye filler, we do find that filler in those areas can really stay for long periods of time. Some MRI studies have showed it can stay for four to seven years, which, when it's placed correctly, that's a bonus. When it's placed incorrectly, it can become superficial or draw too much water there, and then that. That becomes a problem. So in most cases, if we're going into surgery, we want to see what's the baseline problem minus the filler. So we would have you dissolve your filler for rhinoplasty too.

What about the safety of them? Are they safe? Are they toxic? Like, again, social media is very confusing for people. So what? Like, is it. Are they dangerous for us? And why do some people look so funny with them? Is it just like an overdose of it or doing it too many times? Like, some people, they really look like a puff doll.

So, yeah, I mean, honestly, that's your injector technique. So, you know, you can give two people the same paint box and have two very different paintings created. And some people have artistic skill and other people don't. I mean, it's like saying, here's a pair of scissors. Give these two ladies a haircut. Let's see who does a better job. Yeah, people think that filler can be used. Botox is. Botox is Botox or filler. This filler is filler. And you can get it this anywhere you want and you'll get the result you want. That is not the case. It's not all dependent on the person's hand skills. It's their anatomy knowledge, it's their imagination and their artistic beauty skills. So you have to find someone who has a beauty muse that matches your muse. Like, you know, do they have your style aesthetic because they're going to create your face for you. Also, are they talented? Do they have enough expertise? Is this their, you know, 10 flip injection or is it like 10,000, like I've done 10,000 lip injections literally. And so it's like such second nature. Like, you know, I think you have to have put in the hours and you have to have the anatomy knowledge and the skill.

So when, you know, I grew up in the 70s, I was born in 71 and 70s, 80s, 90s, big lips were not in, in fact. And I have naturally big lips. I've actually never done filler on my lips. These are my lips and my, I used to hide them as a teenager. I'd wear like the, the mauve on white lipstick. I can still remember trying to hide my big lips. Now big lips are like this, this whole big thing. And it's just, I say some, some people, they look amazing when they do it and some people, they literally start to look like a duck. Is that also technique or is that just they've been overdoing it too much?

Oh my gosh, that's overdoing it. So that's, you know, the old school teaching and aesthetics used to be that the fillers last a year. You have to retouch it every year. I think there's also. That's wrong. They last longer than a year. You don't have to retouch every year. And there's also some addiction that you get this burst of dopamine when you see yourself with these fresh, pretty lips and you just feel like a million bucks. And then you want to do it again. And it's like buying a new pair of shoes. You want to do it again, you want to do it again. You get that little. So you have to have self restraint. You have to have an injector who tells you no.

Do you tell patients no. Sometimes.

All the time. Every day? Every day, really. You know, sometimes I'll talk them down from a full syringe to a half syringe or even water syringe. It's just the psychology of like they just want to feel pretty there and yeah, to tell them they look pretty already and Then they kind of go with that.

What about upper lip lines? I'm gonna ask because this is something that's bothering me lately. Like, I. Like I've never smoked in my life. Yes. I'm drinking out of straw. I know I shouldn't, so. But it's the. Those lines, those vertical lines I've asked many times, different facial aesthetics. Like, what can I do for that? Like, is that a filler thing that you would put in the lines? Is that, what. What do you do for upper lip lines? A lot of women have that in midlife.

Yeah, it's a difficult problem because that thins out very quickly. So I think lasers are excellent. If you have the downtime to do a CO2 or a resurfacing laser, that would be one of my favorite things to do there. Repeat sessions of microneedling using polynucleotides or salmon sperm type treatments. If you do four to six sessions, you will see a change in these lines. I would do full face. Not just that.

Okay.

I also, in my practice use a kind of a hyper dilute version of filler. So it's filler, but it's diluted by more than two folds. It's very thin and it's just a wash of volume here that just gives the softening. You can treat the exact.

Is that the Sarah V. Thing I've heard of or is that what that is?

No, different. That's just my own technique. I use cannula. I'll use a very thin, watered down type of a filler that spreads like just beautifully. It gives a wash of volume with that volume.

That's awesome.

Yeah, it looks great right away. And then I think you can fill the very, very deep lines with filler itself. If you really want to. We could put a unit or two of Botox anywhere. The muscles pinch in and like they form those accordion pleats or barcodes. So there's about 20 different things we can do. But I think the best thing is as soon as you see the problem, to start early. Because once it gets entrenched, it's rather. It's a. It's a little journey to fix it.

So I gotta do something now if I'm gonna do it. Got it. That's the thing. That's the thing bothering me as of late.

Yeah. Anytime. It's just the face is gonna change over time and its skin is like a piece of paper. The more you repeatedly crease it, the more it will keep the creases.

Makes total sense. Okay, what about Botox and Xeomin and what are they called? Dysport. There's like all these different names for it. They're all talking.

So many different toxins on the market.

Are they all the same thing, just different name brands? Is there one you prefer over the other? Are they really dangerous for us? Are they bad? Does it go through our liver? Again, social media scares everyone. So what do we need to know about those?

Yeah, they're very, very safe. All the toxins are extremely studied. They've been on the market for 20 years, since the year 2000, 25 years now, actually 100 million doses of brand name Botox have been given and now there's so many other toxins on the market and this is nothing. If go to other countries. Here in the US there's five on the market. In other countries there may be like 50 different toxins and they are all the same core molecule. So they have the same core, you know, neurotoxin that helps to stop muscle contraction in the areas where bad wrinkles happen. And they all last approximately the same amount of time. They're all FDA approved for 90 day duration. Some of them report to have results that last slightly longer. So if I was to look at like, what's the real difference between all these toxins? It's purity. That's for me, the most important question. Like if I have to use a toxin or caffeine or drink alcohol or whatever it is that we humans do for the benefit of it, I want the smallest amount of toxin possible to give me the nicest result for as much time as possible and the most safety. Right. So I'm going to go with something that's the most purified, the least junk proteins. Because after all, if you're going to dose this repeatedly, two, three times a year for the next 10, 15 years, your body will develop some tolerance or they will learn the antigens that are in that mixture and it will start to be like a little mini vaccine every time you get it. So you can get resistance to Botox.

So would you use Xeomin or something different? Is that the most natural one or is that a marketing thing?

No, that is Xeomin is the most purified version. It has 10 times less, less junk proteins than like brand name Botox. Dysport has maybe the most junk proteins in it. It's bacterial flagellar protein in it, which is like fragments of things that happen in the processing of the molecule still. All very safe. However, like if I'm going to take a, there's all these formulas on the Counter and one of them has the least junk proteins is like just only the core toxin period. That's all that's in it. That's what I'm gonna use, right. So that's what I use. It may be a little gentler, it may not last as long, quite as long. Although that's also mythology. Like all the studies show every toxins only FDA approved for 90 days. So whatever talk that's out there, that's propaganda about ours last longer. Well, they can't prove it. Otherwise the FDA would let them state that all over their advertising.

Now I'm certainly not a doctor and I'm not you, but I would, I would imagine it also is kind of like patient goal. So like if someone wants to look like an ice skating rink and have no movement, I would imagine you would do more frequent and stronger. But if you're just. Your goal is to not get the impression like the fully imprinted lines, you can maybe do it once or twice a year because your goal is just to soften it. Is that how you kind of determine how often someone does it or what?

Yeah, I would say you definitely should not treat in between treatments. We want people to go like a full 90 days before they get another session. And yes, if your goal is prevention and you don't have any lines, maybe you can get by with two times a year, three times. But if you already have pre existing lines, you probably need to be a little bit more regular with it. And yeah, so most people come once every quarter, like every season or about three times a year is pretty average.

Now why do some people literally look so crazy when they get toxins? And some people look amazing and lifted. Like I see people look like a major Jack Nicholson. Are they like, like what is that technique again? Or is that individual like.

That'S all technique.

That's all someone, an injector has to use their anatomy knowledge to look at your face and imagine underground where muscles. And if I place toxin, I have to really know the effects of how I can subtly change muscle contraction. And then I have to been doing it long enough to understand what the dose will do. So much of it is just injector experience. You can definitely give someone a spiked arch Jack Nicholson look. And on the other hand you can give someone like the most serene, beautiful, uplifted looks like they came from vacation. Wow. Wow.

What about I. So I had a friend, she's hysterical.

She posted this publicly. So I'm not breaking any confidence here. My friend Danny J, she had this experience years ago where she got. She gets Botox regularly and she shares it, and she had gotten it, and then she was at a friend's house, and they were using some tool on their face to like, one of those natural tools that vibrates or put some frequency. And she put it on her forehead without thinking. And the next day she woke up and her whole. One of her eyes had half shut. And she came to find out that the Botox had migrated. And so she had to wait literally the three months for that to open back up.

So what.

Why does that happen? Like, when you first get Botox, do you need to not touch your forehead? Is it just those frequency devices? Like, what have you seen that happen with a patient?

Well, thankfully, we tell patients real careful instructions to. We don't want you to do anything on your face for the next three hours. You have to be upright. You can't go sleep on your face. Don't go crying for three hours.

Okay?

Yeah, three whole hours. And in reality, the toxin binds very quickly, like within one hour. But if you just go right away, if you put on a baseball cap and droop everything down, it will muscles that are going to depress and lower your eyelids, your levator muscle will be knocked out, and then you can't elevate. Wow. Yeah. So you gotta be real careful in the beginning. Right after Botox, I think that's where we started. You know, telling people don't exercise makes sense. Yeah. So nowadays we don't worry so much about exercise, but definitely don't manipulate the face, don't get a facial, don't put on any weird devices, don't even wear your baseball hat.

I would probably say avoid like all the, like, avoid your infrared, avoid all that just for the first night or whatever it is, just because. Why mess with it?

I like this. Yeah, you can lay low till the next morning, and then you can all normal the next morning. Wow.

Okay, talk to me about the, like, skin care products. And, like, what the heck is salmon sperm? Is that what it literally is? It's literally the sperm from salmon. And why is everyone talking about that? And what actually, like, what products do we need to be. What ingredients should we be looking at topically applying or putting in microneedling? And. And can anyone do, like, so many people talk about microneedling. Like, estheticians talk about it. Doctors, is there different grades of it?

It.

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Yeah, great question. So, yeah, let's start with microneedling. There are different grades of it. Estheticians can only do the very low grade microneedling, which is kind of like Amazon devices you can buy, which are 1 millimeter or less. And in the office we can microneedle up to 3-4 millimeters depth, which can kind of take you through the top layer of epidermis into the dermis, whereas blood flow and all of the regrowth structures are. So I think that's definitely ideal. And you have to be so careful. In some states, estheticians can do everything. They can inject Botox, they can do threads, they can inject fillers. Like, I would never, ever recommend that. I would like everyone to see someone who's board certified within the core four specialties, because then there is credentialing, process, education and training where you gone through a whole curriculum and a state board has certified you.

So does that mean like doctors only? Can that be a nurse? Like, who? What do you mean by that?

The four. So those core four specialties where you can most likely get the, the highest degree of care would be like plastic surgery, facial plastics, oculoplastics, and derm. Okay, and then can you see injectors outside of that? Yes, you can see nurse practitioners. You can see in certain some states they can work alone. You can see RNs. They always have to be under physician supervision. And you'd be shocked to know how often that physician is like in another town to do with this person. And then, you know, then estheticians, depending on the state.

So yeah, I'm not, I'm not really enrolled in like the dentist all of a sudden offering Botox or like, like, it seems so bizarre to me.

Ob GYN doctors just.

Yeah, like, oh, yeah, that's true. The ob GYN doctor, they have like, they have a sign like, do if you want Botox out, like what.

You focus on vaginas. Why are you asking about face now? That's interesting.

Well, everyone realizes it's a lucrative type of a thing to add to your practice, but honestly, you really need a lot of I, I would want someone who's fully focused on this and only this all day. And like, why would I pay a nurse when I can pay someone who's got a little bit more credentialing? Like I don't. I teach, train a lot of nurses, so if they have good training, I'm all for it. But more often than not you may find that they don't have supervision, that they haven't had a lot of training. So it's, it falls on the consumer to do a lot of homework before they get someone to shoot up their face.

Retin a Hydroquinone. Is that how you pronounce it? And then salmon sperm. Tell me what those are. Should we all be using them?

Yes. So for home skincare you were asking what are the important things to be on? So I think everyone should be on a retin a after age 30. Okay. And that's usually one or two times a week when you're getting started. Then you'll work your way up to every night. It's just a pea sized amount. It's a vitamin A derivative that's going to help increase skin turnover and collagen production and gives you like better skin. The better, better, much better aging process. So that's easy to add to your routine. Vitamin C I think is mandatory. I like it twice a day in the morning for sun protection, in the night for collagen improvements. And I think a hyaluronic acid also like a product with rich, nice ceramides. As we get into menopause and perimenopause, the skin does not have that nice pliability and it just lacks moisture. And so it's important to add the nice lipids back to the skin. And I would say a great neck cream. Got to start on a great neck cream and eye cream. I have a great one. It has again these very rich lipids and ceramides because the skin of the neck is like the dry desert. So I think those are important products to start on at home. I would always say like up level what you're doing for yourself. When you're 20, you could shop at Target and Sephora and in your 30s, maybe Sephora, maybe you're in into Nordstrom's type brands. But you're going to get a lot of expensive marketing and advertising, you know, at the Nordstrom's level of spending on brand names, it's not necessary. I would definitely suggest to think about physician skincare. And I'm biased of course, being, yeah, having my own skincare line. I'm a bit biased, but I know our ingredients, my ingredients for sure, Stronger, better and more clinically tested.

Now what about the bleaching creams like hydrocarbon, am I saying that right? Hydroquinone.

So it's a great product. It's been around for 30, 40 years and it does work very well to suppress melanin production. But it recently was taken off the market and for. Because of overuse and I think that came mainly from Asian markets and they were using very high doses and it can cause some. It's very rare for it to cause problems at all, but in certain patients it can cause bluing of the skin or very rarely can give you predisposition to skin cancer type of changes. But that is only when overused. And I think certain cultures have the desire to bleach and lighten and.

It becomes obsessive. It's culturally important. And people were just using these products from adolescence in the wrong way on a daily, daily everyday overusing whey. And I only recommend patients to use it with short pulses. We still prescribe it and use it all the time. But there are other products out there that are natural lighteners so you don't have to use hydroquinone. And we're trying to wean people towards some of those natural lighteners. So like vitamin C for example, Kojic acid, Emblica, There's a whole slew of them. I have like five different natural lighteners in our bleaching pads. But then again, I use, I personally use hydroquinone. I have extremely melasma. When it flares, I'll use it for six to eight weeks every night at bedtime. And that turns off the melasma monster. And then you can go back to something that's not so and so. I think the off and on approach in my practice has been good for patients.

So I used to use all the things like retin a the bleaching stuff. I used to use all of it and I loved how my skin looked. And then when I was going through all of my detox stuff, when I explanted, I cleaned up everything. Like I took, took everything out of my skin care and my skin looked terrible. And I remember my makeup artist was doing my skin, was doing my makeup and I said, and she's very knowledgeable with skin. And I said, what's going on my face. Like, why do I have like these spots now and these little lines and like. And then she's. And I'm like, I'm doing all these great natural. And she's like, you're using all natural products, aren't you? And I'm like, yeah, I'm using like I thought she was giving me like a kudos. And she's like, yeah. Every time I see someone switch the completely natural, they rapidly start, the aging starts to show. So I got conflicted like, okay, well. And someone's gonna listen and go, you're so vain. Yes, I am. I'm sorry. I am, I care, I do care about how I, how it looks. So yes, there's a, to me there's a mix of like, I want to be healthy. I wanted the best choices. But there's some things that are going to be non negotiable that I, that I want to use. So I. Is there any natural stuff, like any all natural that you're like, yes, this natural thing is amazing or are you just like, it's just wishful thinking and it might be healthy, make your skin feel good, but it's not going to work.

Yeah, I mean there's nothing truly natural. Right. Like what's natural? Poison ivy, like for your skin. Are you gonna go put that on just because it's a plant based product?

Yeah, that's true. Give you a nice little red rash.

Yeah, right. Like so many plants are very hyperallergenic. They're problematic. And so you can't just say something from nature is always going to be the best choice. And like we, there are many of these products are derived from nature. Vitamin C, of course, citric acid comes from, you know, Lem and.

I think you can use components that have clean beauty aspects so we can develop products that don't have phthalates, that don't have.

Products that are very industrialized and you can put them in solutions and formulas that are going to transform your skin. But I am with your makeup artist, when you start to go all natural, you're basically just adding water content and moisturizer and lipid type of content. That's not enough to really reduce. And when your skin looks old on the outside, it's not vanity. Like that is actual senescence. Showing senescence is this process where skin starts to. Some skin cells turn into zombie cells. They're no longer functional, floating around, creating evil humors, making all the other skin cells slow down and stop replicating. So we're trying to get Rid of senescence, skin senescence. And we can reverse that by giving really strong antioxidants. Really important to add. I would say if you want to do a natural approach to your skin, do a ton of antioxidants. I have a lot of green tea based products. For me, green tea is like a miracle antioxidant. I love it. I would definitely add that to your regimen. It'll brighten and tighten and improve redness undertones really well. I like the vitamin C using that every day. Hyaluronic, which is an ingredient that your own skin makes. So you have the ability to make a little arsenal of very safe products that don't have a lot of added preservatives and, you know, dyes and fragrances. And then just stick with these regularly because if you don't exfoliate and give your skin products that turn it over and make it work hard, it will just get old.

Yeah, that makes sense. That makes total sense.

Yeah.

And I see people sometimes. I'll see somebody on social media marketing, like, they're all natural, whatever. And either I think they don't look very good or if they look really good and then I've seen them in person, I'm like, they're using a filter. There's something going on there. So I think we just have to dig and then we have to make our own good choices based on our beliefs and what we want for ourselves and how we want to age. I want to ask you about the sun. Me and my husband argue about this all of the time. Dr. K. So I. Okay, so just backstory. First of all, first of all, I want to share. I love the sun. I think we all need vitamin D. I think we need natural sunlight. I am not anti sun. Like, I'm not for blocking the sun and being extreme and all that. Like, I think we need some sunlight. However, you will never see me lying out tanning my skin. I just won't do it. I've had basal cell carcinoma three times in my life. I have brown spots all over my body from years of tanning in my 20s and teens. Like, they come out in your 50s and they're not pretty and you cannot get rid of them dark spots. But the basal cell scared me. And I had my first, first bout at age 24 when I saw what they took out of my chest.

It was.

I had a little, little mark, took out a lump like the size of a man's fist. Like, I. That stopped me from the sun. So for me, and I'm not for harsh sunscreens either. So, like, for me, I am outside every day. I get some natural sunlight. But I have a hat on, a big broad hat. And I'm aware. So my skin, my actual skin will get about 15 minutes of real sun a day. Other than that, I'm going to cover. That's me. My husband, he bakes in the sun. Bakes. And he's had squamous cell, but he's convinced that it's not from the sun, it's from the oils that run. I don't know. So help us as a doctor, like, where is the. What is true, what is not what? Social media scare. How do you act in the sun?

Well, I like your approach. I want everyone out there to understand that 90% of skin aging comes from sun. And the ultraviolet will break down your skin. Skin is delicate. It's like a newspaper sitting in the driveway. How long do you leave your newspaper out before it gets yellow and cracked and aged immediately? Right. Just two, three hours. So you. It is your job every day to protect your skin. For sure. There's ultraviolet A, that causes aging, ultraviolet B that causes cancer. And the best approach is a broad spectrum sunscreen applied liberally to your face and anything that's sun exposed and then a big hat. Sun avoidance is key, but I also feel that humans need sun. So the morning, typically it's sunset and sunrise that are the best.

That's what I like. I go outside both those times.

Yeah, yeah. And that's the time when your circadian rhythm needs to get some sun exposure. If you're going to go out without sunscreen, I would do. I would sunscreen your face. Still like the important real estate. Me too. But allow the natural sun to hit your back and shoulders and arms and extremities. And you can do that in the early morning, the late evening hours, sunrise and sunset with a good amount of safety. The spectrum of light that's hitting your skin at those times has protective spectrums as well. And all day long, for humans to be indoors and just under blue light and ultra artificial light sources is not going to be good for your circadian rhythm.

This is so interesting because. Okay, so I just recently interviewed a heart doctor, like a cardiologist. And I saw the same divide there in the heart world. Like, this guy happened to be a vegan. And then there's like people that are carnivore. Right. But when I really interview, like these different cardiologists about what creates heart disease on social media, it looks like these extreme things like avoid all this, only add this. But when I really boil it down, there was a lot of commonalities, like a lot of them for in the case of heart said, oh, if you have lipoprotein little A, that's different. Like, so there was some commonalities or yes, we still need polyphenols. Like, there is some commonalities. So I think these extremes get sensationalized for marketing and social media. So I see the same thing with the sun. Right. I don't think anyone said avoid all sunlight.

Right.

But there becomes this extreme divide. Like this person said, the sun is evil, and this person said so I like what you just said because it's not an extreme answer. It's just anything in extreme can be dangerous.

Right? Very, very true. And I think people get a lot of publicity these days when they state these really loud opinions on their social channels. And so I guess some people don't really care, but yeah, you know, they just want the views. But it's so important to make people understand that there's, there's near infrared light that's within the spectrum of light. That's very healing.

Actually.

There's studies that show that improves fibroblast, which is your skin cell function. And having the near infrared, like, and you're just out there walking in the sunrise and sunset hours, that balances. That's amazing that you're going to get from the UV rays. And so, and that's why, like, I.

An infrared sauna does that. It gives you the near infrared. It gives you the best of the spectrum. Without that. Yeah, I think we're going to see a big. I, I, my prediction is going to. We're going to see a lot more skin cancer because of a lot of this. That's, it's just, it's wild to me that it's come to that. Like, it's like we take some things that are good for us and it's gotten to this extreme.

I don't know that's true. But I think also the sunscreen fanatics have to take it easy a little bit. Like, I love sunscreen. I'll always wear sunscreen. I personally only wear mineral sunscreen.

Can you explain the difference between that? Because that's me too. I do mineral base and then a hat. But some people don't understand the difference.

Well, the composition is the big difference that the mineral sunscreens have zinc oxide and titanium dioxide that's going to be a bit more reflective of sun. When UV hits the skin surface, it should bounce right Off. There have been a couple studies now that show that that thinking is not 100% correct, that the mineral sunscreens do not bounce light off of the skin, but they interact with the UV in a way that disables the uv. It's the same thing with chemical sunscreens. But just conceptually, I'm not a fan of the idea of a chemical entering, penetrating through my dermis, going through reactions that then disengage the bee. So I think that. But I feel the mineral sunscreens are the safest ones.

I agree with you there. Either that or the shade or the protective stuff over you like a big broad rim hat. It does wonders because you're not.

UV clothing is one of the best things you can do is just keep your arms covered and still enjoy the heat and the warmth, the loveliness of the sun. Totally. Yeah. So I'm with you. I think more so than your husband.

Yeah, Him. And I will be challenged.

I think I got.

I said the same thing. He doesn't listen. He won't listen to me. He gets mad at me for not wanting to be tan. And I'm like, you can't convince me after having the skin cancer, like, it's not gonna. It just won't happen with me. Because I know. I went through that. And I know. And having a surgery on my face to remove one, having a Mohs surgery scared me to forever. Like, that's not gonna happen again. Like, I didn't know if it was gonna come up deformed. Like, I happened to be very lucky with that Mohs surgery. Mohs surgery, for those of you that don't know when you have a skin cancer on your face, they have to get all the margins. So rather than just taking the whole chunk out, they don't know. They go slice by slice at a time. You're like, at the doctor's office, the surgeon, all day, you're awake, they keep taking a piece to make sure they get the margins. And some people, literally, you lose half your nose or your ear or.

It's pretty aggressive.

Yeah, it's aggressive and it's scary. And you don't know going in, how deep that skin cancer is. So it. It's wild.

Yeah. That's why I tell people protect this important real estate of the face, because there literally is very little space, place to be missing and moving a skin flap and reconstructing and rebuilding. It's not like your back or your arm. Totally excess tissue we can move around. So.

And get them checked. There's a Kind of a cool thing I figured out recently. I had like a little mark on my leg. I took a picture of it. I uploaded to Chat GPT and I said, I, I prompted it and I said, do not scare me because I'm tend to be, you know, I'll get scared. I said, but tell me what this could be and what I should do. And it was nice. It gave me all the things it possibly was. And then it said, I'm not trying to, to scare you, but it looks like blah, blah. You really need to have a dermatologist check it out. So I thought it was you could tell instead of Google where you get scared, you could say chatgpt, don't scare me, but tell me what I need to do next.

You know, that's a good prompt. That's a really good prompt. Actually, the dermatologists now do have AI that they're building that's really amazingly accurate to do skin scanning photography.

That's amazing.

Yeah, lesions. It'll be very, it's machine learning. It's going to beat all these things every time.

That's amazing. Tell us a little bit.

Don't forget to remind me. I got to tell you about salmon sperm.

Oh, tell me about salmon sperm and then I'm going to ask you about your product line. Yes, yes.

I guess people have the perception that it's literally like sperm that you put on your face. That is not what it is. That is not it.

We use the sperm molecule, the sperm cell, because it's a big cell filled with the giant nucleus and very little else is in it. It has a big nucleus and a little tail. Okay. So in the lab they're able to take that nucleus and break down the DNA fragments of the sperm cell. And then you get these fragments of nucleotides, the acgt, that make up the DNA. We remember that from like seventh grade biology. Right. And so those, that is the reason we use the salmon sperm because it's mainly just a cell full of DNA. We take that DNA that, that's chopped up into little small fragments. Well, when that gets needled into your skin surface, your skin has a tool, like a building block to repair DNA damage. So what is DNA damage? It's brown spots, it's fine lines, it's pigmentation, it's any skin surface disruption or barrier problem. And so you're giving your needling into the skin. Like here is the repair tool that you need to fix this right away versus your skin has to go and manufacture more of the nucleotides. Or salvage them and, and find them. And like, it's just a slower process. When you just deliver the payload right then and there, you can heal faster. And many of these nucleotides are mixed with amino acids, proteins and minerals and like trace minerals, things that we need hyaluronic. And so that's all getting infused like high dose vitamins. And it's just like a rescue shot for the skin. Oh, okay. So it really transforms the skin. You get some instant glowiness from the microneedling. You get collagen production as well. You get this DNA repair so that like you said, your skin has all these brown spots from when you were 20 and you were in the sun and the DNA damage occurred. And now DNA damage is not going away and your skin has very little tools to like fix and repair. It's keeping up with the normal wear and tear of life, let alone like going back and doing the cosmetic brown spot patching. So like here we are giving the tools to do like that.

That's awesome. I can't wait to see how that improves. And I've just so you know, I've done like the Alexandra Light. I've done. Done so many lasers on those. They don't. They have not gone away. And I think mine was deeper than the sun. It was also tanning beds years ago, like. Yeah, years of tanning beds. Yeah. I had tanorexia for sure in my teens.

Yeah. So that we say that like those damaged cells are like the signs of senescence that occur. It's in your skin already and it's very hard to reverse. But they're new technologies that are coming for that.

That's amazing.

Yeah. Come and try a salmon treatment anytime.

I'm gonna have to try a salmon salmon on sperm treatment.

Okay, tell us about your skin line. So you developed your own and I'm assuming you did, because the reason a lot of doctors will develop their own line is they don't see what they're looking for on the market. So can you share a little bit about your line? And I have not transparency as I'm recording this. I've not tried her line at all yet. In fact, I think she said she was sending me some. I'm excited to try and I'll report back, but tell us about it.

Well, for 20 years I've had a skincare line that started with an acne kit and then I get developed a hyaluronic a, vitamin C, retin A and kind of like everything I kept building because I needed it for myself. So the more I'd research it, the more I'd put together the components. So now I have up to 20 different SKUs. But what I'm most excited about this year is a new line that's got. It's really going to work on regenerative longevity of the skin. So it has NAD precursors. You guys have all heard of nad. NAD is the molecule that fuels the powerhouse of the cell, the mitochondria. And as we age, we don't have nearly enough skin energy. The skin stops turning over. That's why you get adult dullness. Why does children's skin glow and our skin gets dull and, like, you know, doesn't look vibrant and vivacious? So I developed this line that has NAD boosters, and it has a very important tripeptide complex. So three different peptides complexed with copper and glutathione, which are such important products for rejuvenation of the cell. And these tripeptides, one of them stimulates collagen, the other stimulates elastin to grow. And then the third one improves epidermal turnover. So it's kind of like it's the holy grail for me because, like, I've never had or I've always had to get these things in different locations. Sure. You get glutathione as an iv, Booth. You know, you can get an iv, you can get it topically, but it's very hard to use when it's straight glutathione, so. And copper is the same way. You can take it orally, you can take peptide shots. But these. These peptides complexed with this tripeptide complex is going to be so easy to use. So we have a product for brightening, for brown spots of a product that's green, that has chlorophyll and green tea. And each and every product in this line has a tripeptide.

Oh, I'm excited to try all these now. Okay. Where can people find them? Is it. Is there what?

It's Kdskin Shop. Kdskin Shop. Ooh.

And we'll link all that in the show notes if you want to try, too. And I'll have to report back.

Back.

Thank you so much. This was so helpful. How can people see you? You're in Beverly Hills or where are you at? Where are you located?

Pasadena and Beverly Hills. Both. Okay. And you can reach me on my Instagram is easiest. It's Beauty by Dr. K. Right here. Beauty by Dr. K. And our website is the same. Beauty by Dr. K. R. K. A-Y.com.

And I, I met her by the way, you all because she my one of my really close friends, Chalene Johnson discovered her years ago and she actually shares that she has gone to you for treatments. You've worked on her skin and her face for years. Yeah, like I think that's how you know her. She shared that publicly. I'm not saying anything I shouldn't. And then to. And then she had her on the panel at her recent camp be more so that's how I got to know her better and I thought I've got to have her on. I want to understand more about what she does. So you see patients from all over. They can fly in work with you, I'm assuming from all over.

Yeah, I see patients from all over and I think it's very unique to have the ability to do everything from just, just your first time Botox, take you through your fillers, put you on collagen stimulators to push off ever needing to do surgery. But then when you need surgery, I do your surgery also.

That's amazing.

I don't advertise a ton because I'm just not like the braggy surgeons of the world that are out there, but I do.

You're also working on people, so you're busy.

Well, I have a very bespoke high end clientele and like they don't want to be talked about. I get it. Yeah. But that's okay. I'm happy to help anyone out there that wants some info on how to age well.

Thank you so much for today. Thank you.

Yeah, my pleasure.

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