Is a Face Lift Worth It? Plastic Surgeon Tells All

Facelifts are certainly having their moment. Kris Jenner, Denise Richards— suddenly every woman over 50 is asking, is this what it takes now? Do I have to do this? Do I need a facelift? Or is there a natural alternative that actually works? Today, the most trusted holistic plastic surgeon on the internet tells us the truth— when a facelift actually makes sense, what works just as well without surgery, plus the honest answers that I've got questions about around Botox, filler, collagen, sunscreen, and the one thing every midlife woman should be doing right now that almost nobody is. So here's where I'm at personally. I'm I'm in menopause. I see my face changing. I see my jawline softening. I see all the things that you all see in the mirror, and I want to know what actually works and like what is the hype and what's the honest truth about every single thing being marketed to us right now. Because every time you open social media, there's just a whole bunch of ads here. And because facial plastic surgery jumped 19% last year and 45% of surgeons now say menopause is what is driving this, which means somebody needs to be telling us the real story. So today's guest, the person I trust on this, Dr. Anthony Youn. He's a board-certified plastic surgeon out of Detroit, known as America's holistic plastic surgeon, with over 13 million, y'all, followers on TikTok. He's the author of 4 bestselling books, including his latest, Younger for Life. He hosts the Dr. Youn Podcast. He's the founder of Youn Beauty. And I'm so happy to have you on Midlife Conversations today. Thanks for being here.

Hey, thank you so much for having me, Natalie Jill.

I have so many questions for you. I just hope you can keep up. I got a lot of them here.

Let's go.

This is a hot topic right now. So first, can you help us set us straight? Like, why? I want to get right into it. Like, everyone's talking about facelifts. They are having a moment. People used to be very hush-hush about them. Now it's a thing. And open social media, Kris Jenner, Denise Richards, it feels like they're just getting more normalized. Help us. What's going on here?

So really, anybody who's over the age of about 60, if they have a sharp, tight jawline, there's a good chance that they've had a facelift. Not everybody, but really the vast majority of people. So facelifts have been happening through Hollywood celebrities all this time. They've been having it done. But lately, there have been certain celebrities who have done us the service as plastic surgeons and been honest about the fact that they've had work done. The techniques are changing, and that can help with it. Recoveries are easier than they used to be. Results are a bit better. And we're looking at aging from a full 3-dimensional perspective, not 2-dimensional. And that's where you're seeing celebrities like Kris Jenner, Denise Richards, who've been very open about having face lifts, and then other celebrities who've been rumored to have had face lifts, but maybe haven't come forward with the fact that they have. So it's a really exciting time because I do think that it's a very powerful tool for the right patient in the right situation.

Is it really changing where it's becoming more normalized, or do we just notice it more because we're in midlife now?

It's probably— I do think that there are a segment of the population, women who are in midlife, who now I think are feeling empowered to have a voice. Because of people like you and some of our common friends who have been very vocal about the fact that women in midlife have been ignored by the medical establishment for so long. And I think that they're having a moment, which is very, very important. And this, I think it plays into part of that.

Do you see more people coming and asking about facelifts now because of—

So I've always been a bit of a facelift specialist. I've always done a lot of them in practice. I do think that there are more and more people talking about it. As far as seeing more in my practice, I mean, I've always done a lot, so it's hard for me to say. I think nationally, 100%, you know, I think nationally healthcare follows certain trends. You know, it's kind of funny, one of the most popular shows on TV, The Pit, you know, it's about an ER in Pittsburgh and just, they just had match day recently and the number of medical students going into emergency room jumped in the last year over the prior years before, because I think pop culture does definitely drives certain types of trends. And having a facelift is something that appears to be doing that. You know, years ago it was a BBL, the Brazilian butt lift, is putting fat in the butt. That really followed cultural trends. That has now dropped and facelifts are having a moment.

So years ago, you could always tell if someone had a facelift. Like they had, there was this distinct windblown look that everyone had. Why now is it so much harder to tell? Like I see some of these results, I'm like, you can't even tell they had anything done.

Yeah, so the old-fashioned facelift, essentially what you would do is you would make an incision from the temple pretty much all the way down to around the ears, and you would lift the entire lower face and neck, and you would lift the cheeks. And that is the telltale sign, is they used to do this where you would lift the cheeks up in a kind of sweeping pattern, and then the sideburn would be moved up and higher. And from the side, you could see this kind of cheek— oh, what would it— it's kind of like a wind-blown type of a look of their cheek. And that was always kind of a telltale sign of it. The newer facelifts are much more judicious in where the incisions are and where the lifting takes place. So for example, when I do my facelifts, I stop my incision really at the top of the ear. They do get a nice lift of the cheek, but they don't get that kind of sweeping up type of an appearance that you can get with some of these old-fashioned facelifts. And the other thing that we're doing is we're paying attention to volume, whereas before everything was just kind of lifting and pulling up. Now we're also adding volume in certain places to really truly rejuvenate the rejuvenate the face in 3 dimensions.

So a lot of us think we understand, and is this just a myth, or is it that it used to be you'd almost just move skin and now you move muscle too? Or has it always been muscle?

So it's, the muscle was added, gosh, probably in the '90s. So it used to be a skin-only facelift where you would make incisions around the ears, lift the skin up, and then basically just pull it back, cut out skin, and suture it. The problem with that is that skin stretches. And so now really it's truly, dealing with all 3 layers. It's dealing with skin, dealing with the fat layer underneath the skin, and then dealing with the underlying muscle layer. Now, you may have heard the term deep-plane facelift. Yeah. It's something that's been used on social media a lot. There's 2 really main types of facelifts going on. There's the SMAS facelift, where you make the incisions around the ears, you elevate the skin, you reshape the fat, and then you tighten the muscle up. And you take care of these layers basically separately. Separately. And this is how I do my facelifts. I think I do it with very low risk of complications, real quick recovery. The deep plane facelift, you make the same incisions, or very similar, elevate the skin to about halfway down the cheek, and then you actually cut through the muscle layer and elevate the rest of the face in the deep plane, actually underneath that muscle. So then you lift the skin, fat, and muscle all as one big piece, and you suture that into a higher position. Two different ways to accomplish basically the same thing. That's really the difference in surgery. The deep plane facelift surgeons will say our results last longer, we get less of the nasolabial folds, or the creases, the smile lines. The SMAS facelift surgeons will say that ours have a lower rate of complications, they heal faster. And really the fact is, is that there are no studies that have shown any clinical differences between these facelifts, whether how long they last, how good of a result, it's just opinions at this time, and two different ways to do it.

So there, it's just really a technique, but same, you could have typically the same result if you—

Nobody could look at one facelift and say, oh, this one's obviously a deep plane or obviously a SMAS. In fact, you know, the funny thing is when Kris Jenner first came out with her facelift results, all these people— and I put this on my YouTube channel— all these people were saying that she had a deep plane facelift. Oh, this must be a deep plane facelift, it's such a good job. And then it came out a month or two later who her surgeon was, and people realized, wait a minute, he doesn't do a deep plane facelift, he does a SMAS facelift. Now Denise Richards' surgeon does a deep-plane facelift. So you can see they both had amazing results. They've both been very open with it. And I think you can, you know, it's just two different ways to get a nice result with the patient. In the end, it's really picking the surgeon, taking care of yourself afterwards, and then also being aware that there's a lot of factors that can impact how long your results last.

Do all of those other names like ponytail lift, or are those just different versions of the SMAS or the— Deep plane?

No. So the ponytail lift is a bit different, and you know, I actually made a video of this because I think that this is a procedure that a lot of the younger celebrities are getting done. So I don't have any proof of this, so this is just my opinion, but Lindsay Lohan looks fantastic. What did she do? You know, she didn't have a SMAS facelift, she didn't have a deep plane facelift, doesn't appear to be. So there are other celebrities, Christina Aguilera, she looks fantastic, you know. And so these are some celebrities I think that may or may not have had a ponytail ponytail lift. A ponytail lift essentially is a combination of a brow lift, a cheek lift, and an upper blepharoplasty. So removal of skin from the upper eyelids, and then injections of fat in the cheeks as well.

So nothing down here, nothing lower.

Mm, minimal. Now you can actually add that to a ponytail lift, but I do think that some of these younger celebrities, they're in their 30s, maybe early 40s, they don't really need tightening down there. They may do some nonsurgical tightening with, let's say, Morpheus8, something like that. But surgically, when you really see the difference between these younger celebrities from before and after, what it is is the eyes are more open, the brows are higher, the cheek looks lifted. This is what I think is going on with some of them. So yes, you have people who are midlife who are in their 40s, 50s, 60s. They are gonna be more candidates for a SMAS facelift or a deep plane facelift. Celebrities who are in their 30s and 40s, a lot of them, when you're seeing these huge changes, are getting the ponytail lift. But the ponytail lift is a big operation. I'm not a huge fan of it because you're talking, in some hands, it's 10 hours or more. And I don't know, the thought of taking a woman, a beautiful woman who's in her 30s, and putting them under a 10-hour operation, just, it's just not right. You know, it's, yeah, it's too much.

Okay, I want to get a little nitpicky on facelifts for a minute because I have a lot of questions here. Like, what is, what about like a brow lift? Or like when you hear things like she had a brow lift or a lower facelift or even neck, like help us understand what the difference is and are they typically all done together?

Yeah, so the term facelift is confusing because some people think facelift or Full facelift means a whole face. So as plastic surgeons, we divide the face into thirds. There's the upper third of the face, which is your forehead and your eyebrows. And that's what a brow lift will lift is your brows, okay? Or a lift of the upper face. There's the midface, which essentially are your cheeks. So there is a midface lift, okay, that can be done. And then the lower face includes the upper neck. And so if you say you had a lower facelift, that typically is a lower face and upper neck. Technically, Natalie, the term Facelift applies to a lower face and upper neck lift. And usually you get some lifting of the cheek with that as well.

Okay.

But that's technically how we separate. Now, there's some doctors who will do an isolated neck lift on its own. I'm not a big fan of that operation, but that is also a separate procedure. But most of the time, you combine the lower face with the neck because when somebody has a lot of looseness to the neck that they want to treat, oftentimes it combines with some looseness of the lower face too.

I think I can speak for all of us in our, we all go like this in the mirror and lift that neck. Yeah. So when you do a neck, lift, what is happening? Where do they cut for that? And is it similar to a facelift where you're doing muscle and all of that at the same time?

It is. So essentially, when you're doing a facelift, you make incisions, and a surgeon makes incisions in front of the ears, behind the ears, and then extending out in some manner. And there's different ways to do it. In general, the incision in front of the ear is what lifts the lower face. The incision behind the ear and down the neck that's what lifts the neck. So really, it's pretty general, that's how it works. And so you're literally cutting out that extra skin that goes to the back of the neck there, and you use those incisions to remove that excess skin.

And are you doing the same thing like you did in the face with muscle, or is it just skin when it comes to the neck?

Yes, yeah. So we have a muscle called the platysma. The platysma is a sheet-like muscle that comes up the neck, and it's the same muscle that creates these bands, okay? So if you have these little bands that move when you talk as you get older, that's actually loose muscle combined with some loose skin. So once again, the modern facelift will remove the skin, but will also tighten that muscle up too, to help reduce the banding and the droopiness of that muscle layer. And that muscle technically combines with the, becomes essentially the muscle of the lower face too.

'Cause if you were to just do skin, that would be less invasive, but it's not going to be permanent, right? I'm assuming, 'cause it's just the coating on top.

Yeah, the problem is if you just do skin, then you're not doing anything with the fat layer or the muscle layer, and the longevity is not going to be as good because, and you may still have the platysmal banding and stuff that hasn't been taken care of. So all the modern facelifts deal with the muscle in one way or another. Back in the '90s, you know, and honestly, my, one of my, my mentor in LA, Beverly Hills, he didn't do a muscle-tightening facelift. He did a lot of other stuff that was really state-of-the-art and advanced, but the one thing he never did was a muscle-tightening facelift, which I feel was not necessarily the best thing for his patients.

What's the longevity of a facelift or this type of work? Like, do you— how long until you start going, "Oh, it's back. I need it again." How does that work?

So studies show anywhere from about 7.5 to 15 years, which is a pretty big, you know, difference. And how do you make that difference? Well, if, you know, age is a thing. So if you have a facelift, you're in your mid-50s, you know, your skin and your tissue quality is going to be much better than if you're in your 70s. Okay. And so, If you're in your 50s and somebody like yourself where you take great care of yourself and your skin quality is good and, you know, you don't have a ton of sun damage and all that, then you're going to have most likely a longer lasting result than somebody who's 70 who may have taken care of themselves. Or if they haven't, then that's even worse. Then you're, you're going to notice that that skin re-droops and the tissues re-droop again. The technique also is important. You know, once again, there is this deep plane versus SMAS argument, and, and there's a social media beef now between deep plane facelifts and SMAS facelift surgeons. It's kind of silly. I don't think the technique is nearly as important as as making sure that, you know, you take care of yourself by having good quality tissues, eating an anti-inflammatory diet, taking good care of your skin, all that stuff really makes a big impact. And then your age, which there's nothing much you can do about.

So with you saying the 7.5 to 15 years, if somebody in their early 40s does this, then they're likely going to want to get it again in their mid-50s, I'm assuming?

Yeah, and I talk to my patients about this all the time. I get patients who come to see me who are quite young, like, "I want a facelift." And it's like, okay, Number one, do you want to trade the looseness that you have for all those scars? You know, because you will have scars. Yeah. Same scars that you'll have if you're older, pretty much. So that's the first thing. And then the second thing is I firmly believe that you can do up to about 3 facelifts in your lifetime before you start looking weird and your skin starts looking not right and stiff and kind of glassy and stuff. Because every time you have that type of a surgery, you're elevating the skin and you're creating new scar tissue. And that scar tissue builds up. Same thing when we do nose jobs, you know, there's a reason why people who've had multiple nose jobs, their nose looks like it's melting is because there's more and more scar tissue that's building up there. And so for me, that's what I tell patients. If they're young, it's like, okay, you really can do this at the most 3 times in your lifetime. You know, you do want to space that out a bit.

Yeah, and I would imagine, 'cause you're also, you're still aging. So it's like, even, it doesn't slow down the aging process. So you could do it, but it's not that it's falling down or coming apart, it's just that you keep aging. Is that? What's happening, or does it actually, like, undo over years?

No, it's just, uh, the way I describe it is you turn the clock back, but it keeps ticking forward.

Got it.

Now, there, there's some parts of it that won't come back, you know. So let's say if you have a double chin and there's fat there that you want to get rid of, and that can be removed at the time of a facelift, unless you gain significant weight, that fat's not unlikely to come back. But what is likely to come back is the skin's going to re-droop at some point, the muscles will loosen again, You know, that's the type of thing you'll see come back.

So, okay, most of my women are not ready for facelift. They don't— they're not wanting— they're— it's scary to them. Maybe some are, but they're like, what else can we do? And we need help here because there's a lot of gimmicks and then there's what actually works. So can you help us? Like, what actually should we be doing? You're the holistic expert here. Like, what really is good and like worth the money and what things are like gimmick and don't waste your time or money?

So I think the first thing you have to consider is expectations. And so there are a lot of things that you can do for your skin that's gonna— that are gonna help, but they're not the same as a facelift. So that's the first thing is, is unfortunately there's no way to non-surgically get rid of loose hanging skin. It just— you just can't do it. Now, there is a big gap between what you get from a facelift and the, the next type of treatment that's less invasive that definitely works. And so you go from a facelift, which is, you know, quite invasive. For me, it's 3.5-hour surgery. The next step is really is going to be non-invasive treatments. Okay, there's no, you know, there's a mini facelift, but it really, you get a lot of times the same scarring of it. So really, there's no like little surgery that does the same thing as a facelift. Otherwise, that's what we would do.

Other than like an upper eye blepharoplasty or something might be this simple, but that's not the whole face.

But yeah, but that's a different procedure. Yeah, exactly. But if you're talking about trying to lift the lower face and the neck and tighten that skin up, You know, you got the apex, which is a facelift, but really there's nothing in between that, that we know works between that and let's say non-invasive skin tightening. So the most popular one right now, probably the gold standard for non-invasive skin tightening is radiofrequency microneedling. The most common brand of that is Morpheus8. And essentially what that is, is that any non-invasive treatment, and some of the invasive ones, they cause the skin to tighten by heating the collagen up to a certain temperature. And typically that's 42 degrees Celsius on the surface of the skin. And what happens is when that collagen— with the collagen makes up the building blocks of our skin— when you damage the collagen to a certain extent, it will become damaged, and then when it heals together, it will heal in a tighter fashion. So they're like fibrils that heal together. And so essentially what you're doing, whether you're doing a laser treatment where you're heating that collagen, radiofrequency microneedling where you are puncturing the skin with a tiny needle and you're heating it up with the radiofrequency from that deep needle, you are heating the skin to a certain temperature and you're causing that skin to essentially shrink a little bit. So then the question is, is how much does it shrink? You know, so if I do a facelift on a patient, I may remove a centimeter or more of skin from each side of the face. If you do, let's say, radiofrequency microneedling and you heat the skin up to cause it to shrink, it may shrink by a couple of millimeters. Okay? That is a big difference.

Big difference.

And that's what you have to keep in mind is that, What you get non-surgically is nothing compared to surgery, but they can work, but they work in a fairly modest way. And so if you said, look, I don't want a facelift, which it's not for everybody, it's a big surgery. Yes, do the— right now, the gold standard for non-invasive skin tightening would be treatments like radiofrequency microneedling. You can do that with a topical anesthetic. I have it actually done, Natalie Jill, to my neck area and my lower face every 4 to 6 months to try to keep it nice and tight.

And do you notice on you a difference when you do it?

I think so. I mean, I'm 53 and I do it pretty well right now. So I'm hoping that it's working. And we've done it on some patients where we do a series of 3 of them and we see a definite improvement. I've had some where they've delayed their facelifts because of those treatments. But the problem with these types of non-invasive treatments is that everybody's body reacts differently to them, you know? So in surgery, it's like, hey, I removed a centimeter of skin. You know, you know you're going to get a certain change from that. But when you're dealing with these types of light-based and heat-based treatments, It really is your body's reaction to the treatments that will get you the result. And somebody's— some people's bodies are more active and they, they will tighten a bit more and others are not as much and they don't see as much. And that's the frustration with these types of treatments.

To me, it's— and it depends obviously on cost too, but you think about what you'd be spending to do all those treatments all the time, like every 3 months where you could just save up and put that towards the actual surgery. That's in my thought process.

Yeah, but I think at the same time, surgery is not for everybody. Some people are afraid of going under the knife, understandably. You know, it's a serious thing and, you know, there are complications involved. So I think it really comes down to, you know, risk versus benefit analysis for each patient is different. You know, there's some people who, they have big jowls and a lot of loose skin, but say, look, I don't want those scars, so I don't want a facelift. And that's totally fine. You know, then we could do some of the non-invasive stuff, but then you just have to keep in mind expectations have to, you know, be in order. You know, I'm a big fan of red light therapy. I know you like red light therapy as well. I think that's great, and I encourage all of my followers to get a red light mask and to wear it regularly. You know, don't overdo it, but to wear it regularly because that can definitely stimulate collagen production in your skin. Our number one selling supplement at Youn Beauty is our collagen supplement. You know, we sell, gosh, 1,000 tubs a month of that, and because it really does help, but it's not going to take the place of a facelift. Once again, it comes down to expectations, and so I think that's really the most important thing when you're talking about spending your money on treatments is having the right expectations of what it can do for you. And then you weigh the cost-benefit analysis, you know, for where you are.

Makes total sense. What about Botox and fillers? I personally do not like the look of fillers. I think that I've not seen anyone get fillers that I'm like, "That looks great." But I'm curious, is that a technique thing? Is that, what's your thought process around this?

Yeah, so the problem with fillers is that plastic surgeons, if it's kind of like, if you give us an inch, we'll take a yard. Okay, so the— we— our face ages truly in 3 dimensions. Yes, things sag, but we also lose volume. We lose volume of the fat, we lose actually our muscle volume, and we even lose bony volume too. Our bone actually shrinks as we get older. And so adding a little bit of that volume back can really be beneficial for the 3-dimensional aging process. But like Everything, I swear, in plastic surgery, we take it to the extreme. And where, let's say, 1 syringe of filler on each side could look really, really nice, then plastic surgeons will put 3 or 4 on each side, and then they get pillow faces and they look weird and unnatural. And then that scares people off of filler because they think, well, everybody's going to look that way. So really, I think with filler, it's not, you know, it's kind of like don't blame the messenger, you know? It's like filler, it's powerful and can be used really judiciously and can be really a great thing because we do age in 3 dimensions, but unfortunately, plastic surgeons have just taken it way too far and have overdone it. And now it's kind of like this— it's like a backlash of like people saying, well, I don't want filler because I don't want to look like a Real Housewife of Beverly Hills, you know? And it's like when you think about breast implants and somebody's like, I'm thinking about breast implants, well, I don't want to look like Pam Anderson though. And it's like, well, there's a lot between, you know, an A-cup and Pam Anderson. Same thing with With filler, like there's a lot between having nothing and looking like a Real Housewife. And I think that there is a happy medium there if people are interested in achieving that, that you can achieve. But also you have to keep in mind that filler can be dangerous. You know, Botox, there's a very small percentage of people I think that may just react very, very poorly to Botox. And there haven't been, it's such a small percentage that there haven't been any studies that have really been able to elucidate that. But like you, I believe in bio-individuality, and I think there's some people that just don't do well with it. Filler, however, but other than that, I think Botox is in general very safe. Filler is a different story. If you accidentally inject filler into a blood vessel and you clog that blood vessel up, people have gone blind from it. You can lose parts of your nose, parts of your lip can necrose. It can be really, really devastating. So if you have filler, I don't want to scare anybody off of filler necessarily, but use the smallest amount necessary to make you happy and make sure whoever's doing it is really experienced and in the office of either a dermatologist or a plastic surgeon.

I think there's a lot of cosmetic blindness and people get guilty. I thought we saw this with eyelashes. We saw this with breast implants, like where you get used to it and then you almost don't see it anymore and you think you need more. So I think sometimes the filler is not just the surgeon's fault. I think the patient comes in like, I don't see it anymore. And then it's a constant adding.

You're totally correct. Actually, Courteney Cox was very open about how that's what happened to her. You know, I mean, I used to watch Courteney Cox on Family Ties. I'm that old. I just watched her there and I was like, oh, she's such a pretty young gal. Then she was on Friends and then what happened to her lips afterwards? And she actually did say exactly what you said. She said, you know, I had a little bit of filler once and then I went and had a little bit more and eventually I had more and more and more and I just got blind into not realizing that it was just way too much in the end. So then she had it melted away, but I swear she's had it injected again now. So I don't know.

It's a thing. We see that with different— we've seen that with eyebrows. We've seen it with eyelashes. We keep seeing it with different parts. It moves.

I think you're totally right.

So when it comes to— I want to ask about Botox again for a second here. There's like a natural version of it. I forgot what it's called. There's a Xymogen or something like that. Xeomin. Xeomin. Is that true or what's the difference when you look at something like that?

I think it's a marketing gimmick. I mean, they're all botulinum toxin type As. It's basically still botulinum toxin, which is one of the most powerful toxins in the universe. We basically purify and put in the tiniest minuscule amounts in certain muscles and will cause those muscles not to basically contract for about 3 to 4 months. So it, it prevents the transmission of nerve impulses to those muscles. Really, I think Botox, you know, it's the number one procedure in my office. We probably treat 10 to 12 people a day with Botox. For after 21 years of doing this, we've probably treated tens of thousands of people, and honestly, I've not had a single major complication from it. Not a single one. That being said, I do have friends of mine, you know, who are in the alternative medicine space, and they've had some patients of theirs who swear that they've had reaction to Botox, where, you know, actually a friend of mine, Ariel Lorre, she's got a real popular podcast, Well, and she called me one day. She said, look, I've had Botox twice recently, and every time I get this horrible headache, and I just don't feel right, and things— I just, I feel ill, and, and all this stuff. And so she stopped doing it. And so I think that there are— but, but if you actually look at the studies, there's no studies that show this in anybody. So I think that this is It's, it's probably a small percentage of people, but there are those people that just don't react to it. And real quick, um, Arielle did share her story on her podcast. That's why, yeah, I'm not breaking her confidentiality.

So, so I've— I have over the years tried it on my forehead because people love to comment on my forehead or my eyebrows. For me, um, because of my strong brows, when I would get it, it really made my face change, and I hated it no matter who I went to. Yeah, so I noticed that with women do. Like, to me personally, I'm not— whatever people do what's right for them. I would rather have the lines than the freaky looking forehead and eyebrows. So that's just, that's just me. And I think a lot of times I can really tell people have bad Botox because it's like it really changes their expressions.

So the key really is that there are 3 most common areas you inject Botox. There's the glabella, which are the frown lines between the eyebrows. Okay. They're the crow's feet out to the side of the, of the eyes. And then there's the forehead horizontal wrinkles. In general, if you stick with the glabella, the frown lines and the crow's feet, it won't really impact how your eyebrows look in general. If you inject the forehead, all bets are off. Yeah. Because the muscles that you are injecting are the same muscles that elevate your eyebrows. And in some cases, if those eyebrows are naturally kind of high and you inject a bunch of Botox on the forehead, that can cause the eyebrows to drop. Yeah. And then you look like you have droopy eyes. At the same time, Sometimes if you inject just centrally, you can create an arch to the brow, which for somebody who has, let's say, a very horizontal brow could be really nice for them. But if you've already got an arched brow and you do that, then it can arch your brow even more, making you look like, you know, Spock or Cruella de Vil. So you have to be really careful with the forehead. And so my patients, I tell them, if you've never had Botox before, leave the forehead alone. Just start with the crow's feet or the glabella. Learn how it works for you. And then eventually, if you're ready, you can try to add some of the forehead in or you just leave the forehead out of it because it will change how your eyebrows look.

Yeah, I gave up on that and I'm going to keep my— my forehead is going to have lines and it'll be fine if I'll get bangs.

Yeah, I mean, and it's definitely not for everybody because, yeah, there's some people that's just you have— you choose either forehead that looks a little wrinkled or one that looks smooth, but your eyebrows look different.

Yeah. Yeah. So what about when it comes to skincare stuff, because that's also confusing for us. Like, now there's like a peptide out there, and is it retinol? Like, what help and how much change can you actually expect from it?

So skincare can make a huge change, but a lot of it too depends on the quality of your skin. So something like yourself, you know, you're not gonna see a massive change in your skin no matter what you put on your skin, because you, you know, your skin looks great already. There are people, you know, we have in my skincare line, YounBeauty, we have a bundle called the 2 Minutes, 5 Years Younger Bundle. So just a quick example, In the 2 Minutes 5 Years Younger Bundle, we called it that because people literally would use these 4 products, it would take 2 minutes a day, and after 2 months, we actually tested them and we surveyed people and they looked about 5 years younger. But these were not people with your skin. These are people with quote unquote average skin who, you know, may be using products here and there, they've got some sun damage, then yes, you can actually see a reversal in the aging of your skin. But once again, somebody like yourself or myself, if we change our skincare, to a different line or something like that, there's no way to expect that we're gonna get 5 years younger from it. So it really comes down to where you start. I think that really the way I look at anti-aging, it's like you're building a house, and the base of the house is gonna be your diet, okay? Because that exerts a profound impact on the health of your skin. And then the first floor of that house is gonna be actual skincare products. And yes, there are certain products I definitely recommend that you consider. You know, you and I are both fans of clean beauty products. It's something where when I went through my training and my early practice, and I really wasn't aware of, I think, a lot of the potential environmental toxins and the irritations and all of that that we're exposed to. I was selling in my office these medical-grade skincare products from dermatologists that really transformed the skin of some of my patients, and they loved it. But the entire time, I had a secret, Natalie, that I wouldn't tell anybody for years. And that secret was I couldn't apply those products to my own skin. I put them on my skin and I would break out in hives, I'd itch, I'd get red and irritated. So I was selling these products and giving them to my patients and most of them were really happy with it, but I couldn't use them myself. And it actually wasn't until I started using some products that were natural and organic and clean beauty products that I realized like, oh my gosh, I can actually put this on my skin and my skin feels good afterwards. But the problem that I found was that those products didn't contain anything actually active to reverse my aging or to fight the aging process. Moisturizers, they were healthy on the skin, but they weren't actual actives in them. And so that's why I started my skincare line, Yoon Beauty, because it's the idea is it's clean beauty but with actual active components. So some things you want to focus on skincare-wise is in the morning you want to use a vitamin C. Okay, vitamin C does two huge things. Number one, it's an antioxidant, so it fights free radicals and oxidation. That's one of the main aging reasons why we age. And number 2, it's absolutely essential for the production of collagen. So vitamin C every morning is the key product every morning to use. And then every night you want to use some type of an anti-aging cream. The most proven one are the retinoids. So Retin-A or tretinoin is prescription strength. Retinol is over-the-counter strength. Depending on how sensitive your skin is, you know, you want to pick between those ideally as a first step. If you have real oily, thick skin that's, you know, not sensitive at all, then go with the tretinoin, the prescription strength, because that's going to be stronger. But usually, especially women who are in midlife, they may notice that their skin's feeling a little bit thinner, a little more sensitive, a little bit drier, especially with the decline in estrogen. Then you want to go for more of a retinol and more of the gentler products. Another thing to consider, you mentioned peptides. Peptides essentially are short chains of proteins that cause our body to react in a certain way. And so as you and I both know, GLP-1, you know, those are peptides. Insulin is a peptide. But peptides can be put in skincare products to influence your skin to create more collagen. And peptides are not irritating to the skin like retinol is.

So are you a fan of that, of the peptides for skin?

Yes, yeah, yeah, definitely. Peptides are great. And another one that's great is bakuchiol. Bakuchiol is a plant-based alternative to retinol. So if you've got real sensitive skin, sensitive skin. Once again, women in midlife, you're finding that your skin's getting more sensitive, it's getting kind of thinner and drier. Sometimes the retinoids can be too aggressive for your skin. Go with peptides. We have one called our Peptide and Bakuchiol Moisturizer, uh, that I use every night, um, and that I think is perfect for that kind of more mature skin.

Is the peptide that copper peptide that people talk about, GHK, or something different?

It's different. That, that is a peptide. There— peptides come in all different forms. Uh, copper peptide is a very popular one. We don't technically have that in our formulation specifically, but I think that that's That's, you know, a very valid one as well.

What about niacinamide? Is that what it's called?

What is that doing? Niacinamide.

Niacinamide. I don't know why I can't pronounce this word. I've tried it.

So one of the things that women in midlife do start noticing, especially after menopause, is they start noticing an increase in dark spots and basically age spots coming out. And so niacinamide is basically a skin brightener. It's an antioxidant as well, but really where it focuses on is skin brightening. So a lot of the over-the-counter skin brightener skin lightener creams contain niacinamide. I think one reason why is it's relatively inexpensive, it's moderately effective, you know, not the most effective but moderately effective, and it can do a lot of different things. So we have a brightening cream at Yoon Beauty, our Yoon Beauty Brightening Cream, and it contains niacinamide as one of the things. Also contains kojic acid and licorice root, all three of those kind of triple action for taking care of pigment. And so definitely, um, in mid-age middle life, I mean, that's a brightening cream is not a bad idea if you're starting to notice these spots come out. And I do think that one of the things that we're noticing, and I see this in my patients all the time, I have patients in their 40s and 50s that say, "Well, I'm not in the sun. I take care of my skin really closely, but why am I getting all these spots coming out?" And I do think that that is actually damage from when you were much, much younger that now for some reason is actually just coming out on your skin. And the brightening creams, and then the other thing is IPL, intense pulsed light, that's a light-based treatment. Can really help take care of that. What about hydroquinone?

Is that more potent than the, the one you just mentioned?

Yes. So hydroquinone is the most potent skin brightener in cosmetic creams. So potent that it can cause, in high doses, cancer in laboratory rats. So it is actually available here in the United States as a 4% or higher prescription. There are certain skincare brands that still have it there, but you have to get it through a doctor's office. It used to be available over the counter as a 2%, but kind of strangely, in one of the COVID relief bills, part of it was taking away 2% hydroquinone off the counter. I don't know how it got into the COVID relief bill, but it did. So you cannot use 2% or over-the-counter hydroquinone. Problem with hydroquinone, a couple of things. The first thing is that I only recommend, if you're gonna use it, to use it for 6 months at a time because you can get resistance to it. And then people with dark skin can get a condition called ochronosis, where it can actually cause the skin to look darker and patchy looking. So really, it's best just used under the care of a doctor.

Well, you saying it's linked to cancer in the studies makes me— why would we use it? I would—

it's really— the only time I use it in practice is if I have somebody with really, really severe sun damage and they really want to be aggressive, or for short-term use. If you've got, let's say, some people who have darker skin get what's called PIH, post-inflammatory hyperpigmentation, where they get darkness around scarring and stuff, and they really want to get rid of it relatively quickly, then I'll put them on a short dose of hydroquinone. There have never been any studies showing that it causes cancer in humans, but at the same time, yes, it's something I would just use in very specific situations because of that.

What about this trend of putting estriol on our face?

Yeah, so estriol or estradiol are the two options. Estriol is going to be the weaker form of estrogen, and so You know, there's a belief that if, you know, because, you know, you go through menopause, estrogen levels decline, there are some studies that do show that if you apply estrogen to the facial skin, that that can actually help increase collagen. So women in the first 5 years after menopause lose 30% of the thickness of collagen in their skin, and then about 2% every year thereafter. Now it does appear that going on hormone replacement therapy can really slow that process down, reduce it, and even reverse it in certain cases. And there are some studies showing that topical estrogen can do the same thing. Now, the problem is some people are taking vaginal estrogen and trying to apply that to their skin, and it's not really made for that. There are actual compound pharmacies that are selling estrogen. Usually it's estradiol, but you can do estriol as well. I think the estriol ones are usually more plant-based estrogens, which are not gonna be actual prescriptions, but they're not gonna be as effective. So you're looking at Probably if you really are noticing that you've got some thinning of the skin and you do want to try to use it for the face, then you do need to go through a dermatologist. There are online, online companies that will actually sell their compounded estradiol cream for the face.

So I tried it and I got melasma and then I threw it away. So I'm not going to do it. It's interesting because there's a link to like with synthetic hormones and melasma. So it just reminded me of like being younger and on birth control pills. At least I had. So I think some people do react with melasma. With?

Well, yeah, so much of melasma can be hormonal. That's why I think after, you know, pregnancy, so many women get melasma, and it's a tough, tough problem because IPL won't even take it off.

Like, I definitely got one from the cream and I can't get it off with IPL even.

Yeah, at this point, the things to do really, if you talk to dermatologists, they'll tell you, you know, wear an SPF 50 because sun can really, really impact it. Obviously, you want to wear protective clothing because the sun does impact it so much. And then there's a medication called tranexamic acid that can help with some patients with melasma as well. So some dermatologists are prescribing it. I have not yet. It's relatively new on the scene. Interestingly, tranexamic acid I use during facelift surgeries to reduce bleeding, but for some reason, one thing it also does is it helps with melasma for some patients. So go figure. Yeah.

What about— so it seems like the skin on our face seems to be easier to treat and change, but on our body, why is it so much harder? So like age spots, why is it they seem like there's just zero way to get them off our body, but you can get them off your face.

I mean, you can definitely get them off your body. If you do want to, your best option for body spots like that would be to do an IPL, light-based, because the creams do take a long time to work. But where it, I think where there's truth here though, is that our, the face of our skin is so used to having products put on it that it's actually more forgiving.

Okay.

Of application of more aggressive products. Than the skin of our body. So for example, if you're using a tretinoin, a prescription-strength retinoid, on your face, you don't want to put that on your neck or your chest. In general, when you put your skincare on, huge thing, whatever you put on your face, put down on your neck and your chest, unless it's a retinoid, unless it's tretinoin specifically. That's too strong, and you could, you could get a lot of dermatitis from it. So the body skin doesn't tend to be as resilient to products as the facial skin. That could be one of the reasons why you may be noticing that. But in general, if you've got a lot of spots that you want to get rid of on the body, then my— I mean, you could douse yourself in these brightening creams, but it does take a minimum of about 6 to 8 weeks to really see results. Easiest thing is just go to a med spa, dermatologist, plastic surgeon's office, and get IPL. That will zap those, and there's no chemicals involved or anything like that.

So I'm— maybe I'm a rare bird, but I'm, I'm like covered in those spots, and mine are from tanning beds when I was younger, which— and, but I've, I've done all the things, all the lasers, they just come right back.

So, yeah, and that's where I do see— it's interesting. Yeah, because you may be like, yeah, I'm not getting sun damage here now, why do they keep coming back? I do think it is stuff that you had from when you were younger, and, and that's why I think it is important to try to teach our kids to— sun protection. And I'm all for the beneficial effects of the sun and for its aid in our circadian rhythms, and I think psychologically it's so helpful and we need vitamin D, but I think that there is a happy medium out there because The worst thing I see in my practice is people who get skin cancer on their face and the disfigurement of it. You just don't want that. So I think there's a good happy medium there, from some of my dermatology friends who are like dousing themselves in sunscreen every day to some of my alternative medicine friends who are putting lard on their skin and going out in the sun all day. There's a happy medium there where I think you can take care of yourself and be healthy and hopefully never get a skin cancer that is gonna disfigure you in the future.

Yeah, I've actually had basal cell on my face. I had it removed luckily with Mohs surgery, and I'm lucky I caught it early. But when I've shared about like using even aggressive lasers like that, Alexandra Light or whatever, to remove spots, you go through this, it's hideous for weeks, and then it would fall off and I'd still have the spots. So I've shared that with people. Some people, it seems like they have like one or two spots they're addressing, but the people like me that have so many of them, I just, I don't know. I mean, please invent something.

So IPL should not cause that much trauma. You know, I get IPL myself pretty regularly and it's typically it's no downtime is what it should be. There's some that are also more aggressive that may be doing that type of thing, but IPL usually is not.

So IPL would be getting rid of it better than those other types of lasers, you think?

Yeah, because it really just targets the pigment. The pigment will turn darker and then it will slough off. And usually, like in my office, we'll recommend a series of, I think, 4. You space them out every maybe 3 weeks or so and there's zero downtime. Now you may look a little— those spots may look a little dark for a while, but it's not like you're oozing or or flaking or anything like that. Yeah, it's, it's not like that at all.

So yeah, okay, I want to talk about collagen for a minute. Collagen supplements, they're everywhere, and it's hard to know what is actually really helpful, what's not. I've always told people, you know, gosh, have bone broth to get it from the real source. But if they're not doing that, I know you're a huge fan of collagen supplements. Talk to us about why you created one and why— what's missing from most of them that we see on the market.

Yeah, so number one, I also am a big fan of bone broth. Bone broth is pretty much pure collagen. If you can get it that way, by all means you can. Interestingly, Natalie Jill though, are there any studies that show that drinking bone broth can improve the collagen of your skin? None. There are no studies, but there have been no studies that show that it doesn't improve the skin. There just haven't been any studies done. Okay. So you have to assume that it probably does. So I'm a fan of collagen supplements just because, you know, I do have my own, but I have used it myself all the time. I use it every day. My wife takes it every day. I send it to my mom, my sister, my dad, when my mom pushes on him, will take it every day too. And the anecdotal stories that we hear are just amazing. People saying that their skin looks clearer, it feels better, their hair feels thicker and stronger, their nails feel stronger, even their joints feel better. Now looking at it science-wise, there are many, many studies that have looked at taking a hydrolyzed collagen supplement. Usually they look at about 2 months and see how that impacts the collagen of the skin. I mentioned to you earlier, you know, we technically lose about 1% of the thickness of collagen every year starting in our mid-20s. After menopause, women, 30% loss of collagen followed by 2% every year. And so we really wanna do everything we can to try to keep that collagen up. And what we're seeing in the skin is just what we're seeing on the surface. You know, there's so much other parts of our body that contain collagen, like our cartilage and our joints, like our bones. And so the studies that have looked at skin show after about 2 months of a hydrolyzed collagen supplement that does increase the hydration of the skin, it increases the collagen content in the skin, and they've even done biopsies of the skin and have drawn blood and shown an increase in the collagen precursors. Wow. So it definitely works. But once again, I think like anything, you have to have expectations in line with reality. Like, it is just a supplement. It's not like a facelift or a laser treatment where 2 months later you're going to be wrinkle-free and smooth. You know, it's just one other piece of that puzzle to help keep your skin healthy and youthful. You know, what you don't want ideally, and you see this unfortunately more in women than men just because of the collagen loss, where you see women who are in their 70s and 80s and their skin is tissue paper thin to the point where you scratch them and it tears. You know, and that's because there's no collagen there. And so anything that you can do to fight that off and to prevent that from happening, I think is really important.

What about tools like derma rollers, gua sha? I do it every day. I don't know if it's doing anything, but what are you—

Fad, real? Yeah, so gua sha basically is like a lymphatic massage of the face, which is great, but it's not going to actually change the architecture of your face. So if you're inflamed, if you've got puffiness, if let's say you went out to dinner the night before and you had a bunch of salty food and you're puffy, then yes, using a gua sha can really help to move some of that lymphatic fluid and to temporarily give you a nicer shape to the face. But it's— and you may get a little bit of exfoliation from it, but typically that's essentially what it does. So keep that in mind, like there's nothing wrong with it, and if it feels good, then by all means do it, but it's not gonna actually move structures of the face like some people claim that it does. Derma rolling, most dermatologists are not fans of it because what that is, it's like a little roller with little pins on it, and you roll it on your skin, and it creates microtrauma. And like the idea of hormesis, where you put your body under a certain type of stress, and as it heals from or recovers from that stress, it recovers in a way that makes it more youthful essentially, That's the idea behind dermarolling your skin, and really the idea behind most of the skin tightening treatments is you damage the collagen and it comes back in a tighter fashion. The reason why a lot of doctors are not fans of dermarolling is because you get kind of— you can get tearing of the skin with it because that needle doesn't go in perfectly perpendicular to the skin. It kind of, you know, because on a roller it can scratch the skin and create little tears. And so a better option is dermal stamping. Where you're actually stamping your skin, where you're getting a very defined penetration of the skin with these tiny needles. You don't get the scratching of it, and you probably will have, as long as you change those tops, and most of them you change the tops, you know, every few times, a low risk of infection. So I'm a big fan of dermal stamping. I actually do it on the top of my head, 'cause I've got some thinning hair here. So I'll dermal stamp that, and I'll put on, you know, different serums and stuff to help with hair growth of my scalp.

So I wanna make sure I understand this. So you're not opposed to the puncturing of it when you use a stamp, stamp, but the rolling, why does the rolling change it? Because it's creating a what?

Because you have a needle that is not going just straight into your skin, it's kind of rolling over it, so now you're going to get a bit more of a tear of that. I see. So ideally, you want it to just go straight in and out, not kind of, you know, gliding across it.

Makes sense. Okay, and how often, if you're doing that, should you be doing it?

You can do it a couple of times a week. Yeah, I mean, usually once or twice a week is usually sufficient. And, you know, like I said, for things like if you've got thinning hair also, All of these can happen in midlife, like thinning hair on top of the head. Couple of things that you can do for that, but dermal stamping is a great way to do that and then apply a topical, whether it's minoxidil, whether it's topical rosemary oil, that type of thing, that you may get a little better penetration of that. There's actually exosomes too. There's a company called Plated that has great exosomes to apply on the surface to help with thinning hair as well.

Got it. If every woman listening, like if they were to take one thing away from this conversation, like the most important thing, what would that be? In your mind?

Okay, so I— two things. The first thing is going to be beauty really is health, uh, and so this is not a practical thing in general, but you know, beauty is health. And so if you're worried about appearance and how things are, you know, how you are aging, then really the first thing you want to do is follow the lot of things that Natalie Jill shares here, you know, is taking good care of your health and maximizing it, because really that's where true beauty comes from. But if you're looking for practical recommendation, I would do two things: retinol at night and a collagen supplement.

Those would be the two things.

Those would be the two things that are easy, that are accessible, and that anybody and pretty much everybody should consider doing. If you've got sensitive skin though, don't do the retinol. Use peptides and bakuchiol. We have our peptide bakuchiol moisturizer. That's what I use. I don't actually— don't use retinol because my skin's sensitive. I use my peptide bakuchiol moisturizer every night.

What do you wish I had asked you that I didn't?

Oh, what do you wish I had asked? I, you know, I— the one thing that I always love to share, and I say this at the end of all my podcasts, we just record a podcast with you, is I think that very important is, you know, with aging and aging powerfully, is to find something that you get a lot of meaning from that gives back in some way. And so for me, I find a lot of meaning in dog rescue. We have a little foster dog right now, Polly. I You know, she was a stray and showed up at the pound. And literally the day that she was going to be euthanized, my wife picked her up and we brought her home. Uh, we've had her for a month now. She just had a recent surgery and she's still recovering, but we're hoping that we can find her perfect home. And so for me, that's become my thing. And I never knew this, you know, I'm 50 now. And just the last couple of years, I realized that this is my mission is to try to save as many dogs as I can. So try to find what your mission is, and maybe it's midlife that you figure out what it is. But that's, you know, find meaning for it so that when someday you leave this earth, you leave it in a better place than, than, you know, without you.

I love that mission. I have a question about that. How do you not get sucked into keeping every single dog that you rescue?

So we have fostered 4 dogs so far. Um, so not a lot. Uh, the first foster was Tinkerbell. I don't name any of the dogs. The only one we named was Polly. Okay. But Tinkerbell came with that name. She had one owner and she has a lot of anxiety. She was dropped off by her owner. She was 13 at the time, no, 12. And one of the rescues we work with said, "Look, she needs a home. Would you be willing to foster her and maybe adopt her?" And so I said, "Yeah, we will." We took her home and after a day I'm like, "Yeah, we're keeping her." So that was our first one. The second one we had was Milo and he was also in the pound for months. He's blind and deaf. And he was in the middle of a, it was an estate problem where a woman basically couldn't take care of him. But he was part of her estate. And so they couldn't adopt him out. They couldn't do anything. He just sat in the pound for months, blind and deaf and scared. And then we ended up taking him from the pound, brought him to our house, and he ended up having severe dementia. And so literally a few days before we put him to sleep, 'cause his quality of life was so poor, we actually adopted him into our family. So he was in our family technically when he passed. And then our third one was Rosie, who I saw at the pound, or actually at a rescue. And she had been in one family for all her life and was just freaked out at the rescue. Now, some places, some dogs who are strays will go to a rescue and they'll be in like a kennel and they love it because it's warm, they get food and attention. Yeah, like it's so much better than, yeah, better than being on the street. But this was a little girl who was living in a house all her life and now she's in a kennel and it's scary. So I saw her, she was like there 2 days and I saw her, I'm like, oh my gosh, I'm taking her home. So we took her home and we did find a home for her about a month later that was perfect. And then our fourth one is Polly right now that we're hoping that we can find a good home for her in the next couple weeks.

But you could be an adoption fail, 'cause it sounds like 2 out of the 4 you ended up keeping.

Oh, no, well, we have 2 dogs right now that are older and that really need our attention. And so our hope is that we can find her a home that I think may ideally would be, you know, a couple, somebody that stays, that's at home all day and only has her where they can just give her all the attention in the world. That would be the ideal situation for her.

So tell us about your podcast. Is it mostly you? Do you do interviews? Like, he's got the Dr. Ian Show.

So yeah, the Dr. Ian Show is about half interviews and half solo episodes. It's all about how to turn back the clock naturally. So yes, I do interview dermatologists, I interview functional medicine physicians, plastic surgeons, and I do a lot of solo episodes. Well, it's like, how do you get rid of dark circles under the eyes? Or, you know, what do you do for thinning hair, you know, stuff like that. And really it's every week, and I've had you on I think twice now. So yeah, it's been a lot of fun. And yeah, something we put out once a week, and it's been a really good journey.

Amazing. I'm gonna link down below links to his podcast, to his website, and also his skincare line. And I know you're not— you're, you're located in, uh, I'm in Detroit, Detroit, but you take patients from all over, correct?

Yeah, yeah, it's, uh, I mean, I have a long wait list So, but it's, yeah, it's, it's all good.

One interesting fact about Dr. Yoon is he is a comedian. He didn't say that as things that I want to share, but his videos are really, really funny. I think he actually really enjoys content creation.

Oh yeah, it's a good time.

So make sure you check out his TikTok and Instagram.

Thank you so much.

Thank you so much.