Rejuvenate Before You Operate with Dr. Anthony Youn

Today I've got Dr. Yoon on midlife conversations. I can't wait to talk with him. He reminded me that we connected back in 2016 when he had a book called H Fix. Well, he still has a book called H Fix, but I recently started really jumping into his stuff again on TikTok because he has 8 million followers on TikTok. Yep, 8 million. And he's not the typical plastic surgeon. He is the one that's wanting to keep you out of the operating room. He's got lots of natural ways that we can avoid the that ways that we can age really well. He is definitely not an anti ager. He's a pro aging well. And he's got some great tips that he shares. I have so many questions for you. Thank you so much for being here today.

Thank you so much, Natalie.

So let's back up a little bit. First of all, how did you end up with 8 million followers on TikTok? Where did that even come from? You're a surgeon. How did this happen?

Yeah. So, you know, it was March of 2020. I had been on TikTok for several months and just kind of playing around with it. And then the pandemic hits and. And I find myself in an empty office with 10 employees who I promised to pay. And when I looked at my bank account, I figured out very quickly that the money I was making the most out of was from social media because I had no patients that I could see. And then I started thinking, you know, as a physician, like, you know, it was a really scary time. People were trapped in their houses. Everybody was afraid of getting sick and their family getting sick. And as a plastic surgeon, I'm used to helping people in one way, but even though I volunteered for my local hospital, they didn't need me at the time. And thank God, because if you have a plastic surgeon taking care of your lung issues, you know, it's bad. So I thought, you know, how am I going to help people in this difficult time? And I thought, you know what, let me just start creating content to educate and entertain. And it was that entertainment part of it that really caught on. And so I got to the point where I started realizing that, geez, you know, instead of, let's say, treating 40 people in my office in a day and helping them, I could help hundreds of thousands of people a day, even by just giving them 10 seconds, 30 seconds, a minute where they chuckle or they are, they forget kind of horrible time it was for them. At that time, I had so many people message me after that and say, geez, thank you so much. You kept me company during the pandemic, and it meant so much to me. And so just putting that stuff out there, my. My content and my platform exploded.

I'm gonna. So it's so interesting because people really gravitate towards you, though. And what I love about what you do on there is you'll almost take something that's really trending or that people think is the. The way, and you will repurpose that and show it. Not in a way where you're really knocking people down. You're just educating and changing people's perspectives on things.

Yeah. I mean, there's so much information out there on TikTok, and now we're seeing a lot of it on Instagram with reels and YouTube shorts where people are putting information out there. And some of it, honestly, is just not accurate. And I'm not one to, you know, I don't like fighting people. I don't like arguing or anything like that. And so sometimes I will very gently and sometimes humorously try to point people in the right direction and say, hey, look, even though this person says that if you've got a tattoo and you rub salt, table salt on the tattoo, that that tattoo will disappear, that's not going to happen. And don't waste your time and your money doing that when it comes to.

Aging, because that really is your specialty here. What do you think really is the answer? Because I know a lot of people will look at social media and they'll say, you know, if I only could afford plastic surgery, if I could only afford injections, or they think everyone does Botox and injections and plastic surgery. And I know you've got a very different perspective on that. Even though you are in that space, that's what you do. What is your take on aging? Well, what do you think is involved there?

Well, I think, number one, aging well is being healthy. And, you know, being healthy, that's where really a lot of kind of this idea of beauty comes from. And so what I really try to encourage my followers to do is to be healthy first, and then with that comes self esteem, self confidence, and all that. Now, yes, you said, you know, I'm a plastic surgeon. I do still operate a couple of days a week. I see a lot of patients in my office. We have everything from skin care to plastic surgery, actual operations. And there are certain conditions where you can only treat surgically. You know, so if you've had four children, you've got a lot of skin hanging from your tummy. There's no cream that you can apply to your tummy that's going to make that skin go away. You know, there's no injections that will make it go away. Sometimes the only real option is surgery. But the good thing is that with technology and with, and with what we're learning with nutrition and supplements and all that, there is so much that we can do short of surgery to help us to feel as good on the out, inside and outside as we want.

So I. The biggest thing that I notice on aging is actually skin changes. Like that is the thing. If I could think of anything that I would be envious of the youth for or that I'll look at my daughter and go, oh my gosh, I can't believe how different my that was. Skin is the thing that comes up now. I happen to be the age where tanning was really, really big in our teens and our 20s, so. And I did the tanning bed thing and all that. And I feel that skin aging is one of those things that there's just nothing we can do to fix it. So I've got a lot of questions for you about that, because you talk about the major causes of skin aging and then things that we could do to even maybe reverse some of that, but even prevent it for the lucky people that have not damaged it yet.

Yeah. And the crazy thing is that the skin aging you're talking about is the part of our aging that we have the most control over, really, and the least amount of invasiveness that you have to consider. And so, you know, I tell my patients and followers, there are four main causes of skin aging. The first is collagen degradation. Every year we lose about 1% of the thickness of our collagen after about the age of 25 or so. And I know a lot of your followers are women who are in perimenopause, menopause, and afterwards. And that increases to about 2% a year once women go through menopause. So that's the first cause of aging. The second cause of aging is inflammation. Third cause of aging is oxidation or free radical production. And then the fourth cause of aging is essentially loss of autophagy is that loss of intracellular renewal or regeneration. And so by focusing on these four things, you can get younger looking skin. You can see big changes in your skin and sometimes in as little as three weeks. That's the crazy thing.

So I know that those all make sense for being able to prevent, but are you saying you can actually reverse and change appearance with some of these things. Oh, my gosh. Okay.

Yeah. And you don't have to have surgery or big chemical peels. I mean, there are ways to jumpstart, you know, by going to a dermatologist, a med spa. But there are things that you can do very simply at home. It always starts with what you talk about all the time. Diet is having the right diet. And so we talk about, let's say, collagen degradation. And so the first thing I tell my followers and I put in my book Younger for Life, is you want to focus on replenishing the collagen of your skin. So once again, you lose about 1% per year, up to 2% when you become menopausal. How do you reverse that? How do you actually thicken the collagen of your skin? Well, first thing is you want to eat a lot of protein rich foods. Collagen is a protein. It's a large protein. And so if you're not getting sufficient protein, then you're not going to have enough. You won't. Your body won't be able to then produce that collagen. And that's one of the things that I know you've talked a lot about on your podcast, is how much protein do you need a day? You know, and I think that traditionally our diets have been low on protein, and we need to increase that.

So this gets confusing with the collagen. So I want to dive a little deeper here because, yes, you can get it from protein, but then you look at, there's so many collagen supplements, and then there's the whole bone broth trend, and then there's that you can use collagen or bone broth protein, but then people say it's not a complete protein. So it gets very confusing. I know for me, I just kind of think of it as an insurance policy. Okay, I'm going to take a collagen supplement and I'm going to drink bone broth, and I'm going to get my protein. I'm just like, I'm going to cover it from all the ways. Can you help break that down? Like, where are we actually getting the right collagen from? Because it gets confusing for people.

Yeah. So if you look at studies. Okay, I don't know of any studies that show that if you increase your protein that it will increase the thickness of your collagen, your skin. That being said, I don't know that any studies have been done that have actually looked at something so general as just increasing your amount of Protein. There have been studies that have looked at actual collagen supplements. A lot of studies have looked. Does taking a hydrolyzed collagen supplement increase the thickness of collagen of your skin? Lot of studies have looked at that. There have been studies that are actually prospective, randomized controlled trials that show that if you take two months. Okay. Of a hydrolyzed collagen supplement, and then you actually biopsy the skin of people afterwards, you can see a thicker amount of collagen in that skin. And there have been so many doctors who will poo poo this saying, oh, it's just that you're having more protein. Well, the fact is, there was actually a. In 2021, there was a meta analysis of 1200 patients, 90 days of hydrolyzed collagen supplements. So these 1200 people, meta analysis, 90 days of hydrolyzed collagen supplement, and they found a statistically significant improvement in wrinkles and improvement in skin elasticity and hydration. So there, you know, there are so many studies out there, but this is a meta analysis. So it's combining multiple studies together to get this big, basically finding. Now, when you throw in bone broth to it. Okay, so what is bone broth? You know, you take 48 hours or so where you're simmering basically different bones and parts of.

Or you just buy it at Whole Foods.

That's what I would do, too. But, you know, the idea behind bone broth. Now, there are no studies that do that show that drinking bone broth, at least that I know of, will improve collagen of your skin or make your wrinkles less.

Really?

No studies, unfortunately, that I know of. That being said, we do know that bone broth is composed of collagen. And you know, if your bone broth has good amounts of collagen, because if you cool it, it turns into gelatin, and that gelatin is a collagen. And then when you heat it up, it basically turns back into the broth. Now, if your bone broth does not solidify into that gelatin, then you got to be more concerned that maybe the quality of it is not as good. So we know there's collagen there. It makes sense that it should improve the collagen of your skin, like a collagen supplement. There just haven't been studies that.

But that makes sense because you think about it, it's all the collagen supplement companies, kind of like pharmaceutical. I know it's different, but they're funding studies. They want. They. They need the studies for that. There nobody has funded that on protein or just plain prote or bone broth yet.

And if they did the one on bone broth, maybe we would find great results. I just haven't seen studies that I know of, and I look for them that have even been done on it.

But you eat bone broth. So you believe that you believe in doing that? Yes.

Yeah.

Okay. And I will say for me, I do. Even though I do take a collagen supplement, having a lot of bone broth in my diet did change my skin. I can. So I don't even need a study. I know what it did to my skin.

I can I tell you, you know, one of the things that I promote, collagen supplements. I mean, it's our. One of our top selling products that I sell. And I can't tell you the number of stories that, that you hear from people. It was funny. I was visiting my mom a couple of weeks ago and I just sent her my collagen. Like she's on auto ship for free.

Okay.

And she's like, you know, Tony, my hair has been getting thicker. Do you think that the collagen may be doing that?

Oh, that's great.

Probably. Mom, that's. That's awesome.

I love that. And I've definitely heard that about hair and nails too. So it makes sense with your skin. So, okay, so collagen is actually really, really important, and we need to be aware of that. What about. You talked about collagen, eating it. What about injecting it? Is that what's the difference? And does that. Are you getting it the same? Can you clarify that?

So, yeah, dermatologists and plastic surgeons will say, well, poo, poo, let's say collagen supplements. They'll say, you know, the only way you can thicken collagen is if you have a invasive procedure to thicken the collagen of your skin. And it's true that there are treatments that can thicken your collagen. Injecting treatments like Sculptra, which is a collagen stimulating injection, can help with that. Injecting hyaluronic acid fillers. Some people believe that that can stimulate collagen production. But you don't have to do that. That, in my opinion, is just a way for doctors to scare you so that they can make money off of these treatments. I would much rather that you start off by doing the things that you've mentioned with bone broth with collagen supplements and then apply the right skin care. Skin care can also be beneficial for collagen skin. And the number one ingredient when you're looking at collagen, the skin is going to be retinoids. Retinoids are derivatives of vitamin A. The prescription strength is retin A or tretinoin. There's non prescription strength, which are retinols that most skincare companies have that if you want to increase the thickness of collagen of your skin, do the dietary things and then ideally add a retinoid to your regimen that can help. One thing that doesn't work though are collagen creams. So collagen is a large protein. Okay. And hydrolyzed collagen, or the reason why you only want to take hydrolyzed collagen peptides is because collagen is so big that it's too big, let's say, for your body to absorb and digest. That's why peptides and hydrolyzed collagen are smaller amino acids and peptides that your body can absorb. If you put collagen in a cream and you apply to the surface of your skin, it's just going to sit there. It's not going to do anything barrier and that collagen is not going to get through. That is a waste of money.

Okay, not to get off track, but you mentioned retinoids and I for years used them and I completely stopped because I got scared about toxicity and microtoxins and things like that. Can you. What do you have to share about that and is that just baloney? I don't. I just think I got hyper aware of all that and I thought I'm not having it anymore. So give us some shares on that.

So, you know, there are people who will believe and if you go on some of the apps that I'm a fan of, you know, there's the Think Dirty app. Think Dirty. I think that's what it's not a. Don't quote me on that because that may be.

I know what you're talking about though it might take you to the wrong kind of thing.

Then there's EWG Environmental Working Group and they've got Skin Deep where they look at different ingredients and skin care products. And some people definitely are anti retinoids. Now I, I'm friends with a lot of dermatologists and all of them will tell you that they recommend retinoids.

Really?

Okay. And the issue that I have that I believe is more of an issue with retinoids, not necessarily toxicity, but is that some people just don't tolerate them. Well, you know, if you've Got really sensitive skin and you use retinoids. Retinoids will create an acute inflammation. And the idea behind it is that if you get started on, let's say retinol, you may get some initial redness of your skin, you may get some flaking of your skin, you get this kind of acute inflammation, you even a mild dermatitis. But the idea behind retinoids is that if you stick with it, you will create this acute inflammation that will gradually reduce chronic inflammation. And that's the good thing about it, is that yes, you may get this acute inflammation. Some ways it's good, you'll exfoliate your skin, get rid of that upper layer of dead skin cells. But usually within about six to eight weeks your skin gets used to it and it tolerates it just fine. And one of the things that retinol does do is once again it reduces chronic inflammation. Now there are some people like yourself maybe too that may say, hey, you know, my skin's just too sensitive. I don't tolerate any retinols at all if that's the case and I recommend bakuchiol. Bakuchiol is a very popular, fairly recently popularized ingredient in skincare products that's made from the Babchi plant. And this is a plant based alternative to retinoids. There was one study that compared retinol to Bakuchiol head to head and found very similar results when you look at anti aging of the skin and the collagen of the skin. But the main difference is that bakuchiol does not create that inflammation, that irritation that retinols, that retinols have.

So I didn't, not to make this about me on here, but I'm going to say the reason I stopped the retin the, that is because I didn't want it systemically going through me and hitting my liver. So it wasn't so much that was drying out my skin. And sometimes I wonder if I've gotten a little overboard on some of that. That's why I'm, I guess that's why I'm asking is this, is that you know, like where you learned that hydro, am I pronouncing it right? Hydrocodone is that. Yes, it could be toxic. So is that like, do you think people have taken that too far? Like, like hey, this is just, this is because of social media and things like that? Or what's your, what's your, what's your friend opinion on this?

So I'm all about reducing the amount of toxicity and I think that we have this overload of toxins, you know, and you can say, oh, well, this one product is safe. But then you. The accumulation of all these different exposures can be potentially harmful. That being said, I do believe that the benefits of retinoids far outweigh the negatives. Once again, being friends with so many dermatologists and plastic surgeons in our fields, nobody has any issues with retinoids in general. So that I wouldn't worry about hydroquinone is a different story. You know, hydroquinone has been shown to cause cancer in laboratory animals, specifically rats. It has not been shown that we know of to cause cancer in humans. But we also know that you can get other types of problems with it. If you are dark skin, you can get a condition called okrainosis where it can cause darker patches on your skin. And we do know that you can actually get rebound hyperpigmentation if you use it for too long.

Yeah.

And so in general, hydroquinone, it's prescription strength. Actually, one of the COVID relief bills that was passed after Covid came out took hydroquinone, 2% non prescription off the market. It's weird. It was part of a Covid relief bill. Wow. But it actually banned the use of over the counter hydroquinone in products in the United States. It is still available prescription, however, and we sell it very rarely for patients who have a lot of major pigmentation problems.

And I think social media watchers need to be careful too, because, like, I know, because I'm. That's one of my battles is like the brown spots on skin. I always want to get rid of it and I get hit with all those targeted ads of like, get rid of all the brown spots by using this cream. And when you look at the amount of the ingredient that's in there, it's crazy high. I mean, you're talking like 7%. It's like. So I think it's. We got to be careful about what we're, what we're watching on ads and what we think is actually going to help us and do the research on that.

Yeah. And for pigmentation, there are very simple options for that. That's something that I put in my, my book, Younger for Life. It's very simple. If you've got pigmentation issues and you don't want to expose yourself to a lot of chemicals and stuff. Start off with a brightening cream that contains either niacinamide or kojic acid or licorice root extract. Those are three very popular effective ways to reduce pigmentation. But ideally, if you have the means, combine that with ipl. Intense.

I love ipl. I love that. I get it every year.

Good. And IPL is great because it targets that pigment. It zaps it away. And then within a week or two, you see those dark spots start sloughing. And for those of you who are concerned about, you know, chemicals and excess environmental toxins, know that this is just light. And you don't need numbing cream or anything. It's just light. And so you can't get more natural than that.

That is my absolute favorite. I do that once a year. And I do recommend going to a plastic surgeon's office or a facial plastic somebody or a dermatologist to do that versus just. I mean, the people are going to kill me for saying this on the med spas, but I feel like some of the doctor's offices go deeper than my experience with med spots. My experience with it.

Yeah. My main concern with med spas is some of them. They all mostly have physicians who are their medical directors and the prom. Some of them, the physicians are like family docs or ER docs who are basically moonlighting as a way to make extra money. And if you do develop a problem, they don't know what to do. And that really gets a concern if you're having injections, especially injectable fillers. I can't tell you how many patients that come to me from a med spa or they had filler injected, they get botched. And. And I say, well, what did the doctor there say? And they go, oh, they just. They said that the doctor wouldn't have any idea what to do. The doctor is a family doctor who's just signing charts. And it's like, oh, my gosh.

Okay, so just make sure. If you're going to a med spa, we're not against med spas, but make sure you understand who the doctor is that's behind that. And who's. And who's running that too.

Exactly. And some of them have dermatologists and plastic surgeons that run it, which is amazing.

Yeah. Okay, so that. Let's talk. So collagen is a major cause. The loss of collagen. And then you mentioned inflammation, oxidation, and you put them in separate categories. And I would have put them in the same. So can help us with that. What is the difference? And what do we do about that?

So they are very similar. And certain foods can kind of overlap. So the way I look at ox, first, let's say talk about oxidation or free radicals. Okay. So free radical production, basically, that is a. That is a byproduct of just normal metabolism. So our body creates free radicals naturally. It's just a part of being alive. But you can get more free radicals. You may get, let's say, attacked by more free radicals than your body can handle. And that's a process called oxidation. And you can get into situations where your body has too much free radicals. And so you want to attack those free radicals or basically neutralize them by antioxidants. Okay, so the idea then essentially is free radicals are these unstable molecules that need extra electrons, and so they can take electrons from, let's say, healthy cells, causing damage to the DNA of those cells. And some people believe that this, a byproduct of metabolism, can be one of the main causes of overall aging of the whole body. And that's why people really focus on antioxidants. Okay. Antioxidants essentially donate electrons to free radicals and to neutralize them. Now, once again, our normal metabolism will create free radicals, and that is okay. It's just that when our body is, let's say, exposed to too many free radicals from pollution in the environment, from eating, let's say fast foods and overly processed foods, from smoking and all these other environmental exposures can increase the body's amount of free radicals that it has to deal with essentially, and overload it.

Makes sense. And poor oils, I would, can do that too. And a lot of the junk oils I know in some of our food.

Yeah, exactly. So free radicals are also produced by the food that we eat. And exactly what you said. Bad oils, especially rancid and oxidized oils, really contribute to it. And so overly processed foods are kind of the big, big contributor to free radical production on top of, once again, all the environmental exposures.

I fully believe that. It's interesting. Twenty years ago, I started, like, really unprocessing my diet. And I feel like that saved my skin because I'm telling you, I was anorexic. I mean, I was in the tanning beds every single day in my early 20s. And I believe wholeheartedly that doing some of these things that you mentioned so far, like, like the bone broth, the collagen, and then really focusing on an unprocessed natural food diet is what the reason I do get compliments on my skin, because there's no. It doesn't. Otherwise it wouldn't make sense. I damage it so much with the sun and tanning beds.

Yeah. And when you look at it, then. So that's the free radical, the oxidation, but there's the inflammation, which is a Whole other thing. And the way I look at inflammation is a little bit different. Okay. Inflammation can be acute or it can be chronic. Acute inflammation can be a really good thing. You know, we mentioned earlier retinol, you get on a retinol, you get a little acute inflammation. That's actually okay. You know, lasers, you get a laser treatment, you get acute inflammation, but your skin can actually benefit from that afterwards.

Microneedling too, right? That's what. Microneedling.

All of it? Yep. Yeah. All of these kind of heat or trauma based types of treatments that cause your collagen to tighten, all focus on basically creating acute inflammation or acute trauma. It's when inflammation is chronic that it becomes a major issue. And so what causes chronic inflammation? Well, when you look at the skin, it's really a lot of it is sugar. It's sugar and it's glycation. Okay, so why is sugar so bad for your skin? Well, two things. The first thing is that sugar can actually bond to the collagen and the elastin in your skin. Now, our skin is composed of about 70% collagen and the rest of it, a lot of that is elastin. And as our skin ages, the way I describe it, the collagen is in tightly packed fibrils. It's kind of like the logs of a log cabin. And as you get older, those logs tend to become frayed. They tend to kind of fall apart a bit. And what you want to ideally do then is make it tight again. Well, when you eat sugar, that sugar can actually then bond with those logs. That the collagen fibers, it can cause them to become kinked. And that process is called glycation. And those sugar protein hybrids essentially that the collagen becomes are called age. Okay. Have you heard of those?

I haven't heard of ag.

So age basically are created then when the sugar bonds with the collagen and the elastin. And this is the same thing that is created actually from overheating foods as well. Okay.

And that's why when you see people roasting a marshmallow, that is total glycation right there. Right. Because you're overheating the processed sugar.

Yes. You're creating age. So ages essentially are toxic for the body, they're unhealthy, they create inflammation. And certain foods are very high in ages. Like bacon. Bacon is a very huge. That's of all the foods. And I love bacon.

Even like organic free range turkey bacon.

No, you know, it's really any type of high fat animal based food in General has a good amount of age. There are actually tables and you can, you can see them. And when you take that food and you overheat it especially that's why when you're, let's say charring your food, you're, you're grilling it on a grill, then that increases the amount of age as well.

Okay, I want to make sure I understand this because I know we're going. I want to make sure people hear this. If I get confused, they know they might be getting confused. So glycation, if I understood correct, if I'm understanding correctly, is what happens when you have that sugar and how that's going to rapidly age you. But age is when you are heating. I want to make sure I understand this.

Okay. So when sugar bonds with the collagen in your skin, that creates an age. Okay.

Okay.

Age are also in the body from, are also absorbed by the body essentially when you're eating those types of certain foods as well. So foods that are not just sugar.

The high fat animal base too.

Animal based foods also will contribute age. And once again, there are lists online where you can actually see what types of foods have high contents of it, have a high content of age. And those also are damaging to your skin by creating inflammation.

So glycation is different. Glycation of the process. Age is what it's created.

And get it from sugar.

Okay.

You can get it from animal based high fat foods, especially when those foods are overheated.

Okay. It's. I remembering, I remembering ordering s' mores with my friend who and she, we were roasting marshmallows and she said, ooh, glycation, glycation. So that's what triggered that for me. So she was talking about the heating. You're doing a combination of it all.

Yeah, yeah, yeah. But it's the most, it's worse if you take, let's say a high fat animal food and you char it. So let's say you take a hot dog and you eat a charred hot dog, then you're going to get the most inflammation. Something like that.

Yeah. And I do that a lot with my bacon. I want it like extra crispy. So I do too.

So, you know, I think like anything, it's moderation. You know, one thing I really don't want to do is scare people and say, hey, don't eat that, don't eat this, don't eat that. And then they go, well, geez, this was my favorite. I have to, what can I eat? And I, I fully believe that there are Times that you should splurge. You know, and that's something that I put in my book is like, you know what? We have to live as well. And, you know, who wants to. Who wants to live? I mean, there's some people who do great living this very strict diet. And. But the vast majority of us, what I try to encourage people is don't feel like you have to eat that kind of quote, unquote, perfect healthy diet. But it's always good to take steps to go there. And so, you know, we know that, you know, for example, with sugar, you know, 40% of our calories American of Americans essentially comes from refined carbs and sugar. 40%. And so if you just take, let's say if you're drinking three cans of soda pop a day and you just start by going down to two, that's a huge, huge thing. And that's what I try to encourage my followers and people, you know, reading my book basically, is take those small steps because all those. You should be proud of yourself if you do that.

Yeah. Otherwise we will get neurotic, like, thinking, like, every single drop. We got to pay attention to it and why it's. Yeah.

And you throw away that retinol cream, you're like, I'm not going to use this. Like, that's okay. You should probably.

I did throw it away. That I did do that. But I don't know about giving up my turkey bacon. So I'm. There's. There's all moderation. I give up the rat.

I agree.

But not this. Okay, so. So obviously we got to pay attention to that, because inflammation, when you're eating a highly processed food, you're creating the problems with sugar and overcharring your food. All of that is going to create. It's because if I understand correctly, it's removing collagen for your skin. It's like basically doing the opposite of what we want.

Yeah. It's damaging the collagen. That's probably a better description.

Right.

And then the other cause of inflammation was sugar. I mentioned there are two causes of inflammation or sugar causes inflammation. Two ways. The first way is glycation, so binding to the collagen and causing those kind of kink, collagen, fibrils. And then the second way is insulin spikes. Okay. So sugar spikes can create spikes in insulin, and that can lead to chronic inflammation.

So it's high blood sugar issues.

High blood sugar. And now you got all that other stuff, you know, where you've covered before, where people talk about, you know, insulin resistance. And all that. So reducing the amount of sugar. You know, if you're going to do one thing to improve your diet, then the first thing I would encourage you to do is just try to reduce the amount of sugar that you eat. 20% of the American diet, literally of the calories of the American diet is from sugar sweetened beverages. 20%. And so trying to reduce that even to 10%, that's a big deal, especially when you're talking long term. And there's so many benefits of reducing sugar in your diet.

Wow. Okay, so four major causes. Did we cover all four of those? Do we?

We covered three.

Three. Okay, so what are we missing here? Yep.

And the one left basically is a reduction in autophagy.

What does that mean?

So autophagy basically means self eating and it's intracellular renewal. And this is the idea that basically as you get older, you know, when your body, when you have cells that are working to, you know, cause your body to function the way it's supposed to, there, there is an accumulation that can occur of, let's say, damaged proteins, organelles and intracellular products. Essentially your cells will create essentially these. Part of it is cellular waste and part of it is, let's say, proteins that have been used up and are kind of old and non functioning. And one of the things our body does is get rid of that using a process called autophagy, where it utilizes those proteins and it can recycle them, it can use them for energy, and in the process, it can get rid of this intracellular gunk that prevents your cells from functioning optimally. By doing that, then your cells will function much better. And ideally they work like you were when you were younger. But like all the processes in our body, this process of autophagy, this intracellular kind of recycling slows down. And it slows down even more if you're eating food the way that we eat in our society, where you're just constantly grazing and snacking. So our body's autophagy processes occur most commonly when you're not eating, when you give your body a break from eating. And that's something that I do encourage. And I know you're a big fan of intermittent fasting, as am I.

Yes. And we're going to get into that in just a second. There's one thing you didn't mention in the four, and I was surprised, but I'm assuming there's a reason why, or maybe it fits into one of the categories, and that's hydration, because we hear a lot about hydration. For skin.

What are your thoughts on. Yeah, I mean, I think that's kind of a basic thing and I do cover that in my book and I'm all about triple reverse osmosis water filters and having good water. But yeah, I mean that's, I guess to me it's basic.

I still think a lot of people don't do it because, and the reason I bring that up is a lot of women listening right now. They're on the diet soda bandwagon or they do caffeine and so they're actually dehydrating themselves a lot. And I think sometimes that, I mean I certainly not a doctor as you are, but I think sometimes even that, that importance of being, making sure you are hydrating, you are getting enough of that, that water can change your skin.

Yeah, well, and it's also reducing the amount of salt, you know, you, you, your intake of salt. And, and there are other factors definitely that can help diet wise. But I don't, I guess I don't consider that to be one of the ages of the skin because it doesn't necessarily, you know, I mean you may dehydrate your skin and you can use moisturizers and drink more water to rehydrate it, but it's not technically, I guess, getting the skin older.

So it's temporary. It's a temporary thing.

Yeah, I guess that's the way I look at. And that's why some people say, oh, I, you know, the reason why I look young is because I use a moisturizer every day and it's caused me to, to stay young looking. And that's technically not true. Moisturizers are great for barrier function. They're great to make your skin feel smoother and feel hydrated, but they're not going to actually slow down or reverse the aging process.

Makes sense. Okay, let's get into some of the diet things that you recommend. I know that you're not a nutritionist, but you've got some very specific things that you encourage, like intermittent fasting. Can you speak into what that does? I'm assuming there's a correlation with the blood sugar, with that. But what are your reasons that you're a fan of intermittent fasting? And how do you define intermitt fasting?

Yeah, so the main reason why I'm a big fan of intermittent fasting, you know, I'm a plastic surgeon, so I'm looking at skin and I'm looking at aging and trying to get beautiful younger looking skin. And so one of the reasons why Our skin ages is once again that loss of autophagy is that we're not getting that intracellular recycling and renewal and that process reduces as we get older. So I'm a big fan of it. You know, there are a lot of anti aging parts of it and there are books written about this just on fasting and how calorie restriction and fasting can lengthen your life. And there are moun studies being done on all that. I'm going to put that aside and let's just talk about younger looking skin. And we know once again as we get older, one of the main causes of the aging of our skin then is that reduction of autophagy. And so for me that's the reason why I try to encourage people to do that. That being said, you know, most of my followers, they're not people who are going to do a five day water fast. Okay? It's too much for them. I can't do that.

I can't either.

Yeah, but the idea behind doing let's say an Overnight fast, 12 hours, 16 hours, we do know that even short fasts, like a 12 hour to 16 hour fast, intermittent type fasts can cause autophagy to be strengthened basically to encourage autophagy. And so that's my big thing with it. In my book we encourage people to try to intermittent fast, at least in a jumpstart. We have a 21 day jump start where you take the first week essentially cleaning up your diet, getting on certain supplements and skin care, including a collagen supplement. And then the second and third weeks we encourage people to intermittent fast just twice during that week. The big part that we add to it that people have not talked about before, that I think is super important, is you follow up that fast that when you start refeeding the next day. So you fast from let's say 8pm to noon the next day. Then you for the rest of that day eat a diet that I call the autophagy diet. It stimulates autophagy. And what that is essentially is high fat, low protein and low carb. There are some studies that do show that if you keep your protein content at 25 grams or less per day, that that can help to stimulate autophagy. Now that is in opposition to what we've talked about before. Yeah, you need protein to help with, you know, stimulating collagen production and all that. So for, for me, what I recommend is doing that very limited, just in the day that you're refeeding. And the idea is that you've got now 16 hours of autophagy going on. Let's continue that for the full 24 hours or more by eating a higher fat, lower protein, lower carb diet.

And when you suggest higher fat, what types of fats are you suggesting in that type?

So it's going to be mainly healthy fats, omega 3 fatty acids, you're talking about cold water fish like cod, mackerel, tuna, trout, salmon and monounsaturated fatty acids. So now you're talking about avocados, olives, olive oil, grass fed butter and those types of things.

So he's not talking about heavy cheeses and things like that?

No, no. And dairy is a whole other subject.

Yeah. Can you talk about dairy and skin for a minute while you, while you just brought that up though? Because that is, that also has a lot of conflicting information about skin and dairy.

Yeah. You know it's funny because even as little as five to seven years ago you talk about dairy in the skin and the dermatologists will get really upset with you. And I have posted anti dairy tiktoks and have had people go nuts on me like attacking me.

Yeah.

But now there are more and more studies showing that dairy is inflammatory and dairy, there are connections being made between dairy and adult acne. So even now the dermatologists, even the traditionally trained dermatologists who are very, you know, anti all of this kind of alternative and holistic medicine are saying, well yeah, maybe if you've got acne you should try going off dairy and see what happens. And so there's a lot of issues with dairy from the hormones in it to the casein. You know, we do know that casein appears to encourage the formation of ilf, insulin like growth factor which may increase the potential risk of cancer. But when you look at overall skin, you look at more of the inflammatory aspects of it. And there are connections between dairy being pro inflammatory and inflammatory skin disorders like acne, like rosacea, like eczema. And so for me, you know, if, if you've got, let's say great looking, you know, so for you, you know, if you've got great looking skin like you do Natalie, and you say, hey, I'm going to have a ice cream, then by all means, like if you tolerate, that's fine. But if let's say you've got, geez, I've got a big adult acne issue and I'm struggling with it, then yeah, go off dairy and just see how you do. Yeah, it doesn't, you know, affect everybody exactly in the same way, but it is inflammatory. And ideally, reducing the amount of dairy in general is a good thing, in my opinion.

I am a fan of reducing dairy for most of the women that come to me because they come to me with autoimmune or pain or. And it is inflammatory. You can't deny it. And it's interesting because people will get very defensive of it. But what I'm always going to say is if it works for you, keep doing it. But until you try and see what that creates for you, you don't really know. And I will say taking dairy, even grains out of diet for people does change your inflammation response. So it's. You might not like that and you might not want to agree with it, but if you try it and you see a difference, you can't really argue it.

Yeah. So in my book Younger for Life, I do have a 21 day jump start where I do what I've talked to you about so far. But one of the big things is that in that 21 day jumpstart, you get rid of dairy, you get rid of gluten, and you get rid of processed foods and sugar and high sugar foods as well. And just by doing that, you know, I know you've had your seven day jump starts and you know, it's crazy. You know, I was talking to our common friend JJ Virgin several months ago and she was saying, you know, Tony, you've always got. This is actually, I think about over a year ago. She's like, you always have to start people if they haven't tried this before, just by cleaning things up and just the act of cleaning up your diet, getting rid of the gluten, getting rid of the dairy, reducing the sugar and all that can make huge impacts on people. I think there's so many people out there who don't know how crummy they feel because it's been just that way forever. Absolutely. And then when they clean up their diet, all of a sudden they go, oh my gosh, like, I never knew I could feel this. Great. And on the flip side, with the skin, it's the same thing. You know, we put people on this 21 day jumpstart. Simple. Just 21 days. You only have to intermittent fast for four days in the whole 21 day jumpstart. And people saying, oh my gosh, my skin is glowing. I have random people coming up to me and saying, wow, your skin looks great. And they don't even know that they're doing this. And this is literally just skin care supplements and diet. That's it.

Okay. I'm going to go there with sunblock for a minute. I know that we didn't talk about it, but there's a lot, again, social media saying sunblock bad, it's causing the problems. I don't know. I'm still a fan of sunblock because I know what it does to our skin. What, what are your, what's your thoughts on that? I know you've seen this on social media, people really knocking sunblocks.

Yeah. The whole idea that sunblock is actually bad for you, I think is not true is, is garbage. That being said, there are certain ingredients of sunblock that I would encourage you to stay away from. And typically those are two main ones which would be oxybenzone and octinoxate. So oxybenzone and octinoxate are potential hormone disruptors and we also know that they may disrupt coral reefs. And so if you go to Hawaii, you go to Florida, you go to the Caribbean, a lot of them will not allow you to use those types of sunblocks or sunscreens anymore. That being said, you know, I'm a plastic surgeon. I have seen so many people with skin cancers on their face that are just. That is disfiguring.

Yeah.

And so for me, I know that wearing sunblock and sunscreen I think is so, so important. It's just wearing the right kinds of sunblock. And I'm also one too that believes, you know, you got to monitor your vitamin D levels and there is something very therapeutic to having the sun on your face. I live in Michigan. The winters can be pretty rough and most winters will go to, to the Caribbean in February. And it feels so good just for your own body to do that. But like I think most things in life, it's going to be moderation. So what I recommend, very simple. The, the Dermatology association recommends, the ADA recommends an SPF at least 30 in the face. If you have lighter skin, then I do recommend ideally a mineral based sunblock and that contains either zinc oxide or titanium dioxide, at least an SPF 30 broad spectrum. Okay. However, if you have darker skin, those types of sunblasts can sometimes leave a little bit of a white hue. So in those situations I do recommend using a chemical sunscreen. Okay. Those sunscreens, the number one ingredient I would look for would be Avobenzone because that has been proven safe. Megazoril is also another one proven safe that does not appear to have any impact on your hormones for your children. I really recommend staying with the physical sunblocks. And the worst Thing that you can do is use a chemical based sunscreen and spray it all over your kids with one of these aerosol sprays. Because then, you know, they're breathing this, these chemicals into their lungs and not where it should be. So for kids, you want to apply it with your hands. A physical sun, sun block, like once, once again, zinc oxide, titanium dioxide, at least in SPF 30. Put that on their body. For adults, on your body, ideally use a sunblock. And then for your face, especially darker skin, then go with that sunscreen. Avobenzone or Megazoral are the ones I look for.

It's. It is scaring me. How many people are so anti sunscreen and sunblock versus anti the specific ingredients. Because I think we're just going to see another whole huge wa. Skin cancers.

I mean, when you see people who come into the office and they have a tiny little dot on the tip of their nose, I send them to a dermatologist. They get Mohs surgery.

I've had it.

See me and half their nostril is gone. They got a huge hole in the middle of their nose. I mean, it is scary.

Yeah.

You know what? One of my favorite people in the whole world. I've like listened to this music for literally like 30 years, almost every day. Jimmy Buffett died of Merkel cell cancer. You got to take this stuff seriously. I mean, because if it took away. I mean, if it took out Jimmy. Yeah, it could take you out too. So do it for Jimmy, if for anybody.

And aside from the skin cancer, obviously that's a big concern, but just, you know, that leathery looking skin, that is what. That creates that. So if you're all for leathery looking skin, then go for it. But I don't personally want that.

I totally agree. I mean, that will age your skin so quickly. And so if you do care about having, you know, youthful skin, I mean, just look at people in Asia. My gosh. I just did a tick tock the other day about how the ajumas, which are like the older moms in Korea.

Yeah.

And my mom's one of these huge hats and they're wearing sunscreen. They wear sleeves and everything.

Their skin's great though.

It works. You know, I mean, all you have to do is compare the skin of your face and your neck and your chest to the skin of your butt. Unless you're noticed, you're gonna. The skin of your butt is gonna be perfect. That's how the skin idea of your face, your neck and your chest could look if you wore Your sunblock every day.

How much I know we can reverse some brown spots, especially on your face, through IPL and some things that you're talking about. Can we change wrinkles or is that once they're there, they're there.

It depends on the wrinkle. So fine lines, definitely you can improve. And that's once again doing those things we talked about with the retinoids, with the diet, with the collagen. All that type of stuff is the deeper lines like your nasolabial folds, which are the lines that go from your nose to the corner of your mouth, marionette lines, which are the lines that come from the corners of the mouth down. Those you really cannot reverse, you can only fill. And really with that, you have to do fillers. Yeah, the wrinkles of the face, the upper part of the face. So like your forehead lines, your crow's feet, your frown lines between the brows, those two, you know, if they're really light, if you're younger, then yes, using things like retinols, doing some mild, like light based treatments can help with it. But in the end, that's why Botox is the number one cosmetic treatment in the history of the world, is because it so effectively takes care of those lines.

Okay, I have a question here about Botox now. And I am someone who has had it before and I'm not a fan personally. And in fact, I went back and did it again at the time of this recording a couple months ago, I tried it again. I'm like, I wanted to see what this does. I liked it for a day and then I didn't like it because it. I want questions about that. So there's different trains of thought. Obviously plastic surgeons, dermatologists say it's great, you should freeze the muscle because then you're going to prevent those deep lines. But then there's this whole, when you look at like facial massage and building the muscle there, it's almost saying the opposite, that getting the rid of the muscle will age your face. Have you heard that? Have you? And can you help us shed some light on these two things?

Yes. So it's kind of two different things that you are tackling here. So Botox basically is a neurotoxin. It blocks the transmission of nerve impulses to muscles. Lasts about three to four months or so. And so there are certain wrinkles of our face that are caused by muscles contracting. Crow's feet wrinkles, frown lines between the brows and the forehead lines are the most common ones. And those are the ones that Botox really does well, after that, when you're talking about facial massage, especially talking about, let's say, face yoga, where people are exercising the muscles of the face, okay? Technically, doing that is going to increase those wrinkles caused by muscles. We call them dynamic wrinkles. Okay? So the more that you elevate your eyebrows and create the lines of your forehead, the more that those wrinkles are going to get inset and deeper and deeper. And so we do believe that injections of Botox can be preventative for those lines. But the reason why some people do appear to look younger when they do, let's say face yoga and things, is because exercising those muscles, actually, and there is a study that looked at this very specifically, that will increase the actual size of the muscles. Oh, okay. So one of the reasons why we age, you know, aging is three dimensions. And one of the reasons why we age is we lose fat, we lose volume in our face. You and I, we have facial shapes that are not like round. You know, we've got a facial shape. The way I describe it, your face can be shaped as either Marianne or ginger from Gilligan's. You and I have a ginger face. Okay? Our face is longer, and as we get older, we're going to become more gaunt. Other people have a Marianne face. It's a rounder face. As they get older, they're not going to get gaunt. They're going to get a little more saggy.

Okay?

So as we get older, we lose volume and we get more gaunt and we look older. And so doing actual face yoga, those massage, those facial exercises will cause those muscles to get bigger. And science has proven that.

Oh, that's why I like it. So because of the shape of my face, then.

But the negative is depending on what exercise you're doing, you may be causing those dynamic wrinkles to get worse.

Okay, it's confusing. See, this is confusing.

It makes sense now that I described it, right?

Yeah, yeah. So is Gua, would Gua Sha fall into that same facial yoga thing? Or would you look at that as something different?

That's different. And so doing Gua Sha, doing any types of facial massaging, that's. That can help with, let's say, draining lymphatics. So if you are retaining fluid, if you're inflamed, then using a Gua Sha device, essentially what you're doing is you're pushing fluid towards a lymphatic system and clearing excess fluid. And that's why people can temporarily look a bit snatched afterwards, is because they're just not puffy.

I Like, it for under eyes. Like, I like doing that under eyes, and it definitely helps that in the morning.

And that's. But that is going to be temporary. It's the same thing that you can do if you say. Let's say you take a glass of. Let's say green tea, you put that in the refrigerator, get it nice and cold, you put a potato slice in it, and then you put that over your eyes. That does the same thing. Getting rid of fluid. That's doing it with caffeine. You're doing it by massaging it out.

Okay. You see, I go back and forth on the Botox thing to say, well, because I hear it, I listen to you, and then I'm like, oh, I should do it. And then I see. So it's confusing. So I've. For right now, I'm not doing it.

I don't think that anybody would ever fault you for not doing it. If you did want to try it, then my recommendation is you limit it to just the glabella, which is the frown lines between the. The brows. Just start with that. I have that in right now. I actually have. There's a new one called Daxify, which I've heard.

That was longer, right? That lasts longer.

Yeah. So right now, if you're looking at me, I have it. And normally I can create very deep lines here.

Yeah.

But did you know that I had Botox?

No, because you have it. You probably did it very well on yourself. So for someone. Yeah, someone like me who has very expressive eyebrows, it, like, really changes my face. So when I.

When I be very careful, people will notice.

It's like. It's like, what did you do to your face? I mean, when I hadn't done it in years. I did it one time. Everyone's. What'd you do to your face?

Yeah.

So.

So if I were you and you wanted to try it, I would say start by using literally like seven and a half units. Just right here.

Right there.

And you want to avoid the forehead. Okay.

Okay.

Botox in the forehead is what caused the eye.

Yeah. It makes you look. Then it's like. It looks freaky. Yeah, I like having my expressions. I honestly like having it. I think it's funny that we've gone so far in that we got to get rid of everybody's expressions, because I think expressions are normal, too.

Yeah. And they're. I mean, I have healthcare influencers who are good friends of mine, where I meet up with them, and you're just like, wow, like, you've had a lot of toxin, a lot of filler, and it's like. Yeah, but then they're all talking about health foods and all that stuff. You know, it's, it's funny, but I.

Mean, pick and choose your battles. Yeah, you've got it. Everyone has to do what's right for them.

Exactly.

Yeah. Well, this is. Okay, where do people get this book? Where do you want them to go? I feel everyone should get it now because who doesn't want to learn some of these natural ways to age?

Well, thank you. Yeah. So we have a website called autojuvenation.com. all the stuff that I've talked to you about, I call is, is kind of under the brander of auto banner of autojuvenation. And the idea basically is that your body can reverse the aging. It can regenerate itself using its own natural processes. And so it's like that 21 day jumpstart. It's the diet, it's the intermittent fasting, it's the improving the collagen of your skin by collagen supplements and by collagen promoting foods and then the right skin care. And so by doing all of that, the vast majority, I feel that people can really look younger and maybe stave off thinking that they need botox or filler or God forbid, surgery.

Amazing.

So autojuvenation.com is where you find it. We have a ton of free gifts if you buy the book or pre order it, depending on when you listen to this podcast, including recipe books and shopping lists and gift certificates and all this stuff.

So incredible. Autojuvenation.com and where do they go to follow you on TikTok? Because you've got to see us. Tick tock. It's so Good.

Yeah. I'm Dr. Yoon on TikTok. You can find me. It's so easy. Dr. D O C T O R Y O U N. And if you've got teenage children, most likely they've heard of me. That's. They have crazy things.

Yeah, my daughter has. Thank you so much. Thank you.

Thank you, Natalie. Appreciate it.