Unknown Speaker 0:15
Today on the podcast, I'm chatting with Anna Allen and her good friend. They have a podcast, and your podcast is called, girl, can you talk girl? Can you talk podcast, right? And your friend is Christy malgosa, yes. And how long you guys been doing that? We've This is our third year, and they're interviewing me, and you asked me so many great questions. Oh, good. I love it this. The thing is, if you have any questions about the progression of how to care for yourself so that you can look better and feel better, this is the girl, and I knew it from the first time I saw you. This is the podcast, because they did not hold back. They asked me so many questions about all stages and ages of aging and how to do it gracefully, and when you can't do enough and you got to go to surgery. And I think we had a good time. We did. We had a really good time. And I know that when I am done, when I'm out of rope, yes, that's when I do surgery, and it's only for from you, like, when I'm out of things to do and wait, zoom in on her skin, because we just did my Luxa Bay blazer on her. How do you love your live results? This is like, two weeks, right? 10 days, 10 days. So good. She's so glowy. Well, thanks for having me on the podcast, and you guys, tune in and listen. You're gonna love this one. You're gonna love it. Okay. Well, first things first. Dr, Kay, welcome. Welcome. Before I start saying a whole bunch of words, I want to welcome you to our show. Thank

Unknown Speaker 1:41
it was not easy to get her on the podcast, not because she didn't want to, but because she is busy and doing good things. So we want to talk to Dr Kay about midlife, facial aging, what is happening? What helps without the trend pressure? Well, I'm really excited to join you ladies and sorry this has taken so long to get scheduled. Every time I had a meeting or a lecture, and, you know, I've been wanting to I've been chatting with Anna, and she looks so fabulous and glowing, but, yeah, we have so many options these days. It is a bit confusing and overwhelming for women out there who want to maintain stay graceful. I think stay natural is my mantra. And

Unknown Speaker 2:20
like some acceptance of aging is super important, because, like, we don't want to be 20 anymore. We're not 20. We realize that

Unknown Speaker 2:29
facial character and identity and, you know, uniqueness, yeah, that's a big one. And this is general education. This is not medical advice. You need to talk to your provider what's best for you. And if you don't have a provider, she might be the best one for you. I am open to doing all of it for more results, but some people might want to just start something to make them feel good, just to get started.

Unknown Speaker 2:52
Yeah, and let's we really want to just like, go through the levels, see where you're at. That's kind of what I want to do, is like, let me do the thing, one thing at a time of what's going to make a difference for my for myself. So Dr Kay, will you, before we get started on the levels of the way that we can treat ourselves to feel better? Will you start at the beginning? And like when a woman says, My face looks older, what are they noticing? First,

Unknown Speaker 3:18
you know what? I think aging starts as early as in your late 20s, is where the under eyes feel a little hollow and you look a little tired. And definitely, by mid 30s, you might feel a little early, drooping or feeling like you can't just jump out of bed and throw your face on and go. You have to, like, take time to make yourself look like you're used to in your case, you know. So I think that the early changes are brow heaviness and dry hollow, and then loss of volume in the apple of the cheek and drooping. And then in our 40s and 50s, we get more of the lower face jowling feelings laxity. 50s and 60s is about neck changes. So there are patterns of aging that it all reflects what's going on under the skin. So it has to do with facial fat pads that are nice and juicy when we're young and bouncy, and then they start to thin. We love it when we look more gaunt in our thieves, but by the time we're our 50s, that thinning of facial fat leads to drooping and sagging, so then we have too much skin. That's where we talk surgery.

Unknown Speaker 4:18
I think the first level that we want to start out is what lifestyle, what things really make an have an impact? What things are old wives, Dale that, you know, our parents told us, like, you can't have dairy or whatever. I don't know. I'm gonna we're gonna ask you, can we

Unknown Speaker 4:35
are the supplements work do? So like, what things actually make a difference? Because I'm going to speak for the midlife women that are listening to this show. Yeah, we don't want to spend time chasing things that don't work. I don't have I don't want to waste the money and I don't have the time because I can't do everything. Yeah, that's very important, and I almost think you have to have a minimalist approach.

Unknown Speaker 5:00
To that, because you have to be efficient. Like we have busy lives. We have we're the household. We have kids. Often we have a business. We have so many people who depend on us. So in my own practice, like the things that are indispensable, like supplement and diet wise, I every day have collagen peptides in my coffee. That's an easy those are the building blocks that you know your body needs to rebuild collagen. So love that. And then I am a big fan of vitamin C. I take multiple different antioxidants daily, and I think the most important ones would be like that one Vitamin C is an excellent one. I take resveratrol. I also I'm taking NAD, precursor to NAD, which is NMN, and that's a full podcast on its own, but that's something that boosts cellular energy and mitochondrial function, and that's truly like the driving force of preserving your DNA, so that you'll have integrity of your skin and your cells and your structure of your system. So that one's super important. I would say everybody needs to be on multivitamin as well as calcium is huge. Women need their calcium for osteoporosis prevention and preventing facial atrophy of the bones. Magnesium every day is excellent for sleep, especially perimenopause, and helps you to stay like it's involved in more than 600 different enzyme reactions on the body. So those are kind of like essential minerals and things like that. Other than that, I take some spermidine, and I take urelife and a which are all like kind of out there biohacking things that people these have the essential mechanism of driving the cells performance and making your DNA have good integrity, and then reducing aging damage DNA. So, like, those are like critical ones that I try not to skip. Coenzyme Q is also another one of those. Yes. And so these are things that we can take, that are supplements that can help us. And maybe again, we would speak to like, I would speak to you about that to get the levels that I should start with. If I'm somebody that is used to taking supplements, maybe it's just like, fill me up, right? But if it's somebody that's new, you might drop them a little bit at a time, correct? Little bit at a time? Yeah, I might start with what I think moves the needle the most, which would be like an amend, the NAD precursor, because you will feel a burst of energy. You will feel your vision get a little bit better. You You can literally not wake up with adult tiredness. The other thing though, we've got the supplement side of it. But then also, what about, like, the lifestyle habits, things that we are physically doing? Are there things that actually help our skin? Yeah, you got to keep it really simple, but I think that everyday movement is essential, staying hydrated. Like all of us, women and Americans are chronically dehydrated. So hydration means electrolytes, plus water, not just drinking, like the big gallon thing right now, you got to put electrolytes in there, otherwise it just kind of actually hyper dilutes your cell, cellular protoplasm. So that's essential. Sunlight is misunderstood. Everyone thinks it's evil and they need sunscreen to the max, but actually you need sunlight exposure for UVB. Your body manufactures vitamin D via its own internal pathways. It's a whole different molecule from vitamin D that you can eat and ingest. And so I like some sun, I will always protect the important real estate of my face. But if I'm outside, I'm going to try get outside three times a day, even during a work day. And you know, take off your shirt, show your arms like sun, all the other real estate, and just pretend she's our girl, Christy. I mean, I love this so much, because you know what electrolytes could, for example, and the sun, it can fall into the like, it doesn't really work. It's just marketing. Do you know? I mean, not the sun part, but for electrolytes like that would have been one of my questions that I was going to ask you, because I have some, I've taken some. I'm probably not consistent, because I'm unsure. I think a lot of it depends on your level of activity and how much you sweat. When we sweat a lot, if we're an athletic person, we lose a lot of magnesium, zinc and electrolytes every day, and so you will feel tired and depleted, and you won't know why, because you think I'm doing everything right, I'm eating right, I'm drinking water. What's wrong with me? Well, you may just be fully dehydrated. You know that it makes a huge difference. If you ever tried an IV, you know that feeling of instant hydration, because you're putting hydration right into the circulatory system. So I think that's critical. I think movement and exercise are super important. And I I think that's weightlifting. You guys are doing strength training, so you know the importance of that, but I'm a fan of exercise snacks, like little bits of exercise throughout the day. Exercise snacks. That's cute. Yes, I am not a person who can go and go to the gym and do the 90 minute cycle of go there and shower and blah, blah. I'll never do it. So I realized myself, it's going to be like, right when I get up in the morning, 20 squad.

Unknown Speaker 10:00
Squats, 20 crunches, 20 push ups. I do, like, little sets of stuff. And even during the day I'm seeing patients, I'm doing, like a squat in every room. You know I'm doing,

Unknown Speaker 10:10
like, clenching of the ABS and like, those things add up and make a big difference. Sure, you guys, you if you're not watching this, you're listening to this, you can see dr Kay is she's very fit, very fit and stunning. So that is good stuff too. Okay, before we get off of weistel, oh, my God, what about food? Because I just want to make sure, like, the quality of food that we eat. Because, of course, we've heard that, but does it affect our skin immensely? And I think that the cleaner you can eat, like real food ingredients, and staying on, you know, the side of the grocery store that is all just fresh fruits, vegetables, meats, that is critical. And I think a lot of people have dairy allergies and sensitivities that they're not aware of. If you're having skin breakouts and inflammatory skin problems, my first few steps of advice are to avoid dairy, avoid gluten, and try to really look at eating highly processed foods, eliminating those because the gut skin connection is huge. I can look at a patient who has rosacea and pretty much understand immediately from looking at their face that they have an inflamed system that's not they're not getting the right dietary requirements into their GI tract. So I also love pre and probiotics. I think that it's crazy that, like, more than 70% of the human body is bacterial. We don't realize that, but on the surface of the skin and on the surface of the intestines, like the two biggest organs of the body, are primarily full of bacteria, and they're good bacteria, but they can turn easily into bad bacteria. So giving yourself a diet that's rich in probiotics, so food that's, you know, highly fiber filled and like, doesn't break down so easily, gives an environment where good bacteria will grow. Yogurt every day, so important, so fermented foods every day. Yeah, oh my goodness, we could stay on level one. Anna, for like, ever and ever. But let's we should go on however. Can we just ask Dr Kay, is there anything in that lifestyle bubble that you're like, hey, we cannot go past it. That off the top of your head, that is important for our listeners to know. I think we've covered everything other than sleep, which we don't realize at all. Bioregenerative repair processes happen during sleep, like maximum collagen production happens during sleep. So I never paid enough attention to that I was sleep deprived in residency and then with four kids, and motherhood is all sleep deprivation. So like, finally the kids are grown, and I have the ability to sleep. And so I think that's really critical that we emphasize that to our patients is people feel guilty for like, needing 10 hours sleep at night, and they people reward those people who are like, Oh, I only need five hours sleep. But honestly, this is where your body does regenerate, repair and set its circadian rhythm. So I think that's that's the other critical thing, trying to get good sleep. And then I would say lastly, is the hormones, which is almost a pillar of restoring function to the female form. Like you, there is nothing that can function correctly without proper levels of estrogen in the body, and we're just programmed in our society to think that it's okay for that to taper off, and we've, you know, hit our maximum utility in life by bearing children, and then we just let ourselves go, and then we just die a slow death,

Unknown Speaker 13:32
decay and deteriorate and like that is not how I plan to age. I think everyone should understand their estrogen receptors in every cell in your body, including in brain, including in your skin, including in your hair follicles. So can you just let it go and listen to your old school OB guy and who's like, that's how nature intended it? Yeah, you can. But I mean, nature intended me to die when I was 30. Like, we've evolved, so we need to, like, help women we live longer, we're going to have more years in menopause than ever before, and so I think correcting your hormones is going to make you feel vital and give all that regenerative ability back to the body. I think my kids would say that my lack of estrogen had a problem with my face too. That

Unknown Speaker 14:14
made me look very angry

Unknown Speaker 14:16
that probably the first step of Botox was like, Mom, you got to get that scowl off your face because I was so grouchy when I didn't have enough estrogen. It's true. It affects your mood. It affects depression. Affects, like, how vital you feel at work, and like brain fog and all this is all of it. It's very painful. Okay, so let's, let's talk about skin care and at home, tools, um, Christy, you want to start with that one, yes. I mean, I have so many questions. Yes, because I like to do I'm like a wannabe doctor. I just want you to know Dr. Kay, okay, I'm a wannabe ball hacker. I try to do all the research, but at some point and I try to get the common denominator from people I really trust. But.

Unknown Speaker 15:00
And all of a sudden you hear something else, and you're like, No. And I don't think I'm the only one. I feel like sometimes we don't know where to go and what to believe and so on. So

Unknown Speaker 15:11
when it comes to skin care, just in general, do you feel like what we put on topically on our face makes a difference? I think some people are just like, Nope, you can, you know, it's all in, it's all the inside. No, the topical is very important for barrier function. So if your skin is too dry, dehydrated, and you don't have a strong skin barrier, you will have earlier, faster breakdown penetration of bacteria and environmental toxins and things like that. So super important for active ingredients, we always want to look at like the size of the active molecule is it under 900 kilodaltons, where it can penetrate into the dermis and actually enter into the area where it's going to make some global change? And so I also look at that when I'm looking at more medical grade active ingredients, but in general, like a great moisturizer, a cleanser that's going to exfoliate, exfoliating twice a week, very important. And of course, the sunscreen, yeah, okay, you said a really big word about absorption. It was like Dawson. What did you say that if it's molecules bigger than 900 kilodaltons, and it's not going to penetrate into the surface of so how do we know, besides going to a great person, is that the medical grade is that what you would call medical grade, when I'm looking at medical grade products, or products that claim to be medical grade, I'll look at their active ingredients, and then when it's on there, it's not on there, we have to do a deeper dive, like research wise, or, you know, even chat GPT these days, knows a lot. So does this molecule have the ability to penetrate into the dermis and

Unknown Speaker 16:53
corneum of the skin? So that's kind of bigger question, because we otherwise, we're spending a lot of money on products that smear on but don't go in, right? Yeah, we needed to penetrate. Okay, Anna, can I ask this question then? Because

Unknown Speaker 17:08
so post meno. Meno. Yes, I'm laughing at myself because it didn't happen in perimenopause and didn't even happen when I hit menopause. But now that it's been several years this past I've had the driest skin that I've never had, and I'm going, what is happening? Oh, my first question is, is the

Unknown Speaker 17:30
estriol cream I've been hearing stuff about that? Is that something that is helps, and what's the deal with the dry skin? I know we have a few other issues that I would say midlife women come that we're going to get into. But can we attack that? What is going on? It's so funny. I just read an article about this last night, and in our office, we're launching an estrogen cream trial. So if you have any listeners out there that want to join our estrogen it's like four months of free estrogen cream. We have a couple different arms of what people are putting on, but in general, many studies have supported the idea that estrogen cream, and people are using their vaginal cream on their face and their neck. Not a lot of skin formulations for good face cream, but those are coming. But yes, estradiol point oh, point 0.01%

Unknown Speaker 18:21
is the typical one that we're using, and that has shown improvements in skin thickness, skin crepe texture, fine lines, wrinkles and just overall radiance of the skin. There haven't been enough studies to say it's proven benefit. Otherwise, we'd all be doing it in the medical where the dermatology literature would be like insisting on it, just like we do for Retin A and vitamin C and other things. So it hasn't been 100% proven, because some studies have shown no difference with estrogen cream, so there's still a gray area. But I think the good news is that when there's these products are applied on the skin surface, there has been no evidence that they go into the system and they don't breast cancer or other things like that. So I think it's something you'll discuss with your doctor and see if it's right for you. In our office, we formulate a compounded version that's a nice it doesn't feel like, you know, vaginal cream. It feels more like what you'd put on your face. We always are careful about is this a melasma patient, because some patients get their brown spots triggered by estrogen and hormones, and then overall, like patients do love it, and there's a big difference when you look at estrogen treated skin in terms of wound healing and everything. Wow. Seal faster, collagen grows better, skin quality and barrier is improved. So we do have a question we are hearing all about this. So Christy and I have we share this in common that we don't like to be duped. And there are so many at home tools that people tell me that they're using and are excited about, and that the things that we are most though, well, there's two. Of course, we're being marketed like crazy, right? But.

Unknown Speaker 20:00
There's two. There's the red light microcurrent at home treatment, and then there's also micro. They have those like micro needling things, what works and what doesn't? You know? Yeah, I think red light 100% is excellent, but you do have to be so careful of who's the manufacturer and what are the brand specifics and what wavelengths of light it is okay. Mostly, a good red light device is going to cost, you know, 100 and up, and some of them as high as $1,000

Unknown Speaker 20:29
they're really strong ones with multiple lasers, and it's very easy to find junk on Amazon that's cheaper. And you might think it's the same. It's not the same. I've seen patients get burns from using Amazon red light. Stuff like, they want to go with the brand that has some credibility, or some clinical studies or trials affiliated, and you want to look for certain wavelengths of light. And if, if, for example, in their marketing and their advertising, they don't even discuss a wavelength of light, then that's a sign right there. Like, what way so the mass that, like you see everybody where you look like crazy, and then you also have the light that you can put in front of you. What if we find a good quality one? What differences? What does it do? Why should? Is it worth our time and our money? Oh, yes, red light. There are multiple studies that show that it improves blood flow, circulation to the skin surface and the vasculature, as well as collagen production for hair, it's excellent for hair growth. Red light turns on certain frequencies and photobiomodulates the mitochondria within each hair follicle and within each skin cell, so that those cells get reinvigorated and have better collagen production and things like that. Best range for superficial skin treatment we usually do, like 630 to 660 nanometers is kind of the wavelength of what's been studied, and it wakes up the skin fibroblasts. So they those are the cells that are the little soldiers that make your collagen and elastin. So that frequency really stimulates them, and then it reduces redness and inflammation. If you have a wound, or, you know, a sore knee or a joint, red light is going to improve healing and recovery for that. And so I think it's one of the most safe and proven and beneficial technologies. And certain wavelengths go deeper, like you have near infrared light, you have infrared light that's warm and heating. It just kind of depends. But for purely cosmetic and facial you want to do 630 to 660 is the opposite. I wrote that down, yeah, just so you know this episode is going to cost my husband, so I don't think he's excited that you're on, but I am excited I already have a red light sauna from sauna space. I can do the light on my face, but now I've got a double down. I'm just saying. And if anybody wants to know names of good ones, they can certainly message me. I don't know if you want to hear names right now, but I do, yeah, like you can give us a few hair and scalp RAM red light is, I think, one of the best they you go on their website, you see the before and after pictures in the clinical studies called Rev me on red light. I use that one all the time. It's a little hat. You just wear it 10 minutes, three times a week. It's like, throw it on while I'm doing emails every night. And then my husband will see me, and he'll want to run it, he'll want to wear it. And you can do two people at once. So it's a little more. It's one of the best ones could has the most laser frequencies and strongest flights. Nice. Also like light stem and bio light for face, those are that I've kind of scientifically vetted bios. Yeah, bio light is excellent. They make a couple different sizes. Light STEM is great, and higher dose is another one that makes a good red light more of a full body treatment. I have a quick question. Have you heard of capitalists for the head that brand capitalists sounds kind of familiar, but I am not really familiar with it. Okay? To look it up. Cool. Ooh. I like that. We have some suggestions that we can dig into. Yeah. So red light is a yes, thumbs up. And then health for needling. Yeah, thumbs up for home microneedling. It really depends on sterility and what product you're going to needle into tissues. Because I am a fan of microneedling, but I think that Amazon, and all these places you can buy everything on Amazon, you can buy filler, Botox, and literally everything on Amazon is so scary I would never I would want a device that's sterilized in a manner that, like I could like that sterility means I can take the patient to surgery, and I don't want to introduce germs. So you have to be so careful of who's manufacturing and and do you really want to needle the skin surface with that? And then don't worry, if you're going to buy those devices, then the tips should be single use. You really can't clean and sterilize it. And you say, I'm gonna run it under hot water, I'm gonna stick it in a flame, I'm gonna put a little alcohol on it, like, that's not sterility. That's like, clean, contaminated. So there's risk that was the surgeon in you coming out. And I freaking love it. I love it.

Unknown Speaker 25:00
She's like, micro needle down myself. That's crazy. You need, like, when it comes to certain you know, Christy, what? What she's talking about is even those rollers.

Unknown Speaker 25:11
Yeah, the derma roller is like we did. I've done those for a while, but if we do, I have even personally tried those at home, and I've not been happy with how the needles get so dull after just a few sessions of rolling. When I'm injecting a face, the needle under electron microscopy looks like a blunted, curved tip after just six pokes with one needle. So like, literally, I'll do only three, and then I'll throw that needle out, and then generally, we'll switch. I just feel like there's certain things go to a professional, like, go to Dr Kay or find yourself a good like, seriously, because I don't think that needles are a big thing to I just, I wouldn't mess with it. And also home micro needling. Like, what's safe and FDA approved and legal to sell to consumers is point, it's like, very short, like, you know, less than half a millimeter, and that's really not even gonna penetrate to the level of dermis where we want to see changes. So are you exfoliating a bit, you're stimulating a bit, but you're really not getting into the dermis, so you're not really growing collagen with that's that is really, that is insightful, that is for sure, and that'll save a lot of people a lot of money. I think of trying those things, I'd rather try a great Retin A stem cell growth factor, or, you know, a product that's really gonna it change their skin. Awesome. So our third level is in office. In office, before injectables. What are the best things to do in office that we can't do at home? So, like peels, like light chemical peels are super effective for melasma. I do a peel like at least three times a year, because at some point you want to resurface this stratum corneum, or the epithelial layer that just sits there and gets weathering and weathering Air Products to penetrate deeper. You want to take away irregularities and just improve luminescence. So I love chemical peels throughout the year, deeper, micro needling treatments. We do both mesotherapy, which is superficial, and then micro needling, which is deeper. Those things are nicely they're best done in our office. Because why? We have growth factors, we have peptides, we have polynucleotides. We have pdrn, the salmon sperm, yes, the inset. The idea of making holes in the skin is so that really effective topicals can penetrate in and work where the work needs to be done. And that includes, like even micro needling. Botox, we do a fun treatment, what's called the Rose facial, or mix a mixture of your own PRP, a little bit of toxin, a little bit of high dose vitamins, and then a little bit of filler, everything that just gives you that glowy effect that one's really fun, too. So those are things you can do before injectables. For my patients who don't want injectables. And of course, there's laser, and I think that many of our patients, most of my patients, will do a laser every year,

Unknown Speaker 28:02
and that is the same concept as a peel. If you're prone to pigmentation, then heat treatments with lasers are not best for you, but chemical peels are if you have bare skin and light eyes, and you can do a laser every year, it's going to tighten, resurface and improve. You know, the function of collagen and the skin barrier looks really beautiful. So those are things, kind of laser. What kind of laser? Because I've been seeing a lot about CO two lasers, I'm not sure which absolute favorite, and that is an ablative laser. So it's going to take off two or three layers of the top of the skin down to into the dermis that does have downtime associated. And I think it's about five days, seven days of redness. Remember, Christy, I did it. The thing that was so great about the laser Dr Kay, is I went in to a place just it was like a party, like a skincare party, and they had us put our face in something to see all of our sun damage, and I had none. It was like, you know, the week, the day, I was able to actually go in public and it I had none. They were like, wow, that's really great. So, you know, we really should do that once a year again, just for like, I mean, we're just in Southern California. There's so much ultraviolet damage. Brown spots, freckles, you think they're cute freckles, they're actually photo damage. They get to get I don't think they're cute anymore. They were cute when I was young. Now I'm just like, No, it's an age spot. One step. I like CO two because it tightens and it takes away fine lines. They completely go away. The deep lines get lighter, less intense than CO two is something like a Fraxel laser, and that's going to give like it resurfaces, but in multiple patches, so it leaves some normal behind, so your recovery is a little faster. So that's called Fraxel. And then lighter than that would be things like a Clear and Brilliant and in general, I'm not a huge fan of doing multiple

Unknown Speaker 29:51
I think multiple lasers with heat over time creates pigment. You don't see it right away. Right away, you look good. But I've been.

Unknown Speaker 30:00
In this practice now for 20 years. So I've seen every laser, and everyone promises you're not going to have brown spots, you're not going to have problems. And then I chronically like for the first six months, perfect, beautiful. Give it 18 months later, and the pigment has returned, and if anything sometimes comes back with a vengeance. So it has to be very curated to your skin type. We pretreat with hydroquinone or different ingredients to stop the melanocytes from multiplying quickly. And then just need to see someone who does a lot of these. Very good, very good. Okay, now, was I hungry for injectables or something? Christy, let's do it. Let's go. Let's talk about it. Okay, so I would say, can we talk

Unknown Speaker 30:39
40s and 50 year olds coming into your office with injectables. What is the most common thing that I think makes a difference, that makes them feel, you know, when somebody has that glow or that lift that you can't tell you're looking at, you're like, you look good, like you just got a glow about you. We're talking generically at this point, right? Because you do it patient by patient. So yeah, what's what are the things that are out there that make the biggest difference? Well, I think Anna is a perfect example. Like, look how good she's looking on camera. 70%

Unknown Speaker 31:15
of your beauty comes from your mid face. So when I see a patient in her 40s and 50s, very often the apple of the cheek has started to fall. They have some mid face heaviness that leads to early jowling and drooping. So I love to do a lateral cheekbone contour, which I will lift and sculpt and PEC see the cheek of high and lateral. It does not give you a big cheek. It gives you a slimmed and sculpted look. So that's kind of my signature technique. And step one, everyone feels pretty once they get a cheek lift, and that's usually done with an injectable collagen stimulator. I love to use some radius for that, and that will build and enhance the foundation, but it also grows collagen, so it's not a filler look. So I think keeping that in mind, we want to use collagen stimulator products. I still use a ton of filler, but I'll use micro droplet technique, and I have, like, an artistic approach to where and when we need actual gel fillers. So start with your cheeks. That's a great tip. Number two, we like to work on lower face heaviness. That's everybody's major concern in our 40s and 50s. So working on the jowl requires me to tighten the jawline and build a nicer angle of the jaw, as well as to pull the chin forward. And so those kind of things can be like, nicely achieved with, you know, just a couple of syringes, one for each side of the jawline, and patients will feel like immediately, like they finally don't look so tired anymore. So that, for me, is game changing. I call that kind of my Liquid Facelift, and then a bit of Botox sprinkled everywhere. The rule is roughly, you know, your Botox units is roughly your age. If you're over 50, you add 10,

Unknown Speaker 32:52
like 50, you need about 60 units.

Unknown Speaker 32:56
And then if we're adding the neck, we might even go up to, like 40 more units for the neck, and that helps with platysmal bands. That helps with the Nefertiti lift, where I'm stopping, the muscles that pull down on the face. And so I can do so much with the injectables, which is nice because they're not a lot of women who say I just want to go right to the operating room. Most people want to just try a few things to see if they feel refreshed and if they feel like they look like themselves again, they feel like themselves again. With the radius is that it isn't. It is not a filler. It is making your own body do the work. So I really loved that. And then I have done all of those things above in current including the sperm thing.

Unknown Speaker 33:40
How did you like that? By the way, I did. I liked it. It was good. I probably need to do it a couple more. Like, do it every month when somebody is just getting started, you know, like noticing their face, and they're like, Okay, I'm finally going to invest in me, right? It's so refreshing. Dr, Kay, to go to you and have you say you don't need, we're not starting with putting stuff in your face that is going to be extra. We want to start with making your skin do something it should be doing anyway. So the collagen is fantastic

Unknown Speaker 34:11
when it comes to all of these things that you're trying, that you're doing at some point, does it? When does it not work? I think that for women who have done some treatments and they feel like they still aren't hitting the mark, injectables will never be as good as surgery. Surgery is the gold standard. That's gold medal. We can get a silver, we can get a bronze, we can get you happier. But if you want the gold medal, you're going to go to the operating room, and that is our dime town time and cost, right? So, recovery. But what you said is, what got had me go to you, is that there's a whole bunch of stuff you should do to your skin before you go to surgery. Right? Yeah, so much. You want to prepare the skin, you want to nourish the skin, you want to stimulate the skin. You can go right to surgery if you have skin laxity, more than a centimeter of.

Unknown Speaker 35:00
Skin that's loose when you pull your surgery candidate. But I can take women to surgery that have older crepe texture to their skin, and it looks like old skin pulled tight. Or we can take collagen stimulated, thicker, more padded, little more youthful skin, and then pull it tight. So I'm a fan of doing that, and my patients will maintain throughout their time with me, until like six months prior to surgery. If you know you're going to surgery, we're going to stop all that. We're going to let the area settle down, let some of the old collagen simulators break down naturally, and then go to surgery. And that's kind of the strategy I think people should think about. Everyone's scared about, can I do sculpture? Can I do radius? Can I do a collagen simulator and do a facelift? Yes, you can. And this is the approach. Is six months prior, or even a year prior. You can stop doing those injectables, because you don't need that money to go into injections. You can then convert it over to your surgery plan. And that's the logical way to do it for me, and then we haven't had problems for 25 years with Sculptra and radius patients having facelifts. It's just been a couple really vocal surgeons that draw attention to their platforms that say, like, oh, you can't do a facelift. You can't, you know, stop doing all the injections. Just come right to surgery and I like, wow, that is not okay? It's very paternalistic and crazy to think that every woman wants to just have a facelift when she's 38 you know? So I'm not, I'm not here for that. I want women to wait you have two good facelifts in your life, and so you want to do the first one when there's lower face laxity, and you can do just a facelift at that point. The second one maybe you'll do when you need a face plus neck together, and that'll be 10 years later. So 55 to 65 is step 110, years later, you can do step two, and that varies like some. Can you do a facelift earlier? Yes, and we do that for rapid weight loss patients, for patients where there's just too much skin, and that's not a problem, but it's very important that women don't get shoveled down this lane of like, you have to have surgery at age 4045 you got to look perfect all the time. Like, that's not realistic.

Unknown Speaker 37:13
Listen up. Listen up, ladies. This is from a surgeon. She's telling you you don't have to jump into surgery. I love it. Yay. That's great. Yeah. Went back. Yeah, I think disappointment when people jump into surgery too soon, and I am sadly seeing that in my office, like I saw a 38 year old woman who had a facelift, and I was just like, this is a crime to make a young woman have a facelift, because, again, she's gonna need one at 48 then 58 then 68 after two facelifts, you just can't look normal for the third. There's just just not possible. There's so much scar tissue, etc, and like so much psychological burden that goes with that, thinking, Yes, that's the biggest part.

Unknown Speaker 37:50
I like that you have, you know, a pecking order if they were going to listen to you. Because, let's put it this way with women, depending on where we're at, and I think our skin on our face, and probably our weight, those are the two things that at some point, if you're doing things that you don't, that don't work, or whatever you get, you're like, I'll do anything, you know what I'm saying us. I think it's important to find the right person

Unknown Speaker 38:17
that's going to give you the proper guidance and the steps, and sometimes actually say no. Like, if your doctor actually says no and it's something that they lose money on, I think you might want to keep your ears open. It should be bio individual based on where that person is at and help guide us as to what really is going to give us the results that we want. That's true. Very true. So where do you think people go wrong like that? Because the whole goal, I would assume, with all of the things that we're talking about, is that we want to look like a better version of ourselves, not like a completely different person.

Unknown Speaker 38:56
Yeah, I think people go wrong because we see, unfortunately, those, the people that we see that makes us go, I don't want to do that. You look crazy.

Unknown Speaker 39:06
It's a little bit of a slippery slope. So you really want to have a provider that will be honest with you and tell you when you truly need something and not just sell you more. Is better, because they make more money that way. So I think it's really important to analyze someone's face and their beauty goals, and then start very conservative. You can always add more, and then just show people what they do and don't need, like, explain to them the pattern of aging that's happening in their face. That's critical to have those level conversations. And too many people see something on Instagram and want to go buy it and it's injectables are not just a quantity or a commodity. Like, I want to buy some cheeks, I want to buy some lips,

Unknown Speaker 39:48
but I'll give you a Picasso paste, right? Like say, got

Unknown Speaker 39:53
Mr. Potato Head here. We don't want that approach to beauty. We want someone to really analyze our anatomy.

Unknown Speaker 40:00
Our base, what makes us unique, and to draw out all of our attractiveness, right? So for me, that's the biggest important thing. Is a consultation with a specialist who understands aging and what's happening in your own personal aging trajectory that they can reverse. And secondly, like, I have all the tools I can go from non invasive to very invasive, like, if you're seeing someone who only has limited tools, they can take care of the skin and the surface of the skin, and they can laser and blast and do all this, well, that's all they're going to be able to do. So it's nice to have someone who has the full vocabulary, because I can offer whatever point you're at. We have a solution for that. Tell us this, when you are giving somebody a facelift, what is your favorite thing? I think in starting in the late like in the 40s, is an amazing time to do an upper bleff and a brow lift. That combination alone makes you look and feel 10 years younger. And so an upper bleff and temporal brow lift, I think that's a beautiful combination that should be maybe half of my patients, that's their first step into doing something more than just injectables, and that's a really pretty solution. Sometimes we'll add a laser at the same time while they're recovering or fat transfer. And then secondly, the other favorite thing is slightly older age group, where they have lower face laxity and sagging and they need to get a little I love to do a mini lift, an early mini lift, if you don't have neck changes, doing a mini lift gives you a lot of extra years before you need the full monty.

Unknown Speaker 41:31
I think a mini lift has a slow it has a relatively quick recovery time, like five days to seven days, versus like a major facelift neck lift, which is sometimes 10 days, and restaurant ready at 14 days, restaurant ready. I love that. Yeah, so I'm a fan of doing, like, small interventions, you know, right when you need them, versus letting it all go and waiting to do the full monty all at once. Okay, well, then when you are thinking about different myths that are out there, what's the biggest one you want to retire? Like, what do you want to get rid of when it comes to facelifts? I think women need to hear this. Well, I think that there's a lot of people talking about doing deep plane facelifts. And I just want to tell you that we've been doing deep plane facelifts for 65 seven, like, 65 years. It's in the literature, like people act like they've invented a new strategy for life, and I'm just like,

Unknown Speaker 42:29
because that's a published technique that we've been doing for years. So yes, the deep plane facelift is good. No, it's not right for everyone, and super risky and lots of downtime when you get into, you know, deep, deep layers and changing muscular positions. It's only for the superiorly qualified surgeons to do that, and you don't actually know what you're getting when you sign up with a surgeon. You're not in the operating room. You're not a surgeon. How do you even know they're doing a day plane, facelift? They're just tacking on some advertising claim and saying that they're doing that. Hopefully we're in an ethical field that people don't do that, but I think you've got to look for people who have lots of experience and they're doing a lot of work,

Unknown Speaker 43:08
and then

Unknown Speaker 43:11
Instagram is it's a dilemma, because it's such a great communication tool. But on the other hand, there is no surgeon posting their half good results, their marginal results. You know, complications and adverse reactions, like a facelift has its issues. It's not the do all and all be all. And I also think patients should understand that you're not one and done. You can spend 100,000 or $200,000

Unknown Speaker 43:36
on a facelift, but guess what? You're still going to need Botox. You're still going to need mid face work, because the facelift works on the lateral edges of the face right here. From here and beyond, we can stretch and tighten, but the mid face we cannot work on. That area. There's so many vital nerves and structures, so this whole zone continues to age and continues to need a little bit of maintenance. After facelift, you still need your routine maintenance. I think that's a big misconception that you think you're gonna, I'm just gonna save all my money and spend 150 grand on a Beverly Hills facelift, and then I'll never need anything again. And that's that's sadly mistaken. So like, I think need to look a little further down the road. And also, people who have spent that amount of money don't necessarily have the result that's so much better than a, you know, average, like, more 50 to 50 to 60 grand facelift. Yeah, you're not that's definitely a message that's come better results. So I want people to be a little more concerning and concerting and how they vet these procedures. So what do you think people maybe regret the most? Is it, man, while I was there, I should have done more? Is it the two?

Unknown Speaker 44:52
Very often, they have the misconception that we can tighten as much as you see in the mirror, like you'll go home. I have a.

Unknown Speaker 45:00
Will test, do you tighten with one finger? Does it take two fingers, or do you have to fingers? Because that'll tell you you need a mini lift, a face lift or a lower face lift.

Unknown Speaker 45:11
Patients often will really pull back tight when they're in the mirror and they expect their face lift to be like that, but so often that they don't get as much tightening as they wanted. So it's, I think, having that really good conversation in your pre op consult where you show the surgeon what you think you want, and they tell you what they can deliver, and then you won't be disappointed. It's like managing, I think, with anything, not no one thing normally does what you want, and that's also why our approach with you is, let's go through all the things so that, because if your skin texture, if you have melasma, if you have acne, well, you get a facelift, you still have those things going on, right? So it's never just one thing that's maybe going to give us the results that we want. It's multifaceted, right? It truly is like the best facelift work, my best work comes when I'm doing a combination of I built some collagen ahead of time. I'm lifting and tightening skin laxity. I'm using some fat transfer, because I'm getting some fresh stem cells in there. And then we might even finish surgery with a light CO two laser to resurface and, like, brighten everywhere. So it's multi depth treatment that I actually reframed the way I thought about a facelift in this episode. I want you to know, because we were thinking in my head when I when we were planning for how to explain these things to people, I was picturing the levels right. But, you know, it's more like you've got level one, and then when you get to level two, you have level two and level one when you get to level three, level one, level two and level three and even level four, like, it's still, you still need to get, like you checked off the first level, and you get to move on, right? It's more like you're adding a level, you're compounding. So true. I'm coming up, I'm doing a lecture, and Monica coming up. It's called the blueprint for aging. And I'm exactly, do you need an assistant? You're going to Monaco. You need an assistant? Okay, good, sorry. Okay, what the blueprint? Okay, got just developing an anti aging blueprint, and that this is one of the premises that you can't just do an injection and fix a problem. Like, it's not one area I'm treating. It's multiple depths in every area of the face. So it's multiple layers. Like you said, we have to treat the bone density change, and we do that with deeper products like the radius, and we treat superficial fat pad change. Maybe I'll use hyper dilute radius for that, or Sculptra. And then we want to do, you know, some skin dermal padding and thickness that might be the micro needling, and maybe laser appeals for the skin surface, like transforming the surface of the skin with like a sandblaster effect, but and then finally, a surgery to tighten and trim. So it's really a combination. All right, guys, I hope you had a great time with this podcast, as much fun as I had. Remember, aging is a path and a roadmap, and there's no pressure, no one cares. Do whatever step you want, but remember to make yourself feel fulfilled and confident. I hope you love this podcast with the girls from girl, can you talk? We spilled the tea. And thank them so much for getting on the podcast. I am so excited to let you guys know that I have a new skin care line is launching. It's our KD skin wellness line, and it's all about peptide based skin care with GHK copper, I have a brand new KD collagen complex. These are collagen and elastin peptides. There's three of them. They're super powerful, mitochondrial boosters, NAD precursors, GHK copper, all the things that your skin literally needs, and you've got none of it. Got a whole bathroom counter of skin care, but none of this longevity based skin care, which is going to change how your cells function. So that's it for now. Guys, find me at my Instagram. It's Beauty by Dr Kay, D, R, K, a, y, and our website is the same Beauty by Dr kay.com that's where you can find our amazing new skincare and tune into lots of podcasts just like this one, learn everything you Need to Know about looking and feeling your best.

Unknown Speaker 49:22
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