Ep. 228: The Park Avenue Face with Dr. Andrew Jacono (Replay)


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Fat Mascara there you are Jessica Matlin making very funny face that me I don't know I feel like our taff it's not like. It's not ideal right now. I okay let's get. Yeah already. Yeah not. Home Studio like a really nice one can somebody sponsor us and? Redo our houses and put home studios in because it seems like we're not GonNa be going to the studio and you know now I can't believe it's the end of the summer, and here we are still remote but still going, and I think we've had a really good summer. All things considered at least infamous cower whereas fatness Fatma's scour were house. Me Too. I am so excited that we got to connect with everybody even more. They have more listeners on the show like hearing their voices great guests twice. So we and I'm loving all of the nice notes and voice memos and e mails you guys have been sending. So we do not. We do read them and I feel like we've gotten closer. To and I know you guys are sick of US complaining about summer. So the good news is it's over we are entering the next season and for that reason actually meant to tell you last week. But here we are we decided this week to do like a little refresh to recenter ourselves. So we don't have new interviews or new content this week other than our introductions and raise the ones at the end of both the Tuesday and Thursday episode. So we're just giving ourself a breather to get in place for our fall season with all of our new guests and lots of fun stuff. We running two episodes. So Today Jessica. Pick like an Oldie but a goodie and we didn't tell each other what we were picking. But today we like showed our hands. So I picked Dr Andrew Chicano author of the Park Avenue face this was from last April I believe yes April Twenty nineteen just a million years ago I. Love this conversation. So much I think if I believe he Was the first test surgeon we ever had, and the reason I brought him in I remember. So excited as soon as I met him at harpers bizarre I'd never met him before he harper's bazaar to promote his book. As soon as he left I remember texting Jim Ding like we have to have this guy on, we have an open plan or we had. An open plan environment at bizarre I was like screaming inappropriately with laughter when he came to the office, I will not repeat some of the things he said, but he gave me really good dirt on like you know like like some kind of like read between the lines kind of jokes about celebrities what people do to the faces he just had like a really kind of Just. Like Oh, no filter kind of also this great discretion about the way he spoke to I just felt like this was like this is the kind of guy you want to be seated next to at a dinner but he also had amazing real world advice about plastic surgery I, felt like He. was very actually conservative about filler very conservative about plastic surgery. He talked about white plastic surgery is like dating, which have to listen if you want to know why he also really into. Subtlety, he thinks a lot of people very overdone. He talked about by people look like snapchat filters and even if you plastic surgery is never you might be thinking listen Jessica Gem, I'm not getting plastic surgery. I don't have tens of thousand dollars throw around. Why do I need to listen to somebody who has a book called the Park Avenue Face? That is not my lifestyle he's just. Really engaging to listen to and he has great perspective about the culture that we live in, which is so much about looks looks looks. So just give it a listen I. Think is a wonderful charming guy. Also, he's a wonderful guy to he does a lot of charity work. So hang on buckle up, hang out with Dr Jacoby no and meet US afterwards and we'll, raise the wand. All right can you believe that we've never had a plastic surgeon on Fat Mascara? I mean that is crazy. I can't believe it. I, am a CO host of. One hundred fifty plus episodes. We've never had a surgeon, but we decided to go straight to the top for our first one. We have Dr, Andrew Chicano, MD DOT FA CS right. That's. More title, I just looked at the book. And you're in New York City board certified plastic surgeon and I mentioned the book you also the author of one of my favorite beauty books ever the Park Avenue face which just which just came out this month. Actually yesterday. Launched. Yeah it's pretty exciting. It's a big. It's a big day. It's a big week. Well, okay. So we've had a lot of germs on the show sure and we've never how does it mention a plastic surgeon so outside of like a hideous disaster where if someone's concerned about their facial appearance, sure when should they see a plastic surgeon as opposed to a dermatologist? Well I. Think you. The truth is, is that Surgery I think lots of times begins where dermatology ends. Because dermatologists do a fantastic job, you know they do a lot of. Techniques and treatments to enhance your face. You know they do things for your skin can laser resurfacing to do facial tightening devices they do injectable treatments, go toxin fillers they can keep us looking great for a long time plastic surgeons do those treatments but I think that plastic surgeons who will train a dermatologist who train both do a great job at those things. But the problem is obviously the certain things. You can't do just a needle or nonsurgical treatment obviously some of those things the dermatologist but never see things like a rhino. Or somebody has you know a small reach in you know you have bags under your eyes is only so much. You can do with treatments. So there are reasons why people seek out plastic surgery, but as we get older and this is a lot about well, my book is about is to educate people not just about the nonsurgical treatments that both plastic surgery dermatology do. But how do you make sure that you're doing the right things for yourself not overdoing it and when you really start thinking about doing something that's a little. Bit more aggressive. So you mention like you know when he started doing things that are more aggressive. Sure. I think a lot of people you know even some of our listeners and we have we have a wide Adrian of listeners but maybe thinking plastic surgery and this is this is not for me. This is like for Mucho later in life for this I don't want like a nose job or something, but they're thinking about like rejuvenation or they might think plastic surgery like little bit dated reference. But like Joan rivers aiming towards who? Joan. It's what folks fear. He's a plastic surgery is synonymous with you know your least favorite looking celebrity. Everybody can think of a time where they watched like the Oscars or or an award show where a celebrity came out looking like they had done something they look like themselves anymore or they look very sculpted artificial tight or their faces looks distorted scary. And that's that's one of the reasons why I wrote the book because. The book is called the Park Avenue face and it's like why? What's the park game you face? Just interview yourself here. What is the? Thought a lot about this book in his reasons why I wrote it, but the thing is, is that The reason, the number one reason why I wrote this book is for the reason we just discussing because people say to themselves you know maybe I'm looking to do something term hands my appearance. But if all those celebrities you know old people from Hollywood people with money and access who can get the best care don't look normal. As an average person out there what chance do I have? So why would I go about the even going on this journey because they don't WanNa, look weird I was like myself I want to look at him I want to enhance my appearance, but I don't want to trade enhancing appearance for looking Waco plastic surgery victim. So the Park Avenue face is something that I deal with all the time because I practice on Park Avenue but because my clients especially those from New York, they prefer different aesthetic and what I mean is that they want to look like themselves they wanna look like themselves but a better version so that's The Park Avenue faces it. Kind of is yeah because what I call I, see this dichotomy I see what I call the East Coast Aesthetic and the East Coast Aesthetic is somebody who wants to maintain their personal signature. They want people to see them and not say what happened. They want somebody look at them and say Oh my God you look amazing. What are you doing? You know did you change your hair? Your skin care regimen must be better. You lost weight you're exercising your life is good. You look vibrant that's the Park Avenue face that is the east coast, the West Coast the Sediq is the overfilled cheeks. It's the overly scooped out Nelson. Gang. Paying there are people in the West Coast surgeons who do east coast work but it's synonymous with the West Coast because we see you know many celebrities. On instagram, we see Bela celebrities, we see celebrities and they're in our face there in our media and that's what makes people afraid. So unfortunately, the West Coast Sediq whether it's created by doctors or requested by those people from the West Coast. Is the thing that people want to avoid. Right so it's not that our our our west coast listeners want to look bad. It's more of this like this Hollywood overdone kind of it is it's an aesthetic and you when you go to La Anybody's been la I'm sure you're as la you kind of walk the streets and you walk around and like people start to look like they're related. Because they have the same over inflated Cheeks Lips Look the same. Their nose looks the same everything looks the same same same. So I, think there's an archetype that may be considered to be attractive in in some fashion Obviously, it is because people get a lot of attention for looking that way. So, there are a lot of instagram models who get you know they've tens of millions of followers and bazillions of likes, and they have brands and all the stuff, but they all look like each other. Down the kind of do because if you can build that face in that body, then you get more attention from people. So it's something that some people aspire to but my park avenue patients don't aspire to that look. So. What I do in this book is I defined this aesthetic, and again I want to be very clear is that I have plenty of my colleagues who I respect on the West Coast who do quote Unquote East Coast work so it's not that doctors only in New York on Park Avenue can create the east coast aesthetic. It said you have to be very clear what you want and you need to make sure you seek out doctors who could create that kind of outcome. For you. So what I do in the buck is, is I go throughout the whole face whether it'd be your skin whether it be nonsurgical treatments whether it be rejuvenating. Your is you know your face, your nose, whatever it is and talk about East Coast approaches. So all the things that create more of a normal look even though can be surgical. There are techniques and approaches that are more subdued than there are ones that are a little bit more west. Coast e let's call. So, if you're a west coast, you can use this book to try to figure out the west coast he kind of procedures and seek them out. But what I do is I let the reader know because it's hard to know this as a person. Yeah we were going to ask you this later I think now is a good time. Say You are considering surgery and we'll get into when you should be your wife might be like, where's the first place you other than reading your book like where do you even star? That's the problem because there's so much information out there. Right. So what people do is that you know we all think we're like super researchers. Literally just talking about that and. We're experts on everything exactly because all I need is my owning Google and like. A plastic surgeon. Need is coupon Google machine. I. Need a good. Twelve hours research and I'll be able to figure out the truth. Certain winds up happening is is that there's lots of conflicting messages out there. So unfortunately, you can get a lot of information but depending upon the source, you may be getting a mixed messages. So that's why I wrote this book because I have so many patients who come in with all those mixed messages and they're trying to figure out which I deserve but obviously save that you kind of have to be a private investigator. What do people want you to do just piggyback off your quest of what you just said. Do People ever come in your office and they said I want this or I'm sure that I don't need this like what what are people telling you that you have to kind of back them off the ledge well, yeah I mean people have their own preconceived notions and that's when you have to educate them, and that's where that's why I spent a lot of time studying and doing what I do so some people come in and They, say I WANNA lift whatever this is, for example, and then they sought to tell you what they want to achieve and you're like, no you don't want to lift. You don't want surgery at all. This would be a much better option for you. So people think that they figured it all out. Sometimes you have to reeducate them, and sometimes you have to save people for themselves because unfortunately you know our industry since it's it's elective. Is No perfect diagnosis, right? So if you have you know. If you have a gallbladder that needs to come out. It's pretty obvious. They scan the Goldblatt is not good. You gotta take it out with US sometimes doctors more ready to just execute what people want even if they're not necessarily a good candidate. Because the patient requests it. So you know I talk more people out of surgery some days than discuss a surgical possibility for them. Because the fact that I realize where it's going and once you educate people people smart, would you give them the information explain to them what this will do how it may not work with their face if it doesn't work with their face because it's not balanced, it'll exaggerate their features were maybe it's just not the right approach and you give them options. You know there are non surgical options are invasive options. Some things. Do this do that? Once you show people pictures of it. This is what I do I show you pictures of this procedure when it does what that procedure would. It does this non-surgical thing and then when you put that in front of people and use some digital morphing of their own pictures, they kinda come around they go yet. You know you're right. I don't like that I like this better. And then you can really help them achieve their goals and it's always best to do it in the least invasive way, and do you want people to go around and we always say like get a second opinion do your research like wellpoint is too many opinions too many opinions because they they come to you then go to another doctor another and all of a sudden they're like. Guinea to do that because as you. How many yeah. I think that you should have four quality concepts. For. Consultation in my office, you do some do them for what I do is I charge people consultation fee but if they do go ahead with any treatment whether it's not surgical surgical applied towards. Product. Whatever just so that the patient doesn't feel like they're losing something for the cost of the proceeds cost of the consultation. But you know some doctors do none you know they don't charge for concerts. But the reason why is is that it's sort of like dating. It's not just about getting the right information you have chemistry with your surgeon. Really starting a partnership. That's interesting. Well, it's true because you need to really trust that individual not just their skill, their ability. But when you have questions and you're stressed if you had a procedure, you need to feel comfortable enough to voice your opinions and feel like you can actually you know go to that person and be able to get answers you need. So if you're in the office and you're talking to them and they're giving you like you're getting a bad vibe, is it okay to say no. Absolutely so in my the bug, I do go over a chapter where how it's best to select a plastic surgeon, and that's one of the say is, and this is one of the big like subheadings within that chapter is to trust your got because I think all of us have had experience in our life have nothing to do with plastic surgery where we wanted to go in one direction but something inside of US said, don't do it and then we kind of did it anyway because we just want so much to do it haircuts. And then what happens is that afterwards in hindsight we go. You know what? I knew this wasn't going to be the right thing i. just had a sense about it. They didn't listen. Gosh getting chills yes. Yes. So but that is definitely one of the key things that I think that people need to do do your research, get together your information, but you really need to have a certain amount of residents would somebody. So one of the things that you talk about in your book that I just think is so interesting is something called filler fatigue. What is filler fatigue? Claw it just. Talk AB-. Water. So yeah. It kind of has the story is this. As we get older I. Think Everybody's experiences You know we don't want to anything that's major, but there's always great little needles can help us look better and commonplaces for people to get fillers. Shadows under there is cheeks get a little deflated we get. So smile lines, marionette lines often called. That's a great name. Yeah about the doctor term nasal labial full like what? Is a Hula. But you know get groups folds and that's things start to loosen. These kind of cavities than shadows interface that are very harsh with lighting we try to camouflage makeup but when we started to progress unfortunately, usually start somewhere and you mid to late thirties and it just gets worse after that helps to everybody people start doing phillies phillies a great because what they do is is it's kind of like spackle. She got some cracks she got some dense she spackle them closed where you put in there and it smooths things out. It looks really great. But the problem is is as we continue to age we require more and more filler to get the same bang for our buck. So you go and you get a little feller when you're a little bit younger, it really pays dividends but as you continue to age the same elephant doesn't really get you what you want and then as you start to add more and more filler two things happened one is face talks a look bigger. So a lot of filler interface. It starts to make your face look around wide and it starts to distort your appearance. You know always you know I kind of say this, and then it shouldn't say this but I will anyway because you guys little joy. When people have too much filler in their face they start to look like the real house of real housewives of wherever you don't these women. A of times of these TV shows they have that kind of look where they'd tap into plastic surgery but they just look weird. Worked on on the reunion show. Yeah. So what happens is that you start eating more and more, and then you start to lose a lot of your facial identity characteristics. Face looks just asymmetric in a weird way even though things aren't falling things are inflated but the problem with that is, is that not only don't you look great you kind of look like somebody who's older trying to look younger and that happened you know. And I'll dare go out there and lie. But you know people like Lindsey, Lohan who probably engaged fillers at a very young age was looking much older than her years even in her twenties said, do you think that it's to start younger I mean I won't even talk about the preventative both tax thing right now because I love preventative talks I think fantastic I think it works wonderfully. Put for fillers. Thank you because we do get a lot of differing opinions on that but for. fillers. If you start early liquid, say like you know I'm a Lindsey allegedly may have or someone like her younger is something that when you're older, you've kind of like the opposite of preventative you of messed up your face. Will does because if you I the thing if fillers are done when when when it's necessary 'cause you could be young and require fillers because some people their faces kind of a little prematurely or they get a little hollowed out a little bit early. So using filler when diagnosed correctly, I, don't think it's a problem. The problem is is when you start to add too much stretch the tissues out. So this is this thing in the body it's called village a creep it's kind of weird. Yeah so he It is a little bit creepy So what happens is that as we start to fill the tissues of our body, it stretches them out. That's a characteristic and plastic surgery that we use where we're doing things like breast reconstruction like if a woman has breast cancer, they put a balloon of this blows it up so that you can create more skin to put an implant and suppress was taken away and this called something expanders. Filler acts like that. Yes, it does. So when you played the tissues, you're stretching the skin out just like gaining weight or being pregnant. So when you gain a lot of weight, you stretch the skin out and then when you lose it the skin sex more people like floppy lips once they're filler, what happens is Olympic get stretched out things over the upper teeth. So people to which filler into lip it goes away now they stretched it out it hangs more. So people have too much filler in their cheeks Philip dissipates their face sags more but then they see it sagging and in the natural response is to go get more filler because the concern is as I don't want surgery. But I don't want to live with my face looking droopy. So they continue to put more and more filler. So what they're doing is they're stretching other tissues at a more rapid rate than as that if they did anything at all psycho. Tawny. I do a ton of people's face-lifts in their mid forties to late forties dot because they look so old, but because they've been engaging fillers excessively for too long. So now they have no option but to do something like a mini facelift at a younger age whereas if they didn't do anything as aggressive, not fillers at all fillers, a good tools, all these things, select tools and youtube belt. Is Very Cliche to say but too much of a good thing is not good for you everything in moderation doctors who are going to have your back and do things appropriately at the right time versus people who are out there who are profiteering lots of Med spas and places who don't have good medical supervision by good dermatologists plastic surgeons will be more than happy to empty more vows a filler into your face because they make more rain because you pay prevail, get you to do six miles. I made six times the amount of money than if I just put one violent. That you know he's calling the West Coast Aesthetic Nicey people here in. New York that you know like just like you said the West Coast doctors. Are. New. York. Gear East Coast the Newark Newark area as he plenty of girls with the big cheeks. Chin that's a look. I agree and I don't think that it's pretty I think it's archetypal and it looks it looks like a snapchat filter. Guys. 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None of the sweaty cotton you know that same silky material that you have pillows that make your hair Shinier and are good for your skin night uses that material in their face masks the masks come with these little disposable filters which I love their one hundred percent mulberry Silk Lightweight Jessen I've been wearing them this summer. They're really nice in the hot weather coming a bunch of beautiful colors. And what I love about night for every mask purchase, they donate five surgical masks to healthcare professionals until they reach their goal of sixty thousand mass donated. Okay, the night one, hundred percent mulberry silk facemask is available at discover night dot com. If you use the code, Mascara Twenty they're going to give you twenty percent off your first order that's discover night dot com. You mentioned a mini facelift but like I before I asked you about faceless what's the youngest person you've done a facelift on? I've done plenty of people in their mid to late thirties who have over gauged fillers that he very it's usually because of that not because they were Aggie at that age. Wow people don't say that as routinely. But if you've been doing fillers from your mid twenty s eve like cheekbones and you just wanted higher cheekbones and you just kind of went for, you went to forward a little too much for too many years. If you saw that twenty-five by the time, you're thirty five, all that filler strategies out it weighs your face down fillers have wait they don't defy gravity they strapping waits on your face. Over a decade. But again, here's the thing. Using, the right amounts and doing at the right time for the right reasons we'll protect you doing excessively and doing too much quickly will cause problems. So it's time not me maybe Philip Fatigue or maybe because you've done your work and your homework in you've consulted and you're really ready for say some type of facelifts what can people expect these days because I think we all think like Oh, my God you're GonNa be bloody and gross in swollen for eight weeks in you're GONNA have scars behind your ears and everybody's GonNa to know what what does it entail these days Yeah. So that's definitely true for older style approaches to face lifting which a lot of services still do. So people do wind up and I do lots of revision work with large long incisions that are hard to hide, and then people will take forever to recover. So then they're they're a newer techniques. So the techniques we use today, they usually use an incision that's much more hidden. It's literally about one third or seventy. Seventy percent lesson shorter in length in a traditional face the decision we have better technology. It goes inside this little thing called the traits. So in front of our ear canal, this little piece of cards pokes out the some people get their trade gets. So you make an incision inside that thing not on the outside. So the incisions hidden, it goes around the year low of onto the back of the year. So it's like this weird pigeon s kind of shape. So you can't see it and we go down with telescopes and we don't do as I don't go under the skin layer I, go straight from the incision under the muscle layer. The reason why is if you're under the skin and you lift them, what happens is very tighter polled you go onto the deep layer faces is called a deep plane facelift. makes. The Last time you did this I did two of them today like a couple of hours ago you digging around someone's head. Out Dig. I. Never did. I. Gently separate the tissues and lift them sounds more invasive than say this old technique is. Take to heal. So this is funny so Somebody out here just did have a facelift on somebody her she's the she she put on story on Instagram. She's called the eyebrow Dr Ed she chronicled her recovery over one week after week she was back at work with essentially no bruising swelling. What I this technique it would does is it doesn't disrupt the blood supply to the face. So the face heels very quickly what often do is is we use what's called hyperbaric oxygen. With a couple hyperbaric oxygen chambers, it sounds kind of futuristic Michael Jackson? Yes. He's the sleep in one in his home in years ago cold it's not cold at all. It's just you sit in it's like a big silicon tube that's clear glass. So it's not like being an MRI. It's big. You can see through it they do is they put oxygen or high pressure which makes the bruising swelling in the healing happened at three times the rate of you do your surgery within one of those. Before and add the mealy after the surgery get hyperbaric oxygen therapy treatments I'm not really. Better than any patch ever. Do that to this is article on steroids? Okay. So I have tons and tons and tons of patients who don't have time to recover their on television. There's celebrities or models. They're people who are veterans. Of course, we have delays or people. Nobody, wants to acknowledge the fact sees the. Celebrities who look unbelievable who will remain nameless and you to see them you just like you just smile from ear because you like they just look amazing. Those people have had work. How can you tell their people in their late forties early fifties who are conic just like they don't age they're not aging because they've had help. Okay Jennifer Lopez. Have commented in a single celebrity. Let's let's set the record straight. I want them coming for your license because people need there. But. Can you tell watching those people walk by because you're an expert? Can I? They've had the work done I. mean if I was in their presence, I absolutely could, but you have to understand something a lot of the images we see of those people. There's very few of those images that retouched Social Media and you look at what's being put out there. It's been face to like everybody. Else's Eyeso- I have to say feel really happy that you said the thing about like you know if you see someone who looks amazingly blow away in their late forty s plus. Maybe even before. I think we all think you know it's it's Avocados and Diet and yet so. Alcohol it what I call it horseshoe. The thing is, is that everybody and I? It's interesting. I actually instruct my patients because everybody has fear that people are going to find out. If you don't have any stigma out of surgery and you don't look weird or pulled over. People just look at you like confused because when you walk into work after a great procedure and you look seamless and you look youthful people expressed subscribe to you know Oh my God. You had a great vacation and if they dig further people see what are you doing you skin looks amazing. I tell people to say things like you know what I'm on a super I'm on this antioxidant diet. Using. So eating this myth though that we all feel inferior because age Jennifer Aniston, but here's the good. Fortunately, we live in a very judgmental society and unfortunately revealing that you've had surgery even though it may not look like plastic surgery could be very detrimental to people that can affect their careers. It affects the personal relationships I have to tell you that I have people who their best friends they've lost best friends they don't talk to. Their family members anymore because people have very strong judgments about plastic surgery. So even if you look normal, it can really disrupt people's lives. Can you talk a little bit more about that that we weren't going to ask you about that but I'm I'm really curious 'cause I know you're you're seeing you're seeing is that clients patients who are in probably a world where this is not crazy because you are the top of the the car. The thing is people don't like people. This is this is something I say all the time. Our friends and our family member and the people that are confidence want us to be okay. But they don't want us to be great. And I'm not you know and it's unfortunate but it's human nature. I don't think that people are evil but it's very hard for people when they see other people around them that their their peers that are excelling there excelling in the fitness of the accelerator appearance, etc. Excelling in their financial aspects of their life, people don't like out lawyers people want. It makes us feel inferior. It makes us feel uncomfortable. So if you give people the understanding of why that's the case and if it's related to plastic surgery, people love out people. Oh, you know Janey looks fantastic. The reason why is because you kind of got him facelift you know and then Don't I look good and there are some people who have bravado and have that personal power to do that. But there are a lot of people who will unfortunately feel very very violated law and feel very sad and then really unfortunately will even like wish they never told anybody that they had done and in the face of looking fantastic normal natural a beautiful. So my suggestion is to most people is. that. It's better something that you keep to yourself because I've seen how can really affect people in a very negative way now not the way they look obviously but the way that other people deal with that information and it said that it is that way but that has been my experience and I have done literally over three thousand facelifts. So I've been down this road with so many people. So you see. Patterns of behavior. So for me, it's kind of silly just like I talk people out of surgery you know it would be really beneficial for me to tell everybody to scream from the hills that I did their surgery. But I I usually tell patients that you know unless they have a strong opinion about it that they should see how things were going and kind of keep a close to their chest advocacy. The spouse will now they have a spouse right often but I gotta tell you I don plenty of plastic surgeries on women who don't tell their husbands and I've done surgery on physicians wives, and they wait for their husbands to go away to a medical convention for a week or two their husbands come back often surgeons and they don't tell him. Surgery another plastic surgeons wife many. Things a lot of the plastic surgeons bring me their wives because they want me to do this to wipe surgery because I'm a specialist and face lifting. But then other ones they don't they don't want their husband to do it. So then I do it. But by the time, you ever done a husband whose wife is a plastic surgeon. I've done one. So, that was that was a because she didn't want to operate on her husband. No, it's she actually brought me. She brought me her husband. So I have a really funny story. So here's this. This is really cute. So I was lecturing in Singapore on at a meeting teaching facelift and amid a plastic surgeon from Germany and he says, you know he saw me do a live surgery in this stuff. He says, you know, I want you to do my wife's face. Love. So he brought his wife to have me to her face left. This is probably about two months ago and I did a facelift and he Scrubbed for the surgery which I do all the time I have no problems with another plastic surgeon watching me do the procedure and assisting me you know they just you know hold things while I'm working wife's facelift and she looked literally like twenty years younger right there. She was in her early fifty s he was in his late fifties and she was wheeled out he walked up in, pulled me aside and said, she looks amazing. She's gorgeous. He goes I want mine tomorrow. So the next morning I came in at four thirty in the morning I put him before everybody else I did his face lift and then they left at a week they got their hyperbaric oxygen treatments. They look stunning and we needed to fill out paperwork for them because in the EU they have facial recognition and even though they look like themselves they. Arguably. Look twenty years younger. So I had to get some extra paperwork filled out so they can cook they were concerned that if we're going to be held at the border, not gonna be able to go back in because they didn't look you know look like, how could you be a fifty eight year? Old Man you look like you're thirty eight years old. Impossible it right there. It's pretty funny. I have a million stories like that. Second Book, which is all you're finding story. But I think I'm going to write the closer to the end of my career. So okay I, talked about a lot of your patients have you ever turned away some piece? Every day and is because they want crazy. You know overly filled everything. Well there's different reasons. One of the Dublin reasons why turn people away is because they're not at a good phase in their life to think about plastic surgery so. People logically. Yes. Okay. So and it doesn't mean they're cuckoo or it means is that lots of times people are going through big changes in their life they want to get. Done because they think it's going to improve the situation they're in. So often people whose job or they feel like they're aging in their career has been affected. They want to run in and get a facelift or if somebody you know unfortunately is in the middle of a divorce you know they they. So they're not. They don't have the emotional preparedness to be able to engage. It's a very stressful time and people make a lot of very snap judgments during those times than probably. Shouldn't have. All these things. Though it's like people do often when I break up they first thing to get a haircut. I'm GonNa but this is the thing is not a haircut. The hair doesn't grow back. So you know making those kinds of snap judgments and decisions during time of emotional turmoil is usually the person's best interest. So I'll tell people that and I will turn the Moi that's one of the most common reasons but other than that it's has to do with not being the right time with the right procedure. So just because somebody wants something doesn't mean they should have happen. So somebody WHO's coming in for a face lift prematurely doing surgery before it's necessary doing anything when it's unnecessary will make things look natural. So doing a face lift on somebody who really doesn't have eight to treat can do nothing but make them look distorted. Interview is turning into why not to go to Dr go because my next question sort of along those lines how do we stay out of your office? Then like how do we stay looking young if we don't want to get surgery till later or get injectables to later well. or at all I mean thing to do any of this, which is a lot of people. Well, of course, it is. Well, the first thing is is that you know I this is fortunate truth here we could all save you. Let's all feel comfortable with our aging appearance and just like you know embrace it, you know be joyful about your aging and it is a privilege, right? That everybody lives forever. You know I'm you know I'm getting to be a little bit older. Now what I find is that there's so many people that I went to college with my Frat brothers I went to med school with where they were contemporaries who aren't here anymore. So it is a gift to be able to age, but that doesn't mean we want. To look older unfortunately, we're in a very high pressure situation. Now because we have these high resolution digital cameras, we don't we look like all the time or images get over social media. You know I just had a book launch party at number on Tuesday and you know we had a photographer there. He saw some very unflattering pictures from my profile with my. Citing, absolutely. I'm like Oh my God I need a neck lift pasta. Because my head was down of assigning a book and I'm like, Oh my God it's like I'm a plastic surgeon that can be walking around like this but we are very hyper aware of our appearance and it is hard to age today than it was thirty years ago. But what can you go ahead? Please sorry I it is hard to age I was thinking about asking this vote was like maybe this is just me like with a leading question projecting. So you feel like I don't know what you meant, but I think the culture is way more like youth orientated. Getting we'll, of course, it is because you know from my perspective thirty years ago if you picked up Vo Cosmo or L. Right and you looked at the cover, you would never see somebody who seventeen years old gracing the cover agree. But today is almost it can never be young enough. It's going to be babies on the. Back mean if we look at the progression, you know supermodels were like in their late Twenties and early thirties years ago today they're like sixteen seventeen years old here. They looked more I. Know It's Two more women you know and now it's like. They don't look like women. They look like kids you know and they are kids but we have this obsession with us to the point where we're putting seventeen years out there in a hyper sexual way, which is a little bit weird I. Mean I'm a Dad I four kids you know in thinking about my daughter at seventeen years old you know having it all out there on display. It freaks me out a little bit I know that it's healthy for our youth. But the thing is is that it raises the bar for what people see as being the archetype of what we aspire to and I don't think that's fair good but it's Something, that we're all dealing with and I think that we have to be as a society a little bit more cognizant of that it'd be more regulatory understand how it affects women, how it affects men, how it affects how we interact with each other because it does so but save all that stuff and then you know that's like that's a that's you know like those are big ideas and it's really wonderful to talk about. But you know unfortunately sex sells and that's what people put out there. Unfortunately, the more people click and the more people engaged that kind of content the more we feed it you know as an industry certainly know that firsthand. But if you want to try to minimize your aging, the most important things are obvious I think you know, and these are the things you will read over and over and over again sun exposure is a disaster is doing a lot better than we ever did with that I think that most people men and women would never go and do what I did when I was growing up, which is ice to put like baby oil night I know in and fry my skin or put like coppertone to on I mean I'm dating myself here but putting on coppertone four was like Oh my God how do you do that now today? We have to the so cute. Cumana. Even make this stuff anymore. Only like eight and that was not that long ago. But the thing is now people use better some blocks every an I do take care of a lot of young clients. Who Come in and they're coming in for skincare and all the things that are gauged. So you have to protect your skin. You should be using retina as part of your regiment or some kind of retinol because that builds up the college maintains college leaves it'd be skin sunblock and some form of vitamin A derivative retinal retina will pay huge dividends for you to use one. Of course, I do like a prescription one, the US Retina, the as the prescriptive type. So as you get older, you need something a little bit stronger bird retinol, which is readily available over the counter in many different products. And preparations is a wonderful way to be able to maintain your skin. So those are like pretty inexpensive and attainable ways of doing this retinol is cheap, but it's definitely not the same as going to a dermatologist or plastic surgeon more prescriptive medications. So you do those things and that'll pay huge dividends I think once you get past that, you know obviously, we don't want to gain lose too much weight as we stretch our tissues out with a tissue expansion maintaining away appropriately and avoiding toxic foods and you know this is this is the truth gluten sucks. It tastes wonderful. It's toxic to our bodies is. Strong words from a doctor. They are though you know you know and this is the thing I saw like like a bowl of pasta every once in a while. Everybody, it's toxic to everybody. Toxic. Toxic is of a car I. Love CARBS and I. It's harder and harder for me to eat them because as I eat them get bigger and bigger and they've got to run more and more to burn off. But the truth is is that there's lots of inflammatory properties to food you know. Ogres, of course, to simple shift sugars, processed carbs, and you know it tastes really really good. But you know what? There's a lot of truth if you just. Thinks and the we all know what to do. We learn from Grade School what he's supposed to do eat fruits and vegetables and good produce. You know you eat you know lean meats. I mean everybody knows what to do it just don't taste so good. So the more alcohol we drink more tobacco, we smoke and all those things you. You can't be you can't be an angel all the time, but trying to minimize those things that definitely age your tissues, Asia, skin there's no question that eating a lot of processed foods sugar. It definitely puts a toll on your skin eight dermatologists will tell me. I thought I was looking at me like. You're on fish right now we're both shrinking are see. Here's the thing you said. Good. Eat a lot of little little cheese possibly four nights a week. Meats. But here, here's the thing. It let's saying that you have to be perfect all the time but trying to be as it of these things and minimizing your exposure to them we'll definitely do better for you over the long haul over decades of your life but but save those things I think those. Has Ancient Grain. But boats hawks is definitely something that helps as you start to age and usually in the early thirty and beyond because you start to get. Clues toxic but. Unfortunately because you the best way to think about your skin and vo talks is thinking about wearing a leather coat. It's brand new is the leather Silky and smooth. But as you start to wear it and you look at the elbows where the folds over and over again, you fold the leather over and over again, you start to get Craxi wrinkles. So people who engage boats, hawks not when they're twenty one years old. But as they saw sea lines and wrinkles, it will prevent you from getting more characteristic lines in the upper. Third of the face, the forehead, the IRS around the is crows feet. If you maintain that, you don't to do talks all the time but even if you do it once a year to minimize how much those muscles flex will stop you from getting more wrinkles in your skin. So those are the main things that I think you do in the early phases of your life. Obviously, you continue to age you put a little filler and it is supportive, but you don't overdo it. You know, and then you late nature take its course. You given us a lot of advice too much. Know we have to learn all of it. Okay. Before you go one last question what's in your medicine cabinet right now what do you use on your face? So? I use the. point Oh. Five known, which is Retin-a I use this thing it's it's skinceuticals it's vitamin C I I love it. So I put that on my skin everyday day at nighttime. If I'm feeling dry I, you know this is going to be very You know. Maybe I don't I don't want to suggest that you need to use such a fancy Moi's Moisturizer, but I have lemaire cream that I. You know most these moisturizers they're very equivalent for something the Silky feel that stuff and Love Love Yeah they'll put it on all the time but thing especially during the wintertime you know when you're in New York and it's winter you get just gets very dry and cracked but you get used something as simple as sita filthy to fill moisturizer is wonderful. It's very inexpensive and it's something that's available to every Reforms Pharmacy. So the main things you WanNa, do she want explicitly your skin? You want to support it with some kind of a vitamin A derivative. I use RETIN-A use retinol used you some kind of antioxidant the the vitamin C's You know vitamin C, e Ferulic from skinceuticals is one of my favorite but there are multiple preparations of these kinds of things something that's antioxidant protective something to build a college layers and something to moisturizes skin and your great. Great Oh my God you you should be on TV. That was he has he's been on like the today stuff I used to have my own TV show. Well, it was. It was I do a lot of charitable surgery. So I do a lot of pro bono surgery on children, but I also do reconstructive surgery on women and children who are victims of domestic violence. So fantastic. So I so I had a TV show. Thank you in on Discovery Channel and this was probably my God probably two, thousand, two, thousand, nine, it was only one one you know once one. Season that we did it. You know what I did was is I and I do a lot of this work. But one of my friends was a TV producer and he's like eels great work in which do a TV show about it. So then I you know every episode, I would do to people who had a story unfortunately had facial disfigurement from domestic violence. And we did that and it was a very interesting process to be in a TV show, but it's a lot of work. Yeah. Yeah. One of my good friends this is funny One of my good friends is Dr. Paul Nassif was on Botch yes. Yes. Yeah. So Dr Paul Nassif, you know he's you know we're we're very close and he's you know the amount of time that you spent. I knew I did it for one season you know doing a television show it actually makes it very difficult to be a surgeon and take care of your patients. So sticking. Dr. Nassif is a great surgeon and he's also he. He's also really great on TV I. Love Watching Them. He's funny. But I'm lucky that we have you in the studio today and thank you so much for all of the. Thank you. I'm going to go have some pasta. You give me a lot to give out for thought. Also I hope you're like working in twenty five years because you might get a little tingling for me. I do have for children and to support. We'll see in. To be I'm. Going to be old. Sharp you don't WanNa come to me. I'll send you two guys that trade. Thank you. Dude. deadlight light. So glad you get interview and when you can you explain why I was like that is it. That's what makes a good podcast interview. It's somebody who'd want to sit next to it like a dinner party and for me someone who is educating me at the same time they are entertaining me and I love I. Loved it. Loved it. Thank you for bringing that back into everybody's feed to this week. I'm so glad you dug it. Yeah. Okay. So you WANNA. Raise the wand. Yes. Do I get to start sure go ahead. Okay. So I'm actually going to raise a wand to a brand I have fallen in love with all over again. So I actually discovered the brand through a former podcast guests. Okay. It's all like keeping all on the FM. Today. So core organics that is former podcast guests, Miranda, Kerr's brand. Now before you start thinking, okay, she's a supermodel who has her own brand great core organics is the shit right and. I'd not a huge cursor. It is amazing. I got really back into Cora when I gave my friend Lucy a couple of core products that I have extra ones lying around and then she. wrote me from like she was on a trip and she was like this is amazing and she's like not a huge beauty person like she's not gonna like she's not someone who asks for product or like law this product and she she loves something she loves something like pay for it. She is going crazy for chorus. So I was like, what have I have cora got some stuff that can start using again. You're like, why didn't give it away yeah? Yeah. Yeah. The. Second. Cora. So I was like you know what? I have core products too. So I have quite a few. Lucy. Give it back. I know I know she's crazy about this space oil. There's a lot of course thinks she's Well, I, I'm a few things, but one of them that I like it was like right next to my bed I started using get that now is. Easy is the core enriched body lotion. It is so good. It smells so spa like I rub it all over my body like single night and I wasn't using body lotion all the time because I'm lazy cow it is fantastic. It's got a hogue oil of course it's organic because that's Miranda she's very fancy like that. She's like healthy organic yacht back Adamia oils cocoa butter. Nobody extract her whole remember the Nonni. The nonni of the new we should remember eight her interview. Accent was delightful. Kept saying no need. Really, an accent. Asmar she was incredible. I mean her face is of mesmerizing to anybody show on. She's like she's she's absolutely beautiful person. It's just wonderful. You massage it in and I. Even my husband said like to be like to like like you know tm but he said like my skin felt really soft and really nice and I was like I have to keep using this I'd my husband said my skit fell off. Like I, feel like if it made me feel good. So Anyway I. Love It, and I love it. It's an pumps. You could just like like a lazy lazy animal I push and Rub it on my body when I'm in bed like it's not. An animal metaphors or cow. What else have we got? When you're get dry. It's not like a butter. We need to unscrew the top and then you have to like put your little pollen. You completely know what you're talking about I think yeah great? A brand that like it is similar sort of way it was one of these brands that get so much hype that I got one of the products and I was like I know I have to try this but you know you don't go through cleansers that often I was using another cleanser that was making me breakout quit that and I reached for Jordan Samuel. Skin I know forever, right? Don't all the models love him. One of those backstage brands a couple maybe two years ago not even and then like a beauty editors were whispering about it and. In the know people. That it's the same with happened with Vintner's daughter I was like against against it against it. Fine. I'll try it, and of course, it was amazing because there's a reason these word of mouth products like they're usually really pricey and they start out with a very cliquey type of person who likes it and for. The Galateri and in me wants to not like it for that reason. But here I am. In Jordan Samuel and his lovely the after show treatment cleanser. Oh my gosh. I just realized it DA models after show like he does do all the models. So this cleanser is like if it's so it's just such a nice experience because it's a gel that more into like a creamy oil I feel like I'm getting a little. Erica my we say we're eating. A fund snack that requires work like for example, I'm trying to think of a good example I don't know eating shrimp like would be one but that's bad. One free let lettuce roles. All of a snack Tivi and I love a snack. The food is an action. Well, this is like a beauty tips. Like. Oh, cleansing face it just wash my face I'm like having a little spot treatment because of like the formula that changes consistencies and has a lovely smell gets off all the makeup and it's sort of like, oh, I haven't been double cleansing with this because it's sort of to me the bomb and the foam cleanser sort of in one doesn't really foam up late. And fine. All you people told me about Jordan Samuel. You're rights. It's great. So I'll put a link on the blog. My favorite thing was when you said that you were against a beauty product. To just like you're gonNA pass you were against no because you don't be such like I don't know a Knuckle word a contrarian. You're not like burning down a Sephora you're. Just like if I want to not like it but I I guess with the Jordan Samuel you can't you're going to that bandwagon is going you're getting on it and we're all getting on it. Okay. We'll see you on Thursday. We got another fun interview and we'll we'll meet you back here. We hope you enjoyed the show. It's your reviews and feedback that help us make the podcast even better head over to itunes to rate and review us or e mail your thoughts to Info at Fat Mascara. Dot Com. The also, WanNa answer. European. Here products, you love to share Reza one product view or to ask achieve question, email us at Info at fat Mascara if you send it as a voice memo file, we can even share your voice on the podcast. You can also do that by leaving us the voice message our phone number in the United States is six, four, six, four, eight, one, eight, one, eight, two. Thanks so much for listening.

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