Speaker 1: The biggest mistake that I see is people who go
Speaker 1: do procedures and are disappointed. And the reason that they're
Speaker 1: disappointed is because they are going to somebody who didn't
Speaker 1: try to figure out what is the best thing for them.
Speaker 2: The cosmetic dermatology industry is an enormous business across the world,
Speaker 2: and it's growing every year. New products and procedures emerge
Speaker 2: all the time to meet the growing demand. I know
Speaker 2: many people have questions about what procedures are safe and
Speaker 2: effective and what they should avoid. So I thought we
Speaker 2: could talk to doctor Dan Belkin, a board certified dermatologist
Speaker 2: who practices at New York Dermatology Group. Dan graduated Amherst
Speaker 2: College magna cum laude. He received his medical degree from
Speaker 2: wild Cornell Medical College, and he studied non melanoma skin
Speaker 2: cancer at Rockefeller University. I've been seeing him for quite
Speaker 2: a few years and I rely on his thoughtful expertise.
Speaker 2: Welcome to my podcast, doctor Belkin.
Speaker 1: Thank you so much for having me mine.
Speaker 2: I actually called doctor Belkan Dan, and he calls me Martha. Yes,
Speaker 2: and how long have I been coming to your office?
Speaker 1: I think I met you about five years ago, maybe
Speaker 1: six years ago.
Speaker 2: Introduced by my daughter. I think originally Alexis always finds
Speaker 2: the very very best practitioners of their art. Yes, and
Speaker 2: I consider dermatology and skincare and facial care and art
Speaker 2: form for sure, are a real artist. D thank you
Speaker 2: so much. It's really amazing what you can do to
Speaker 2: help people look better feel better. And you're also your
Speaker 2: advice is so good. And doctor Belkan actually practices so
Speaker 2: many of the new techniques that you may not have
Speaker 2: heard about. So I thought we would talk about all
Speaker 2: the different kinds of things. Why don't we talk about
Speaker 2: what you do for me? Because everybody is so interested
Speaker 2: when they see a selfie of me posted on the internet.
Speaker 2: So many comments are about my facelift and who did it,
Speaker 2: when did I have it done? And all this and
Speaker 2: how much retouching is on the photograph, And I just
Speaker 2: want to set the record straight. How do you describe
Speaker 2: what you do for me?
Speaker 1: So you know, I think you're an inspiration to a
Speaker 1: lot of my patients who see you, and many people
Speaker 1: wonder what you're doing and how you are looking so beautiful.
Speaker 1: And I think you're a real testament to the idea
Speaker 1: that taking care of your body, taking care of your skin.
Speaker 1: Doing sort of minimally invasive treatments conservatively and regularly can
Speaker 1: keep you looking beautiful at you know, any age, even.
Speaker 2: Longer, longer than you can imagine. Really yeah, yeah, And
Speaker 2: there's so many articles day after day after day about
Speaker 2: what people can do to reverse You're not going to
Speaker 2: reverse aging, you're not going to get younger numerically, but
Speaker 2: you can really prolong youthfulness, activity, energy by taking care
Speaker 2: of yourself in several different ways. And I think going
Speaker 2: to a really good dermatologist can help you feel better.
Speaker 2: I remember when my mom, at eighty five years old,
Speaker 2: went to a plastic surgeon and she said, I just
Speaker 2: I want to face something because I just want to
Speaker 2: look good. And he said, well, you're going to look good.
Speaker 2: You're not going to look younger, but you're going to
Speaker 2: look good. And she said that's enough for me. I
Speaker 2: just want to look good.
Speaker 1: I think that's a great attitude. You want to try
Speaker 1: to look the best you can at your age and
Speaker 1: not necessarily younger. I think for you, you do look
Speaker 1: a little bit younger than your age, which is a
Speaker 1: great collateral. But for most people, I think what they
Speaker 1: should aim for is to look the best for their age,
Speaker 1: because I think when you try to start looking younger,
Speaker 1: you can start looking a little bit uncanny where you
Speaker 1: look where people can't tell what age you are, and
Speaker 1: that's not so great either.
Speaker 2: Oh I don't know about that, well, I think in
Speaker 2: your I don't. I never. I don't think a lot
Speaker 2: about age. But I don't want to look my age. Yeah.
Speaker 2: Well all, and that's why I really work hard at it.
Speaker 2: I work hard at my exercise, I work hard at
Speaker 2: my diet, which is a very healthy, normal diet. I
Speaker 2: don't do fad diets and I don't do any pills
Speaker 2: or anything like that. But I just eat really well
Speaker 2: and I watch what I eat. That's really, I think
Speaker 2: a secret. And so doctor Bell can describe what you do.
Speaker 2: Let's start with my face first of all.
Speaker 1: Good, let's see. So what I look at when I
Speaker 1: look at you or anyone is sort of what can
Speaker 1: we do with all of the tools that we have
Speaker 1: at our disposal. So we have botox like like products
Speaker 1: that are neuromodulators that can soften some muscle and on you.
Speaker 1: What I do with the botox is I try to
Speaker 1: reduce downward pull on the face. So I do a
Speaker 1: little bit in the jaw line and on the neck
Speaker 1: so that we can reduce kind of the banding on
Speaker 1: the neck and reduce the downward pull on the face
Speaker 1: to keep those muscles a little weaker so the muscles
Speaker 1: of the cheek can pull.
Speaker 2: Up more up. I see.
Speaker 1: Now we've tried a little botox on your upper face,
Speaker 1: which has not.
Speaker 2: Gone that like that at all. My eyebrows kind of
Speaker 2: go up in a V and that looks so unnatural. Yes,
Speaker 2: and because I don't have lines in my forehead.
Speaker 1: Right, so it's not really necessary for you. So you know,
Speaker 1: I've tried to give you a little lift. It hasn't
Speaker 1: really worked that well on the upper face, but I
Speaker 1: think neuromodulators like botox have worked really well for you
Speaker 1: on the love.
Speaker 2: I have a nice neck for my age, you do,
Speaker 2: and a nice jaw line. My draw looks good. It
Speaker 2: looks better after you than any at any other time. Really,
Speaker 2: it's for a long time I was worried about that
Speaker 2: because that was my mom's problem, a little jowlly right,
Speaker 2: and and after you, really it has really really helped
Speaker 2: the appearance of my face.
Speaker 1: I'm happy to hear that.
Speaker 2: Yeah, very good. And now you're doing something else in
Speaker 2: my cheeks.
Speaker 1: I do. So. The other thing that we use on
Speaker 1: you is filler. Now there, filler is sort of controversial
Speaker 1: these days. I think there is a trend to dissolve
Speaker 1: filler and a lot of kind of a lot of
Speaker 1: celebrities are famously dissolving their filler. And I think the
Speaker 1: reason is is because filler is done kind of on
Speaker 1: every corner, especially in New York and all these medi spas,
Speaker 1: and you don't know who's doing it and how well
Speaker 1: trained they are about that. Yeah, and so when we
Speaker 1: use so filler can be really overdone. When you look
Speaker 1: around and.
Speaker 2: Was that when you see a really plump lip, yes,
Speaker 2: oh I see.
Speaker 1: Really big cheeks.
Speaker 2: I don't go for that.
Speaker 1: No, and so on you. When we do filler, we
Speaker 1: do it very conservatively. We don't do it that often.
Speaker 1: And for you, I like to use fillers that what
Speaker 1: we are what we call biostimulatory fillers. So I would
Speaker 1: say this is another trend moving a little bit away
Speaker 1: from hyaluronic acid fillers, like regular fillers.
Speaker 2: That kind of erase a line or increase right. Okay,
Speaker 2: that's hyerlonic.
Speaker 1: That's hyaluronic acids, which is your body's natural moisturizer and
Speaker 1: your skin and your joints, and it's still a great tool,
Speaker 1: and we can use it to kind of hydrate the
Speaker 1: lips or soften some lines. But I think it's been overused,
Speaker 1: and I think a lot of people respond to that,
Speaker 1: and many people come into the office and say, please
Speaker 1: don't overfill me. Please don't make me look like the
Speaker 1: Real Housewives of New Jersey, you know, and so sorry, real,
Speaker 1: I shouldn't, I shouldn't denigrate anybody, but on you. I
Speaker 1: try to steer more toward what we call biostimulatory fillers.
Speaker 1: And there are two that are on the market. One
Speaker 1: of them is called Sculpture and one of them is
Speaker 1: called Radis. They're both biocompatible, biodegradable, but they're not made
Speaker 1: of hyaluronic acid. They're made of lactic acid and calcium, respectively,
Speaker 1: and they've been shown to stimulate collagen and elastic fibers.
Speaker 2: Because you'd put some in my cheeks and.
Speaker 1: A little on the jaw jaw, so.
Speaker 2: You're giving me more plumpness in my cheeks where you
Speaker 2: tend to get hollower, as you.
Speaker 1: Say, exactly, and it doesn't only create volume but it
Speaker 1: doesn't create volume just by patching in exactly. It creates
Speaker 1: volume by stimulating your own skin cells. Alp sculpture which
Speaker 1: is lactic acid based, and radius, which is calcium based,
Speaker 1: and those create volume by stimulating your own collagen, almost
Speaker 1: like a fertilizer in the skin. So it doesn't only
Speaker 1: give you volume, but it can help with skin texture too,
Speaker 1: and a little elasticity so that when we do it
Speaker 1: on the jaw, you have not only improvement in terms
Speaker 1: of volume, but also a little improvement in terms of
Speaker 1: skin quality and what else. And other things that we
Speaker 1: do for you are laser. So laser is a very
Speaker 1: wide category.
Speaker 2: And doctor bell Can, by the way, everyone is an
Speaker 2: expert with all the latest and best lasers. That's one
Speaker 2: of your specialties also, it is. And I'm really pleased
Speaker 2: with the results of any any laser treatment that you've
Speaker 2: given me. Thank you, you know, because here in that
Speaker 2: v of your decolte, that's sun damage, that's a brown
Speaker 2: spot here or there. Those lasers are really effective and
Speaker 2: they really work. They're a little painful, yes, and ask
Speaker 2: your germansologist to make sure they give you all that
Speaker 2: nice cream that that sort of deadens deadens the effects
Speaker 2: of chains, the sensations. But but it really works because
Speaker 2: this part of me, my decolte and I across my
Speaker 2: chest is looks so good now, and that that is
Speaker 2: a combination of your work and also pilates. Yes, I
Speaker 2: even find that it's getting nice and bony and looking
Speaker 2: good and flat and nice.
Speaker 1: Well, you do a great job of taking care of
Speaker 1: yourself sort of from the inside out, which which makes
Speaker 1: my job much easier. And you're also good with sun protection,
Speaker 1: which makes my job much easier. But lasers can be
Speaker 1: used to target pigmentation, target redness, and target sun damage
Speaker 1: and sort of resurface the skin. And so that's what
Speaker 1: we do for you. Those are the main three things.
Speaker 2: So it's not so complicated, and it's not cutting me
Speaker 2: and sewing me up. It is really preventative and very
Speaker 2: encouraging because it really does make me look better.
Speaker 1: The other thing that I like about this stuff is
Speaker 1: that in a way, it's many of these things are
Speaker 1: actually good for the health of the skin. Laser resurfacing
Speaker 1: not a blade of resurfacing like a fraxle for example,
Speaker 1: that's been shown to reduce pre cancerous cells, so it
Speaker 1: actually can prevent skin cancer.
Speaker 2: Too on my chest, Yes, and that really does result
Speaker 2: in a very nice smooth skin.
Speaker 1: Yeah.
Speaker 2: What's the age group of your patients.
Speaker 1: My patients are from their twenties to their nineties.
Speaker 2: Yeah.
Speaker 1: Especially after it came out that you were one of
Speaker 1: my patients, I get a lot of women in their sixties, seventies,
Speaker 1: eighties wanting to look like you.
Speaker 2: How are they doing?
Speaker 1: They're doing good, Well, we're good.
Speaker 2: Well. My friend Charlotte went to you recently, and Charlotte's a
Speaker 2: little older than I am. I'm eighty two. And Charlotte
Speaker 2: looks amazing. She is so happy that she found you
Speaker 2: through me. But she's so happy because she's she's a
Speaker 2: pretty woman and she just needs a little attention. Yeah.
Speaker 1: I think sometimes little things go a long way, and
Speaker 1: I think people sometimes, you know, when I see on
Speaker 1: your Instagram some of the trolls that you get, one
Speaker 1: of them is, you know, tell us who you're plastic
Speaker 1: surgeon is, And I end up telling a lot of
Speaker 1: people there wasn't a plastic surgeon. It's it's just minimally
Speaker 1: invasive things for a long time in a really thoughtful,
Speaker 1: excellent way. And the other thing is well, of course
Speaker 1: Martha can do it because you need millions of dollars,
Speaker 1: and that's not really true. You just have to choose
Speaker 1: what's the most impactful treatment. So, you know, I think
Speaker 1: the problem with a lot of these what's out there
Speaker 1: and these medi spas and even all of the articles
Speaker 1: about kind of the next best thing, people will go
Speaker 1: in somewhere and say I want Morpheus. Morpheus is radio
Speaker 1: frequency micro needling, and everyone's talking about Morpheus and it's
Speaker 1: just a tool. So if you want Morpheus because you
Speaker 1: have brown spots and so you think Morpheus is going
Speaker 1: to rejuvenate you.
Speaker 2: You're wrong.
Speaker 1: So you spend all this money, you go through all
Speaker 1: this pain, and your brown spots.
Speaker 2: Are still and they will not be told that that's
Speaker 2: wrong treatment.
Speaker 1: They usually are not. I mean, if you have a
Speaker 1: good doctor who's thoughtful and is not trying to sell
Speaker 1: you something, then you.
Speaker 2: They know because somebody will asks. They'll see a friend
Speaker 2: who's had Morpheus, and then they'll say, oh, I need
Speaker 2: that too, and they don't really need it, right. Yeah, yeah,
Speaker 2: I'm not like that at all. I never come in
Speaker 2: asking for anything extraordinary that somebody else had, because actually
Speaker 2: I don't really ask people. So much what do you do?
Speaker 2: And then I might say, oh, what are you wearing?
Speaker 2: It looks really great, But I don't really ask them
Speaker 2: so much about their You.
Speaker 1: Know, honestly, you're a pretty easy patient, maybe surprisingly to
Speaker 1: some people, because I think you recognize expertise and you
Speaker 1: defer to it, and not.
Speaker 2: Only expertise artistry. I call what you do artistry because
Speaker 2: you have to be an expert. But if you don't
Speaker 2: have if you can't look at me and see that
Speaker 2: one little thing is more crooked on one side than
Speaker 2: the other side, then I don't want to work with you.
Speaker 2: I want you to have the same I have a
Speaker 2: very strict artistic eye, right and I can see defects,
Speaker 2: and I want my doctor to see the defects also,
Speaker 2: and you do. You're you're one of those guys that
Speaker 2: can really see a defect and fix it. Thank you.
Speaker 2: And that's so important listeners to pay attention to, because
Speaker 2: you can go to a doctor who might look make
Speaker 2: you look like everybody else that he sees, and you
Speaker 2: don't want that. No, there's no one note in skincare
Speaker 2: and dermatology. It's just not a one note thing. Everybody's
Speaker 2: face is so different structured differently, and you might all
Speaker 2: have the same bones, but you certainly have a different
Speaker 2: confirmation of those.
Speaker 1: Book definitely, and everyone has different things that make them beautiful.
Speaker 2: And so you don't want to go when you say,
Speaker 2: like this laser is going to hurt. Have you tried
Speaker 2: it on yourself? Or has somebody done it on you
Speaker 2: before you do it other people? Do? You always test things?
Speaker 1: Not always?
Speaker 2: Not always?
Speaker 1: But I have tried a lot of things, and I'm
Speaker 1: not a good patient, and I understand that these things hurt,
Speaker 1: and I'm not good at tolerating it. But you know
Speaker 1: how it hurts, I do.
Speaker 2: Okay, that's good. Yes, that's good because I think some
Speaker 2: doctors don't know that, and it's like, oh my gosh,
Speaker 2: you're getting shocked to do.
Speaker 1: But it's very even botox gives me tears in my eyes,
Speaker 1: which is really not that painful.
Speaker 2: Well, doctor Billiken is a young doctor, a handsome young
Speaker 2: doctor who I don't think you need too much stuff
Speaker 2: done to your fat.
Speaker 1: But I've got you know what I'm going in your
Speaker 1: direction where I've you know, since I was in residency
Speaker 1: when I was in my late twenties. I do little
Speaker 1: things here and there, to sort of stay fresh and
Speaker 1: hopefully never need anything more aggressive.
Speaker 2: Right. Oh that's good, Well you look great. So let's
Speaker 2: debunk some treatments that people are talking about all the time.
Speaker 2: What are benefits, which ones are worth it, and which
Speaker 2: should be skipped?
Speaker 1: Botox Botox is a great treatment, of course. The reason
Speaker 1: is is because what happens is with time, your skin
Speaker 1: loses some collagen and elasticity, so it loses some of
Speaker 1: the proteins that give it firmness, but your muscle strength
Speaker 1: stays the same. So when you're young, you make expression
Speaker 1: and your skin bounces back, and as you get older,
Speaker 1: your skin doesn't bounce back the same way. And so
Speaker 1: what botox does is it balances the muscle strength to
Speaker 1: the elasticity of the skin, so that you should have expression,
Speaker 1: but we're reducing it a little bit to sort of
Speaker 1: match up with the elasticity of the skin. And I
Speaker 1: find that people who have done botox somewhat regularly for
Speaker 1: a long time look incredible in their older years because
Speaker 1: they've prevented a lot of these lines and and crinkles
Speaker 1: from forming. And you're one of those people, you've done
Speaker 1: it for a while, and now even if you don't
Speaker 1: do it for a year, you still relatively smooth because
Speaker 1: your skin has stayed You've kept it nice and smooth.
Speaker 1: Fillers fillers, So fillers is it's a great tool. Like anything,
Speaker 1: it's just a tool. So you have to know what
Speaker 1: you're trying to treat and you have to use it
Speaker 1: to treat that. Fillers are great. I think a lot
Speaker 1: of people are scared of them, and I understand why.
Speaker 1: Hyaluronic acid fillers actually have been shown to give you
Speaker 1: some collagen stimulation. So when they're used conservatively and well
Speaker 1: and smartly, they can be really helpful for long term
Speaker 1: skin aging. But when they're overused, and we've all seen
Speaker 1: examples of that, and I won't name anybody, but when
Speaker 1: they're overused, you can look very odd. Yeah, lasers, Lasers
Speaker 1: are fantastic. They're powerful. Again, you have to think about
Speaker 1: what you're trying to treat, so you are if you
Speaker 1: want to treat sunspots, you have to use a certain
Speaker 1: type of pigment laser. If you want to treat malasma,
Speaker 1: even though it's pigmented and brown, you wouldn't use the
Speaker 1: same type of pigment laser. You have cars scars, you
Speaker 1: can treat scars, you have to and similar to you know,
Speaker 1: even with scars, what are you trying to treat? Are
Speaker 1: you trying to treat texture, redness, browning? So lasers are great,
Speaker 1: but they're just tools and one size really never fits all.
Speaker 2: So how many different kinds of lasers do you have
Speaker 2: in your office?
Speaker 1: What you say, I probably have about like twenty or
Speaker 1: fifteen to twenty kinds of devices maybe, and some of
Speaker 1: them are are not We don't even use anymore because
Speaker 1: we have something better.
Speaker 2: And by the way, doctor Bilkin and his partners have
Speaker 2: an amazingly modern office with the latest equipment and peckably
Speaker 2: clean and bright of your lighting because it's so bright
Speaker 2: and you can see everything, right, which is so important. Right,
Speaker 2: But I really think you have a great, great office
Speaker 2: for the treatment of skin. Yeah, what about skin tightening? Now,
Speaker 2: have I ever had skin tightening?
Speaker 1: We've done I don't know what I've had. We've done
Speaker 1: a little bit of skin tightening on you. We've done
Speaker 1: a little ultrasound tightening. I think we've done I think
Speaker 1: a long time ago we did a little soft wave,
Speaker 1: which is an ultrasound based tightening device. And I think
Speaker 1: we've done a little bit of all thera, which is it?
Speaker 1: I think we did, Yes, we did, so that that's
Speaker 1: a great ultrasound based skin tightening that I think works. Again,
Speaker 1: it has to be done by the right person, it
Speaker 1: has to be done thoroughly, but I really like all Therah.
Speaker 1: Then there's radio frequency based skin tightening that can be
Speaker 1: really helpful to morpheus or radio frequency micro needling is
Speaker 1: a very popular treatment right now now, and that's for
Speaker 1: skin tightening. But I think, well, like what on my face?
Speaker 1: Why would I have root you that we haven't done
Speaker 1: that on now? Because it doesn't give you any lift.
Speaker 1: It just plumps up. It stimulates cauldron in the dermis,
Speaker 1: so it kind of plumps up the skin. So it
Speaker 1: can be good for sort of a crepy texture, but
Speaker 1: it's not going to give you lift, which I think
Speaker 1: is what most people are looking for. And so it
Speaker 1: still has a purpose and I still use it on
Speaker 1: some people, but not that often, not as often as
Speaker 1: you would think, you know, hearing about it in the media.
Speaker 2: Right, So what schedule do you recommend to your patients
Speaker 2: for these treatments? Do you see someone once every three months,
Speaker 2: once every six months? What's it? What's a normal A
Speaker 2: regimen of treatment.
Speaker 1: I think it always depends on what somebody needs. I
Speaker 1: think for you, we've been doing about six months probably
Speaker 1: maybe yeah, I.
Speaker 2: Don't even count. I just look in the mirror and
Speaker 2: I tell if I need to touch, yes, and what
Speaker 2: it appeals to. I forgot to mention peels in that list.
Speaker 2: What what? What are? Peels?
Speaker 1: Peels are a more old fashioned modality, and there are
Speaker 1: some dermatologists that are really really artful with peels, but
Speaker 1: it's a very specialized sort of sort of thing.
Speaker 2: That downtime after appeal to you do you do?
Speaker 1: And it depends on how strong the peel is. There
Speaker 1: are very light peels where there's minimal downtime, and there
Speaker 1: are really really deep peels where your whole face is
Speaker 1: burned off. And there are dermatologists that really focus on peels.
Speaker 1: As a laser fellowship trained person, I tend to prefer lasers.
Speaker 1: I think they're more targeted. I think, you know, if
Speaker 1: you have redness, we can target that, if you have brown,
Speaker 1: we can target that. I find peels a little harder
Speaker 1: in my hands, but.
Speaker 2: I find them harsh. I mean I have never done
Speaker 2: I did a little surface peel once and oh I
Speaker 2: hated it so much. But my skin doesn't require it,
Speaker 2: I don't think I don't think so either, very smooth skin.
Speaker 1: And not No, it's a little bit more broad strokes.
Speaker 1: It's not as targeted.
Speaker 2: But be careful everybody with peels, because you can do
Speaker 2: damage with peels. You can do damage with all of
Speaker 2: these things if you're in the wrong hand exactly. So
Speaker 2: for a while people talked about baby botox. What's the
Speaker 2: theory behind starting botox at a young age and when
Speaker 2: is the right time to start.
Speaker 1: Yes, there was a time when baby botox was a
Speaker 1: very popular concept, maybe a couple of years ago. I
Speaker 1: usually tell people that when they're starting to see lines
Speaker 1: that are at rest, that's a great time to consider
Speaker 1: starting to get botox, Like what kind of lines, So,
Speaker 1: like on your forehead, you have some lines with movement,
Speaker 1: but if you are not making any movement and your
Speaker 1: face is relaxed and you're starting to see little fine
Speaker 1: lines there, that's a nice time to start.
Speaker 2: You know. Well, quite a few years ago I noticed
Speaker 2: two lines between my eyebrows, yes, vertical lines, and some
Speaker 2: doctors said, just put scotch tape on your face every
Speaker 2: single night between your eyes and you will not have
Speaker 2: those lines. And I did. I did it religiously. Just
Speaker 2: put a piece of scotch tape here, and I don't
Speaker 2: have those lines anymore, you know. There it's a habit
Speaker 2: because you're squinching, right, or if your eyesight is bad
Speaker 2: and you start to squinch, you start to get those
Speaker 2: lines around your eyes exactly.
Speaker 1: And that's what I mean, those etched lines where even
Speaker 1: when you're not squinting, you still have those eleven lines.
Speaker 1: There are silicone patches that you can buy and put
Speaker 1: them on at night to keep the skin smooth so
Speaker 1: that you're not you know, you're not movement.
Speaker 2: Does that work? It does? That's that's good. So when
Speaker 2: do you recommend someone get a face lift, which is
Speaker 2: an operation versus treatments like fillers or botox. How do
Speaker 2: you know when a person needs a facelift?
Speaker 1: Well, like with anything, all of this sort of elective stuff,
Speaker 1: nobody really needs anything, So it really just depends on
Speaker 1: what somebody's expectations and goals are. Facelifts can be done
Speaker 1: so beautifully these days, where they're so natural they're hard
Speaker 1: to detect, and it's a great treatment, But it just
Speaker 1: depends on what somebody wants. There are people who just
Speaker 1: feel very strongly that they never want to have a surgery,
Speaker 1: they don't want to go under. And then there are
Speaker 1: other people who are completely fine doing that.
Speaker 2: They can't wait to have one.
Speaker 1: They can't wait to have one. And there and then
Speaker 1: there are other there are some people who want, for example,
Speaker 1: the neck, if you wanted if you told me, I
Speaker 1: don't want any laxity on my neck, I want I
Speaker 1: want all of these bands gone, I would say, well,
Speaker 1: that's going to be a surgical issue. Then then you
Speaker 1: would need to have a necklift, a surgical necklift. But
Speaker 1: if you say, I'm okay with getting that reduced, I'm
Speaker 1: okay with having them be a little bit retracted and
Speaker 1: not as prominent, then I would say.
Speaker 2: Okay, we can do that with boattox. Right, what does
Speaker 2: what does next surgery require? Where do you cut and
Speaker 2: how do you.
Speaker 1: Next surgery would be Usually they would combine it with
Speaker 1: the lower face and they would make incisions around the
Speaker 1: ear and so I'm sure everybody is seen, you know,
Speaker 1: scarring around the ear, which can be you know, noticeable,
Speaker 1: but you get scarring around your ear, and then they
Speaker 1: go under and they tighten up, not only the skin,
Speaker 1: but also the fascia of the face, so the layer
Speaker 1: of the face that's muscle and connective tissue, So that
Speaker 1: gets moved too. That gets moved too, because it's not
Speaker 1: just skin that's becoming lax with age, it's also the
Speaker 1: underlying tissues of the face.
Speaker 2: You set me on to something that I love so
Speaker 2: much and I will not leave the house without it.
Speaker 2: In the morning. You recommended that I use tinted elast Yeah,
Speaker 2: what is elastin? Really? It comes in a tube. It's
Speaker 2: mine is tinted and you can get it also like
Speaker 2: a smooth clear ointment, right or cream.
Speaker 1: Alastin Is is a company that a lot of dermatologists
Speaker 1: really like because they have clinical trials that show whatever
Speaker 1: they want to show, and a lot of these kind
Speaker 1: of anti aging skincare products there's no evidence behind them.
Speaker 1: It's it's really just a marketing employ and so when
Speaker 1: I recommend something, I look for things that have some
Speaker 1: evidence that show that, Okay, if it's anti aging, is
Speaker 1: it stimulating collagen, is it stimulating elastic fibers? And so
Speaker 1: that's why I like Elastin. They have trials that show
Speaker 1: that with skin biopsies there's something that I've recommended for you,
Speaker 1: which is the nectar, which is that sort of clear one.
Speaker 2: Yeah, that's so good too, It's great.
Speaker 1: And then the sunscreen is just a sunscreen, but a
Speaker 1: tinted sunscreen has more coverage, so it has more UV coverage.
Speaker 1: And UVA is the type of UV that causes aging
Speaker 1: signs of aging, and so to have a tint means
Speaker 1: that you're you're blocking more of the UVA and typically
Speaker 1: you get better coverage with that.
Speaker 2: I'm wearing that also, Yeah, you do every day? Yeah,
Speaker 2: I put I put the lass in the chinge It
Speaker 2: moisturizer on every single morning. I add to it a
Speaker 2: little serum and so I thin it out a little
Speaker 2: tiny bit and I just put it all over my face,
Speaker 2: all over my chest, all over my lower arms, in
Speaker 2: my hands, and it works. It really works. And it
Speaker 2: looks like you have to make upon Yeah it does.
Speaker 2: And even if you don't, you look really better with it.
Speaker 1: You look a little bronze done.
Speaker 2: It looks really great. What's the correct order in which
Speaker 2: to layers, serums, moisturizers and SPF And how much does
Speaker 2: the skin really absorb these things?
Speaker 1: The skin doesn't really absorb that much of them. So
Speaker 1: there are certain things that the skin does absorb. So
Speaker 1: retinol is a great ingredient to look for. It's a
Speaker 1: vitamin A. A retinol or a retinoid is a prescription
Speaker 1: version of it, and the skin does absorb retinol well.
Speaker 1: And so there are certain products that we know is
Speaker 1: absorbed really well. There are other things that the skin
Speaker 1: probably doesn't absorb very well. So you know, there are
Speaker 1: certain peptides. For example, peptides are protein chains. Many products
Speaker 1: will advertise that there are peptides. Well, peptide just means
Speaker 1: a protein chain. So if it's a large protein chain,
Speaker 1: it may not be getting to where you want it
Speaker 1: to go. It may be sitting on the surface of
Speaker 1: the skin. The skin has a stratum coranium, which is
Speaker 1: is a barrier. It prevents absorption. So that's why I
Speaker 1: look for studies that show that you're actually getting an effect.
Speaker 1: Vitamin C is another ingredient that can be a great
Speaker 1: ingredient when the vitamin C is active, but it oxidizes
Speaker 1: very easily and quickly, right quickly. Yeah, So many products,
Speaker 1: if it's really not from a super reputable brand, they
Speaker 1: may have vitamin C that that oxidizes very quickly or
Speaker 1: sort of inactive when you buy it, and you know
Speaker 1: they're going to advertise that it has vitamin C in it,
Speaker 1: but it doesn't mean that you're actually getting that benefit.
Speaker 2: So in your practice, have you found any kinds of
Speaker 2: creams or serums that really are superior to all others.
Speaker 1: I think that the two brands that I think have
Speaker 1: very good evidence behind them in terms of anti aging
Speaker 1: products are Elastin and the peptides that Elastin uses, and
Speaker 1: then skin Medica, which uses growth factors, and those are
Speaker 1: typically the two that I will recommend for sort of
Speaker 1: an anti aging regimen. Now there's a lot of brands
Speaker 1: and products that I like because they feel good, because
Speaker 1: they moisturize well, but that's little less hard to come by.
Speaker 2: I have not tried skin Medica, have I. I don't know.
Speaker 2: I'll get you some. I need some. Yeah. I like
Speaker 2: to try everything. Yeah, And I am like a human
Speaker 2: experiment and I really think it's important. But it's not
Speaker 2: just as important as what you put into your body
Speaker 2: your skin, as it is what you put on it.
Speaker 2: Oh definitely. So I'm experimenting a lot with what I'm
Speaker 2: eating and to see what makes a difference.
Speaker 1: Are there any supplements that you like that you've used.
Speaker 2: That not really? You know, if I get a blood test,
Speaker 2: and which I do twice a year, I think that's
Speaker 2: a very good thing to get and have someone analyze
Speaker 2: your blood. Do you agree with that having your blood red?
Speaker 2: Kind of like? Yeah, I was low in vitamin beach well,
Speaker 2: oh definitely. So why would I be low invitamin beach twelve?
Speaker 2: I don't know, but I must not be eating the
Speaker 2: right things. So I've changed my diet enough to add
Speaker 2: enough vegetables that have more vitamin B twelve. Also, I
Speaker 2: take vitamin B twelve now as a supplement just to
Speaker 2: and it went up like three hundred points. Great, so
Speaker 2: for the next you know, in the next four months
Speaker 2: or something. And iron, I'm low on iron. It turned
Speaker 2: out that the same time that my blood my BE
Speaker 2: twelve was going up, the iron was going down. Now
Speaker 2: why why would iron go down? Anemia a little bit,
Speaker 2: or being under the weather or being tired or whatever.
Speaker 1: Well, definitely, all these things if you feel crappy, I mean,
Speaker 1: all of these things can cause you to feel not
Speaker 1: so great, right.
Speaker 2: So so you have to take care of that stuff, right,
Speaker 2: And that is a big effect on your appearance, right.
Speaker 2: And I also think that what we've gone through for
Speaker 2: the last three years, the pandemic and the covids and
Speaker 2: the and now the rsvs and everything else that's coming around,
Speaker 2: I think that we have to be much more aware
Speaker 2: of and get and get a blood test every now
Speaker 2: and then and see see if you're failing in any way. Yeah,
Speaker 2: what are some of the non evasive options to improve
Speaker 2: your skin regimen that doesn't require needles and surgery? What
Speaker 2: would you say? It was a good daily regimen.
Speaker 1: A good daily regimen. So everybody really should be using
Speaker 1: sun protection. I know every dermatologist says it, But we
Speaker 1: know that culture violet is a carcinogen. We know that
Speaker 1: it upregulates enzymes that break down collagen. So if you're
Speaker 1: doing if you're spending any money on laser or injections,
Speaker 1: but you're tanning, you're sort of you're being counterproductive. So
Speaker 1: a really good sunscreen sun protection, and there's many different types.
Speaker 1: And I always tell my patients that if you find
Speaker 1: it greasy or you just don't like the feel of it,
Speaker 1: that you're not going to wear it every day, tell
Speaker 1: me and I'll find something that you like, because I
Speaker 1: like the elastin product, but there are many sunscreens that
Speaker 1: I hate wearing. So sunscreen, A retinol or a retinoid
Speaker 1: is great for most people, not everybody, but it's we
Speaker 1: know it's it's a really good powerhouse skincare ingredient. It
Speaker 1: has great evidence behind it. We know that it stimulates
Speaker 1: collagen and helps reduce skin cancers and wrinkles.
Speaker 2: Once you're is there a brand of that that we
Speaker 2: could recommend.
Speaker 1: Or retinal there's there's a lot of a lot of
Speaker 1: good options for retinol. You Beauty has something called the
Speaker 1: Resurfacing Compound that I really like that has retinol in it.
Speaker 1: Elastin has a good retinol.
Speaker 2: And then, of course we're all finding out that skin
Speaker 2: cancer is quite rampant because of our laxity and using sunscreen,
Speaker 2: and that's a pretty dangerous thing to get some a
Speaker 2: spot that then turns into a skin cancer. Or you're
Speaker 2: an expert in that too. I read I didn't know
Speaker 2: you were an m H, which you want to avoid
Speaker 2: at all costs.
Speaker 1: Right, it's a guy's name who invented this procedure where
Speaker 1: you take just a little bit of the skin cancer away.
Speaker 1: You look under the microscope and then if you still
Speaker 1: see it there, you just take a little bit more.
Speaker 2: I see, Okay, that's I know. I avoided it so far,
Speaker 2: so yes, hopefully I can avoid it forever. I was
Speaker 2: never a big sunseeker. I didn't I didn't lie out
Speaker 2: in the sun too much. But we used to put
Speaker 2: you know, lemon juice in our hair and baby oil
Speaker 2: all over our skin when we were kids. Right, but
Speaker 2: that has stopped, yes, of course.
Speaker 1: And people you know who are really really careful with
Speaker 1: the sun or sometimes wondering, well, why did I get this?
Speaker 1: Why do I have sunspots? Why do I have a
Speaker 1: skin cancer? Unfortunately, it's sort of from cumulative sun exposure.
Speaker 1: So if you've had a lot of sun exposure in
Speaker 1: your younger years, it does catch.
Speaker 2: Up with you. Yeah, so if you have young children,
Speaker 2: it's going to I did to make sure they have
Speaker 2: sunscreen on them, right, and and also wearing the long
Speaker 2: sleeves while you're swimming. I I wear those you know,
Speaker 2: sun what are they called sun rash right?
Speaker 1: Rash cards?
Speaker 2: Rash cards? Oh? Yeah, of course you always wear a hat,
Speaker 2: but helmetch So how do you approach treatment for skin cancers.
Speaker 2: I know that when when I when I noticed a
Speaker 2: tiny little spot on my nose, you sent me immediately
Speaker 2: to have it tested, right, which, and then there's a
Speaker 2: what is that appointment that you can put on. You
Speaker 2: can hardly spill it and say it I am I.
Speaker 1: Q you I I O D M O D and
Speaker 1: that is we're using sort of off label, but it's
Speaker 1: it's an immune stimulator to keep skin cancer at bad.
Speaker 2: Okay.
Speaker 1: The most common are basal cell carcinoma and square a
Speaker 1: cell carcinoma, which many people who are fair skinned enough
Speaker 1: sun will get. And those typically are not that dangerous,
Speaker 1: but they're frustrating because they're often on the face or
Speaker 1: the neck and they have to be cut out, and
Speaker 1: so we do MOS on those because MOS allows us
Speaker 1: to take as little as possible and keep it very
Speaker 1: very small, and then we have a very small defect
Speaker 1: to reconstruct, and so usually we can keep it sort
Speaker 1: of cosmetically elegant.
Speaker 2: Oh good.
Speaker 1: There's a third type of skin cancer. The most third
Speaker 1: most common type is melanoma, which is much more dangerous,
Speaker 1: and that is when if you saw in your body
Speaker 1: a dark spot that was changing or growing, it can
Speaker 1: happen anywhere, even where the sun doesn't shine, and that
Speaker 1: can be much more lethal. Where finding a lot of
Speaker 1: those really early, we're taking them out surgically and we're
Speaker 1: not you know, and you don't have to do anything further.
Speaker 1: But they are the type of cancer that sometimes they
Speaker 1: go into your lymph nodes, sometimes they spread further than that.
Speaker 1: Sometimes they need chemo, and sometimes they can be lethal.
Speaker 2: So be very careful with any changes in your skin
Speaker 2: or any spots that appear that are right. Yes, what
Speaker 2: mistakes you see people make when it comes to taking
Speaker 2: care of their skin, Yeah.
Speaker 1: I think I think the biggest mistake that I see
Speaker 1: is people who go do procedures and are disappointed. And
Speaker 1: the reason that they're disappointed is because they are going
Speaker 1: to somebody who didn't evaluate them and didn't try to
Speaker 1: figure out what is the best thing for them, and
Speaker 1: they're doing something that's missing what their goal is. And
Speaker 1: I think that can happen with filler, and it can
Speaker 1: happen with radio frequency micro needling, and it can happen
Speaker 1: with laser. And so I even if somebody wants to
Speaker 1: do some thing locally, maybe they live in New Jersey,
Speaker 1: they want to go to a medspa New Jersey. I'll
Speaker 1: still advise them, you know, go for this, not that,
Speaker 1: because I don't want them to make that mistake and
Speaker 1: be upset and have a complication and that sort of thing.
Speaker 2: So when you get when you get home to after
Speaker 2: work and you have your nice dinner or you've gone
Speaker 2: out for dinner, what do you do before you go
Speaker 2: to bed? What would you advise anybody to do before
Speaker 2: they go to bed?
Speaker 1: So you want to wash your face for sure?
Speaker 2: Using what?
Speaker 1: Using? Most you know, even drug store gentle cleansers are
Speaker 1: totally fine. There are some other cleansers that I that
Speaker 1: I really like. There's one from again New Beauty that
Speaker 1: is what it's called the conditioning wash, which is very moisturizing.
Speaker 1: I think I've given you one of those.
Speaker 2: I love that. Oh and by the way, I've just
Speaker 2: finished it too, that I use in the shower. I
Speaker 2: love it. I use it all over my body. Yes,
Speaker 2: and it's it is so it SuDS up nicely, but
Speaker 2: it's it does leave your skin very moisture somehow.
Speaker 1: It moisturizes instead of drying you and it's clean to
Speaker 1: really clean.
Speaker 2: And I use a I use like an oil camellia
Speaker 2: oil to clean my face at night.
Speaker 1: That's great.
Speaker 2: It's hot wet rag.
Speaker 1: Yeah, you know that's called oil cleansing, which is which
Speaker 1: is helpful because your skin has you know, your sebum
Speaker 1: on your face is oil based.
Speaker 2: And I would never go to bit with my makeup
Speaker 2: on it, right right, I won't. I mean even no
Speaker 2: matter how tired I am. But my face gets washed
Speaker 2: and lubricated and serumed and everything before I go to bed.
Speaker 1: So cleansing is very important. And then you know, you
Speaker 1: would use you most people can use a little bit
Speaker 1: of moisturizer, so you might use a hyaluronic acid serum
Speaker 1: something to give your skin some moisture. And then most
Speaker 1: people could benefit from some sort of barrier, like something
Speaker 1: a little thicker that keeps the moisture in overnight. You
Speaker 1: have a lot of repair going on at night in
Speaker 1: your skin, and so keeping it hydrated is.
Speaker 2: Helpful for that. And then when you wake up, you
Speaker 2: take your shower.
Speaker 1: And then when you wake up, you wash your face again,
Speaker 1: you put on some moisturizer, you put on some sunscreen,
Speaker 1: and you're good.
Speaker 2: Yeah. Yeah, So taking care of yourself is not so hard,
Speaker 2: but it does take a bunch of care, and it
Speaker 2: does take some thought and it also takes some good
Speaker 2: advice from a dermatologist. And I've put my trust at
Speaker 2: doctor Belkin. I think that your explanations of all these
Speaker 2: things that we talked about today are so good. And
Speaker 2: thank you so much for joining me on the podcast.
Speaker 2: Thank you so much for Dan Dan Belkin, and you
Speaker 2: can follow Dan on Instagram at doctor Dan Belkan b
Speaker 2: E l k I N for his advice on the
Speaker 2: best skincare practices.