00:05Thank you all for being here. Dr. Carl Truesdale is a dual board-certified facial plastic surgeon.
00:13Please go onto his Instagram. You will go down a rabbit hole like you have not believed when
00:18you see his facelifts. They are absolutely mesmerizing. As he says, he takes 20 years
00:24off, maybe 30, and it is true. Dr. Kelly Killeen is a dual board-certified plastic surgeon. There's
00:32a difference. And she specializes in breast reconstruction and augmentation. And she's
00:39with The Practice Healthcare in Beverly Hills, a place that everybody needs to know about.
00:43And then Dr. Prem Tripathi, so lovely to have you here from up north near San Francisco in an area
00:50I just learned about. Bay Hills Plastic Surgery. Sounds like a place I want to move to. A lovely
00:56enclave. All right, we're going to get right into it. Dr. Carl, just hypothetically speaking, I just had
01:03one of your mesmerizing facelifts. I'm 20 years younger. Okay, what am I doing after leaving the
01:10OR, getting home? I want to ensure a beautiful outcome, and I want to maintain that outcome.
01:16What do I need to do as far as diet, as far as any protocols you recommend, supplements, therapies,
01:23et cetera? Skin care? So this is a great question, and hello, everyone. Thank you again for having me.
01:29It's an honor. So what I tell my patients is everything begins with a preparation. So I can perform a
01:36flawless, beautiful surgery, but unless we have a plan on how the patient's going to recover, everything
01:42will kind of go into the trash can. And so part of that is making sure the patient is optimized
01:47medically before we even go into surgery. So the diet, avoiding certain medications, avoiding
01:54certain activities, obviously smoking, all of those things set the stage for a beautiful recovery and
02:00therefore a beautiful outcome. When the patient leaves my operating room, typically the next stage is
02:06right? They're in the inflammatory stage. We want to decrease the inflammation. So that's where the
02:12icing, the sleeping with the head elevated, avoiding salty foods, all of those things help put the
02:17patient's body in a position to heal itself because a lot of doctors, we just have to get out of
02:23the way,
02:23right? We have to let the body, we have to listen to the patient, we have to let the body
02:27heal.
02:28So decreasing inflammation, there's a lot of different protocols from hyperbaric oxygen,
02:34red light therapy, peptides, all of those things are at play. And so what I tell my patients is when
02:40we are going to fight aging, right, which is a battle we're all fighting right now, I want every
02:46single player in the field. I want my general, I want my foot soldier. And so I try to bring
02:52as many
02:53of those things into play as possible. So true. And you mentioned HBOT, by the way, hyperbaric
02:59oxygen therapy chambers. I want one of these in my home because they're not even good pre and post
03:05surgery, which of course they are so popular now and so essential. They're just good for general
03:12health. And Dr. Colleen, I know you can speak to this because at the practice healthcare, you guys
03:17have, and believe me, I've looked at HBOT chambers, you have the best of the best, the top of the
03:22line,
03:22the most innovative I have seen. Dr. Castle has schooled me on why yours are so excellent.
03:29They do it all at the practice. I'd love to hear from you about why this therapy is so essential
03:35pre and post, and what the protocol is post-surgery with HBOT.
03:40So I'm an evidence-based girlie, for those of you that follow me online. And so I don't want to
03:44recommend things to my patient that are shenanigans. I want things to be evidence-based. I want to make
03:49sure that it's actually going to make them better in the end. And in the world of plastic surgery,
03:55we are also experts in wound care, which a lot of people don't recognize. And so all of us have
03:59used
03:59hyperbaric oxygen therapy to heal complicated wounds for years. I do breast cancer reconstruction as part
04:05of my practice. I have radiated patients, and I know there's evidence that hyperbaric helps soften
04:10radiated tissue and helps my mastectomy patients heal better. But we really can translate that into
04:16cosmetic improvement or elective surgery improvement by adding hyperbaric oxygen therapy.
04:20Because in addition to adding a little extra oxygen to the area, which is the obvious effect,
04:26it also decreases inflammation and swelling, which is why my facial plastics friends love hyperbaric as
04:31well with their facelifts. And the problem is, is that there's a lot of hyperbaric in town that's
04:37not real hyperbaric. So it's not getting to the pressures that you need based on the evidence that
04:43we have in the literature to actually get an effect. So they're just spending hundreds of
04:47dollars to like sit in a tent and breathe oxygen for a few minutes. I mean, certainly if that's
04:52your jam, have at it. But I mean, if I'm going to spend a couple hundred dollars on something,
04:57it better work. And so you really want to go someplace that has a physician or a PA, MP on
05:03staff
05:04that's experienced and educated at HBO, and that is going to give you the proper protocols.
05:08Now the truth is, is there's no accepted protocol for after facelifts, even after mastectomy or with
05:13my radiated patients. So it's really going to depend on the individual patient and what we're
05:19worried about. So for a patient right after a facelift, who's not particularly worried,
05:24it's just, we want to augment their healing. It's probably going to be a 60 minute session
05:27for several days after surgery. If we're worried about your healing, your skin doesn't look great,
05:33you're a mastectomy patient with some concerning healing, it might be two 90 minute sessions in one day.
05:38But it's just important if you're going to invest in these therapies that you're going to someone who
05:43understands them and is going to give you the right therapy for what your particular problem is.
05:48Thank you. And again, I learned so much about it because I did do some H-bots and I did
05:53sort of
05:54the subpar ones, although I still felt like they worked a little bit. They're not doing any harm,
05:59right? Probably not. And when Dr. The one thing I'll say though, is about a lot of these not great
06:04places is they don't follow the rules and fires and severe bad things can happen, even with the
06:11fluffy ones that aren't real hyperbaric. And so, you know, if you're going someplace, they're letting
06:16you take your cell phone in and they don't make you take your jewelry off. It's, it's risky.
06:20Run, run. And that's why it's really important that you, if you're going to choose to do these
06:24things, you want to make sure that you do them safely. Thank you. So, so interesting and fascinating.
06:30Glad to know that you guys have the ones that are the real deal. And Dr. Prem, I would love
06:36to talk
06:37to you. So again, hypothetically, I've just left your office. I've had all the things done, the laser,
06:42the microneedling, the injectables, also obviously lots of wonderful plastic surgery.
06:47I want to let this work and go the long run. I don't want to have to come back to
06:53your office
06:53too quickly. I want to let the at-home regimen with the skincare help as well. I want to protect
06:59that investment. So in addition to SPF, which we all know it's been drilled into our heads,
07:04what skincare protocols at home, both after procedures and then as well for ongoing skin
07:11maintenance, do you recommend so that we can just look ageless all the time?
07:14Yeah. Thank you for having me as well. I think, you know, the philosophy around skincare is really
07:19about scientific evidence as well, right? I think if you're actually trying to make a huge change in
07:24your skin, you're trying to make a scientific change to the biology of the skin. So while it's
07:29kind of nice to try the mists and the toners and stuff, it probably is not doing as much as,
07:33you know, a retinoid. So all of my patients get a very solid one-year protocol, which preps their skin
07:39prior to any surgical procedure, gets them prepped for any laser procedure, and then it continues
07:44thereafter. So they're getting their peptides, they're getting their retinoids, they're getting
07:48their vitamin C. They get it even prior to the surgery. It's just included because I want their
07:52skin to be in the absolute optimal shape. Some of them haven't worn sunscreen their whole life.
07:57Some of them maybe smoked 20 years ago, and so their skin is still not the best it could be.
08:01So I think you have to focus not just on the collagen production, maintaining collagen that you do have,
08:07minimizing, you know, or minimizing free radical damage from the sun, but also pairing it with the
08:12vitamin C. So the solid things that I tell my patients are, of course, an SPF, vitamin C, a peptide,
08:18an exfoliant, and a moisturizer. That will just keep your, and a retinoid, of course. That'll keep your
08:23skin in the best shape possible. It's about consistency, not trying 20 different things.
08:27And love to hear about some of the brands that you recommend to your clientele.
08:32Of course, SkinCeuticals. So the reason, you know, the thing about skincare is we know, right,
08:37medical grade is sort of a term, right? It doesn't necessarily mean that it's higher medical quality,
08:44but that the science has been put in. The effort has been done to create those scientific literatures,
08:49compare patients side by side, compare even a split-phase study. So I want to be ensured that I
08:55have giving my patients things that work. These are not cheap products, right? They last three to four
09:00months, but they are actually efficacious. So SkinCeuticals is the top thing that I use in my office.
09:05Everyone gets the CE for real, like everyone gets PT-Ox. It's just part of their sort of maintenance.
09:10I don't want them to necessarily have to choose between 200 different products. If I say a peptide,
09:14I want to know that it's going to make a huge difference. The last thing is obviously sunscreen
09:19and tretinoin. All of my patients are on tretinoin. I need them to build college.
09:23Retin-A.
09:24Or retin-A, yeah, retin-A. Because I'm a firm believer in it. I've used it for 15 years,
09:29and everyone in my office is on it, and it's just the thing to do.
09:33Retin-A is still the gold standard, right?
09:37Pretty much, if your skin can tolerate it.
09:39And I would say SkinCeuticals is here, obviously, that I was using that Floratin and CE Ferulic for
09:4715 years. I get so many compliments on my skin, and I really credit to when I got into medical
09:52-grade
09:52skincare, that's what I started off on. So kudos to SkinCeuticals. Thank you, everybody.
09:59Thank you, everybody.
Comments