- 6 minutes ago
Entertainment reporter Catt Sadler helmed the "No Knives Out: Nonsurgical Solutions" conversation, which she kicked off by noting that she got a facelift three years ago and "now I'm talking about my facelift all the time, ad nauseum." Sadler was joined by Dr. Macrene Alexiades, Natalia Guzman FNP-C, CANS and Dr. Kian Karimi for a discussion of the knife-free alternatives.
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00:06Listen to these bios because you guys, Dr. McCreen Alexiatis is a highly decorated New York-based
00:12dermatologist and, yes, scientist. She holds three degrees from Harvard, no big deal,
00:18and is associate clinical professor at Yale University School of Medicine. She also founded
00:23the skincare brand, McCreen Actives. Anybody have those in their vanity? I want some.
00:29Natalia Guzman is a nurse practitioner based in LA and co-founder of Atelier Aesthetics. She is at
00:35the forefront of all of the very latest, most advanced energy treatments, which we're going
00:40to hear about in just a minute, and is hired. This is so cool. Hired by so many leading companies,
00:45like some of the ones here today, and actually doing the training on the ground of a lot of your
00:50favorite injectors. So, so cool. Can't wait to hear about that. And Kian Karimi, hi. He is an LA-based
00:56double board certified facial plastic surgeon and one of the co-founders of EasyGel. He is also a
01:03pioneer in regenerative aesthetics, which we were just hearing a lot about as it pertains to longevity.
01:08And I love that you're on this panel because this panel is no knives out. So this is the
01:13non-surgical solutions, which I personally, I'm not the expert. You guys are the experts,
01:18but this is the space that is blowing up. You can't be scrolling. You can't be like,
01:22we're taking in so much information. It's really exciting because not everybody wants to go get a
01:27facelift. Not everybody's ready for the facelift, or they don't have the money for a facelift. So
01:31these other alternatives that are out there, I feel like there's so much exciting, cutting-edge
01:37science. You've got the toys, you've got the tools, you've got the devices. Of everything out there right
01:42now, I'll start with you, Dr. McCreen, as the scientist, like what are you seeing, loving, like what
01:47does everybody in the room need to know about today that maybe they don't know about? And actually,
01:52I think you guys need to pick up your mics. Sorry.
01:55Well, first of all, thank you for including me in this incredible, prestigious panel. It's an honor to
02:01be here, and I'm delighted. And well, you know, I have three Harvard degrees, my PhD is in genetics,
02:07and actually my thesis was on stem cell biology. And when I first started in dermatology and lasers,
02:14one of the first things I did was start to pioneer laser devices. This was in 2000, when lasers were
02:21really just starting. And so in my career, I have focused on device development, injectable development.
02:28I've had a hand in the FDA trials of pretty much every injectable and every class of technology that's
02:34been launched in the last quarter century. And in some cases, been a co-developer of these, such as,
02:39for example, radio frequency. And my time with Alma dates back 25 years. I actually invented,
02:46prior to my advent to the industry, lasers were delivered using a stamping method. And one of
02:52my inventions was mobile delivery of technology. So the ability to deliver either laser or energy-based
02:59devices in movement. And that first paper was published with Alma, believe it or not, 25 years ago.
03:04And that changed the industry because it allowed us to deliver energies to deeper and deeper depths
03:09without burning the superficial aspect of the skin. Then in over the last 25 years, I've published more
03:16than anyone on RF. So I'm known as sort of like the pioneer in radio frequency. I'm one of the
03:21co-developers
03:22and inventors of RF microneedling, for example. And what that has enabled me to do by working on energy-based
03:28technologies is really recapitulate what we do in plastic surgery. But more importantly, like in my
03:35classification scheme of skin aging, and in my work as a geneticist, I'm the lead consultant for Allergan
03:41AbbVie in genetics, for example. It's basically my belief system and my philosophy, and I believe it's true,
03:48is that I can bring the skin back to the age before it starts to deteriorate. So follow with me.
03:54Aging is really the changes of skin with the passage of time due to ultraviolet, toxins,
04:01and also innate ability for the cells to not really replicate themselves without mistakes.
04:07And those mistakes are called mutations. And believe it or not, it starts in our teens,
04:11not in our 20s. It starts at a pretty young age. And so what I've done through a combination of
04:18different types of approaches is try to restore the skin back to the age of before it starts to deteriorate.
04:24Hence my ability with celebrities, actors, people of stature, to enable them to continue to move
04:30their faces, but they don't have wrinkles just like we did when we were young. And so that's really my
04:35strategy and my approach, which is to restore the skin back to its pristine state. So we have RF
04:40technologies, we have lasers and devices. We also have skin care, which is extremely important. And I believe
04:47that we can turn on the repair mechanisms of every aspect of the skin using delivery of active
04:55ingredients. I was just named the first columnist for heliodermatology. And my first column, which just
05:02came out a couple days ago, is on peptides. So I'm world renowned for peptide development. And that is
05:07just one class of ingredients that we can use. There's peptides, there's microencapsulated hyaluronic
05:12gases, there's DNA repair, antioxidants, you know, keratosis reducers, there are so many different
05:18types of active ingredients. And if we can get those into the skin with regularity, I believe they can
05:23replace even the devices that I helped pioneer.
05:26Yes, you didn't, you're not just using the devices, you built them basically. Wow.
05:30Now you see why I didn't do her introduction. I'm like, boo, wow.
05:33I have, but in terms of excitement for right now, because I have over 60 devices in my practice,
05:39I'm dual certified in the United States and the EU, and I have multiple offices. Right now,
05:43we are really hot on the trail. My next era, so like I defined the temperature profiling for RF,
05:49which is how they program the device parameters so that you maximize results and minimize or eliminate
05:56side effects. We have a new classes of technology. There's ZERF, there's density. Those are fantastic
06:02because they're new sets of frequencies. And what I'm doing now is developing which frequencies are
06:10targeting the dermis, the subcuticular, and how we can restore the skin without surgery,
06:17like a SMAS facelift using devices. And the other is, a nod to my friend here, is I'm obsessed with
06:24regenerative medicine, PRP, PRF. PRF has all but replaced the majority of filler in my practice
06:30because you have the advantages of filler with incredible rejuvenative potential there. So I
06:36find that super duper exciting. Ooh, my gosh. Yes. Go ahead, clap. We got options. What you're
06:42saying is we have options and we don't have to go under the knife. And that's incredible. Even,
06:46even some of the products you're talking about, which we'll circle back to in just a minute,
06:49Natalia, I'll go to you next because I, what I love about watching a lot of your shares is yes,
06:55you are an educator and you're out there like training others on all of these options that we
07:00have to beautify. You're paying a lot of attention to what's below the neck. I've noticed that, you know,
07:06so many of us are talking about the skin on our face over and over and treating the skin on
07:10our face
07:10and investing in our face, but we're not taking care of what's going on below the neck. What are
07:16you seeing that's exciting? I see you working on some booties, like you've done reshaping of the
07:22arms. Is there new technology and new treatments devices that we should know about that, that are your
07:28favorites? Yes, absolutely. I am not inventing the devices, so kudos to you, but I do get to use them.
07:38So
07:39we do focus a lot from the neck up and we forget about the decollete, the body, everything else is
07:43aging at the same time. So there are multiple things that you can do starting with one of my
07:50favorite products. And I know before Crystal was talking about it, Sculptra is truly, truly by far
07:56the best product. I'm actually 102. You can't, you just can't tell because I have a lot of Sculptra in
08:00my
08:01face. But with that in mind, I think that really thinking about this, this cell senescence and
08:07bringing back that collagenesis, the elastin back in the body and trying to regenerate and getting
08:12ahead of the problem. I think it is important. And now that we have a lot of patients that are,
08:18you know, Ozempic, you know, I feel our best friend Ozempi is around. I feel like we are seeing
08:23that a lot more too. So we have to stay ahead of the game with those issues that we can
08:29potentially see,
08:30for example, elbows, the knees, the legs in general, we're aging everywhere. And really just focusing on
08:36the face and neck won't add up because then we can't wear dresses that have short sleeves or even
08:42dresses. I've had patients that say I used to have beautiful legs, I used to wear really short skirts
08:46because that was my thing. And it's no longer happening. So what are we doing, for example,
08:51things like Sculptra, I love to use Sculptra for the body regenerative, it looks very natural,
08:57low potential of complications. And I think that is something that we really have to talk about,
09:02because there is a lot of bad noise out there when it comes to Sculptra. But whether you're planning to
09:08get, for example, a thigh lift, I've worked with plastic surgeons for my entire career as an injector.
09:14I actually worked with Dr. Kian Karimi for nine years of my career. And I also worked for face and
09:21body
09:21plastic surgeons before that. And even before I became a nurse, I was a front desk receptionist
09:26with plastic surgery. So that's really how I fell in love with it. But you can get a thigh lift,
09:31you can get an arm lift, but if the skin is not at optimal for the surgery, how are we
09:38going to
09:38make those results last? And it's the same thing applies to the face, the same thing applies to
09:44everybody everywhere else in the body. Now, in terms of devices, doctor mentioned, you know,
09:49things like surf, I love Everest, that's another skin tightening device that I use. And it is a
09:55Korean device, I think Korean devices are hot Korean skincare is hot. And we do have another one,
10:02which reduces the bulkiness, but at the same time, tightens the skin, which is the Onda Pro,
10:07which is the newest device that's out there to help with fat and skin tightening, especially those
10:13stubborn little areas of the body that will not go away, no matter how much you work out. Or,
10:17you know, even if you are doing a GLP one, other devices thinking about resurfacing the skin,
10:23CO2 lasers are great. One of my favorites, especially because I am darker skin, I can't
10:28necessarily fry my skin as well. So using something like Cool Peel for the entire body is a phenomenal
10:34device, no downtime, literally no pain, super easy. I'm a cry baby, so I don't do that. And then as
10:40doctors said as well, skin care, what is your homework at home? Because I usually tell patients,
10:47you can work out two, three hours a day, but if you're eating pizza at night, you're not going to
10:52lose weight. So it's the same thing. You have to do the homework at home and utilize the proper skin
10:58care. I don't necessarily like to emphasize the idea of medical grade, because I don't know if that
11:05is very, it brings proper with patients. A lot of the times, if I tell them, you know,
11:11it's medical skin, skin care, I don't necessarily think they're like, Oh, I love that, that it's
11:16medical skin care. They can go to CVS and buy whatever they want. If it works, they will stick
11:21to it. So usually I practice what I preach. I try the products, I give them to my patients. So
11:27I tell
11:27them my experience or my girls in my office too. And that's really how we maintain the getting ahead of
11:34the game with all these devices and products. I used to beg patients to do Sculptra before.
11:38And now I get patients sitting in my chair. They're like, I just want Sculptra. I'm like,
11:41thank you, Jesus. And I'll finish with that. Why have I not had Sculptra? That's my takeaway
11:47today. Where have I been? I'm telling you. I mean, I hear it all the time. 102 over here.
11:52I'm coming over. I'm coming over. I'll see you soon. Dr. Keon, should we talk about filler? I mean,
11:58I feel like filler, so many of you are injectors and there's got to be still a place for filler,
12:03but I feel like it's a bit of a dirty word and it's like people overfilled and all those faces
12:07that we've all seen. We're like, what did they do? And I myself have dissolved filler. It moves,
12:11it migrates all the things. You founded something called easy gel. I don't know if this is kind of
12:16related. I feel like it might be, but you're working on, instead of putting things under the skin that
12:21change the shape of the face or give us the volume or the tightness or whatever, you're using our own
12:27bodies and our own skin to kind of do the work for us. Can you talk a little bit about
12:32why and
12:33bio-stimulators? I had to look that up. I was like, what is a bio-stimulator? These are important.
12:38Absolutely. Well, first of all, thank you, Kat. Thank you, Alicia and the whole THR family for
12:41having me here today. It really is an honor. And I'm so excited to be here and to talk about
12:47all of these things. And as a facial plastic surgeon, but also as someone who does injectables,
12:52someone who does sculpture for patients, energy-based devices,
12:55I've always felt like I've had the privilege to kind of bridge that gap between surgical and
13:00non-surgical. And I've always surrounded myself with brilliant minds like Natalia,
13:04nurse practitioners, nurses, PAs, non-MDs, because there's, first of all, you might,
13:09you guys might not know this, but over 90% of the non-surgical treatments that we've been
13:13talking about today are performed by non-MDs. And there's nothing wrong with that. In fact,
13:18they're brilliant. They're great. And so, and they know a lot about these sort of things.
13:23And so to answer your question, Kat, so half my time is spent in surgery, half my time is
13:29basically trying to delay the inevitable, or sometimes someone doesn't want surgery ever.
13:34And we've heard about a lot of great energy-based devices. So the bottom line is that filler,
13:43which has been around since 2003 in the United States, went through almost an epidemic boom
13:49during COVID. And during COVID, you know, we were still working. We were shut down for like, what,
13:55six weeks. And then after that, everybody started seeing themselves on Zoom and on, I mean, we're
14:00like, like, damn, is that what I really look like? That's exactly what happened. And so our phones were
14:07off the hook. And at the time, a face was in front of me, I would inject filler. I would
14:12have patients
14:13come back because the companies would say, oh, it only lasts a year. The patient would come back and we'd
14:17put some more, put some more. Well, inevitably, what happened is that we started overfilling faces
14:23and people started seeing this like sexy field of aesthetics and think that we all just make a lot
14:29of money and don't have to work that hard. And neither of those is necessarily true. It's actually
14:34extremely hard. We have to be equal parts scientists, artists, technicians, and psychologists
14:41in every single setting. That's what we have to do. And so that's really what happened. So
14:48concurrently, while that was happening, I've been working on PRF. I had the privilege of bringing
14:52PRF to the United States in 2015, 2016. Natalia and I did a segment on the doctors together. And at
15:00the time, it was like, oh my god, what is this thing? It's actually the dentist and the oral surgeons,
15:04and we have some dental colleagues here that discovered, so to speak, PRP and PRF. And we
15:10were able to translate it into our world of aesthetics. PRF is great. So for those of you
15:15who don't know, PRF stands for platelet-rich fibrin. We take your blood, we spin it, and we basically
15:21take out the red blood cells. So you get the platelets surrounded by their fibrin, inject it back
15:26into the skin or on the face. We would do this and people were like, oh my god, this is
15:32amazing.
15:32I have my under eye hollows are gone. I've got the lips that I want. I've got cheeks, whatever.
15:38But it wouldn't last. And so that's where EasyGel came into play. EasyGel is basically,
15:43it's still 100% natural, but we are heating a portion of the blood to unfold a protein called
15:50albumin to have more longevity. And now EasyGel has become extremely popular and Dr. McCrean and
15:56Natalia and a lot of people are using it. But again, there's something for everyone. And I've done,
16:02I've published studies on EasyGel because as a scientist, it's my duty to recommend things
16:08based on evidence and based on science. And so we've published a couple of articles. The big
16:13question is how long does it last? And what is it really doing for your skin at a biocellular level?
16:19And so all the hype is great. Haley Bieber plugged that she did EasyGel, which was fantastic. I didn't
16:25treat her. But people are being more open about their treatments, which is great because the
16:31dentists here, I'm always jealous of them. They're with all of their celebrity patients,
16:34like, look at my teeth. For the celebrities here, why are the teeth okay to show, but you can't talk
16:39about your facelifts or your fillers or your bio-stimulators? That's changing though.
16:44It is changing. It's changing. People aren't talking about it. Now we got a big Hollywood
16:48reporter event about it, you know? It is changing.
16:51Two quick points I want to make. So basically the punchline here is that for patients that are
16:58trying to do non-surgical aesthetics, Sculptra, EasyGel and lasers. That is like the cornerstone
17:05of every single treatment that we do almost every single day between myself, my PAs,
17:10nurse practitioners and all that. Here's another thing. A lot of you may have heard noise from my
17:16plastic surgical influencer colleagues that these things will also ruin your facelift in the future.
17:21Has anybody heard of that? Show of hands. Okay. About half of you. That is not true. And I have
17:27been
17:28on task force with plastic surgeons that do both injectables, study injectables, energy-based devices,
17:34and do plastic surgery. And the answer is it will not ruin your facelift. In fact, we are getting
17:40your skin ready for a facelift. And so now there is a certain time period that you need to kind
17:47of
17:47stop or cool off on those treatments. So you're past that inflammatory phase or that phase that's
17:53building collagen and elastin and now fat cells. We know Sculptra makes fat, which is pretty cool.
17:58Um, and so that I just wanted to kind of, you know, dispel that, but fillers are still a thing
18:04and, and fillers don't necessarily migrate. It's if too much is placed, then the filler has to go
18:11somewhere else. There's only so much volume in our fat pads. If you exceed that volume, the filler has
18:18to go somewhere else. If the injector is moving the needle or the cannula the whole time, then that
18:23filler is spreading in different areas. So, so filler migration, is it real to some extent,
18:28but it's definitely overhyped. Just while I have all three of you, um, as far as devices and toys,
18:34I know we've talked about what we're loving. Is there anything like in your practice or just for
18:38people, you know, when they head out to go try something new and spend their money,
18:41what is collecting dust in your practices? What should they like? It's a waste of time. It's not as
18:46efficient. It's not as effective, but it's still maybe out there in the conversation. Anything to stay away
18:51from? Well, listen, I, I'm sure you've got a lot of devices. I've heard people mumbling like they,
18:56they know. They're like, oh, I, I, I hate to like, you know, bag on any, any technology, but I
19:01mean, I
19:01would say at one point our, our Morpheus 8 was really popular and, and now it's not so much. Well,
19:08it's
19:08very painful. Yes. I tried that once. Because it's my area specialty and I went toe-to-toe with the
19:14FDA and I
19:15run the, I won that battle. Here's what happened in that particular instance is that device penetrated
19:21the market into non-physician, non-RNs and contract. I mean, the reality is in the state of New York,
19:29the practice of medicine includes injectables and lasers is for MDs, DOs, PAs, NPs, and some RNs. So
19:39then they put them into spas and people who are technicians. And I reviewed all the mod data. They
19:46were using parameters that were twice the power levels that, uh, I had identified as the ideal
19:52target for that particular technology. And they were using depths that were too deep for the upper
19:58face. And that is why they were targeting the fat. So that just goes to show you that, you know,
20:02you can
20:03put your knife in the toaster and burn yourself. Like nothing has changed in lasers because back in the
20:09day when we were doing CO2 laser, you could, you could scar someone with a CO2 laser. There isn't
20:14a single technology that you can't use that have an adverse event. And so unfortunately the word got
20:20out that it was melting fat, but that is true. If you go too deep with any technology, you can
20:24melt fat.
20:25At one point it was actually a YAG laser that was used that they exited because it was melting fat.
20:30So it's really more about education, much like was said on this panel, Galderma is doing a good job.
20:37We need to educate people. But also I do think that it's important for the companies to take
20:42responsibility and make sure that they're placing them with the correct users of the technology with
20:48the correct parameters. That's really important for me. I absolutely agree. A lot of technologies
20:55in the energy-based space have approval for, you know, heating, electromagnetic stimulation,
21:02and whatnot. They don't actually have a specific indication for rightage reduction,
21:07for example, or cellulite, but many do. And so it's important to understand. But again,
21:12we use many treatments off-label and that is part of the practice of medicine. And that is up to
21:18the jurisdiction and the judgment of the physician. But, you know, and it's very costly and expensive to
21:25get specific indications too. I think as a non-physician injector here, I definitely agree
21:31with both of you. It has to do with the user error. And 99.99% of the times, even
21:38with Sculptra,
21:38they're like, oh, but it gives you nodules, but it does this, or fillers. Oh, I don't want to be
21:42puffy.
21:42Again, it comes back to the injector. And a lot of the times, more doesn't mean better or stronger,
21:49where it hurts more is the best thing. So less in my experience, in my practice, like I said,
21:55I've been practicing for 14 years. Less has always been more because we can always add more. But if
22:00we cause a problem, then there's a problem. And what we do as medical providers, everybody says,
22:06oh, that product gave me lumps or that product, that machine dissolved my fat. And it's like, no,
22:12actually, Morpheus 8 did what you told it to do. The problem is, is you didn't know what you were
22:17doing. And now you're blaming the machine. And so those are things that we need to take food for
22:22thought as injectors, whether you're a physician, nurse practitioner, or PA, and as a patient as
22:28well. And as the consumer, how do we know? How do we navigate? How do we get to, you know,
22:34everyone can't come and see all three of you? That's the great question. And Dr. McCrean and
22:38Talia both have good points. Just, we have to go away from commoditizing these things. Because they are
22:44devices, they are procedures. And so someone earlier said, you know, you got to look at someone's
22:50overall portfolio, right? So you have to look at the practitioner's credentials. You have to look at
22:54their reviews. You have to look at their before and afters. And is it that practitioner performing
23:00the treatments for you? And that's not, if it's not, it's not necessarily a bad thing. But who is
23:04actually performing the treatment? And even in California, a lot of, quote unquote,
23:09illegal treatments are done by non-licensed practitioners, because the owner of the
23:15clinic thinks that the laser is just going to do its thing. Well, that's not true. Morphe SA can be
23:20great, or it can be not so great. And that was the same, that's the same for any technology out
23:25there. There is no dummy proof technology. And so it really, you have to look at the whole portfolio
23:31and look up your provider. And usually, you know, people, or even with Sculptra, like you said,
23:38I mean, I did send you a lot of my patients when we working together, having Sculptra as well,
23:42threads and all these different other procedures, Morpheus 8. It is the constant that a lot of people
23:49blame, like a nodule from Sculptra, a nodule from hyper dilute radius or filler, but not the variable,
23:56which is the injector, the injection technique, how much did they do. So they usually say, oh,
24:02look at this lump, but they don't say, look who did it. They said, this is just the product. And
24:07we have to use a little bit more of the critical thinking as to, okay, what is really the problem
24:11here? Because everybody and their mamas want to inject. Well, there's, but there are factors that
24:18I think it's important to educate people on. So the way Sculptra works, and by the way,
24:23I was involved in the FDA trial when it was owned by Dermic in 2000, before it was even bought
24:28by
24:28Galderma. So I go way back with Sculptra and it's polylactic acid. And the way regenerative medicine
24:34works is either through the fundamental stimulation of your own stem cells through something like PRP or
24:40PRF, which is completely safe, or it's like a foreign object and you get like a scar tissue reaction,
24:46right? So when you're implanting something in the skin and your goal is to create a wound healing
24:51response as in the case of Sculptra, unfortunately, and it is in the MAUD database that there isn't
24:57not the nodularity complication is just part of the bell curve. And so I don't know if it's as simple
25:04as the person injecting it or if it's, but the product itself is designed to do this. So just be
25:10aware, be aware of what that is. And with respect to filler, an important point that was not brought up
25:16here is it's the cross-linking. There's something called BDDE we use to cross-link the hyaluronic acid.
25:22And it's sort of like a Lionel train track. You can break up the tracks, but the tracks are held
25:28together by these cross-linkers and we don't have an enzyme that can break those BDDE bonds.
25:33And that is why filler, unfortunately, is forever. So whenever I inject and I'm an artist, I make the
25:39assumption it's forever and I get a forever result that's literally flawless and perfect. So that takes us
25:44back to what Natalia is saying, which is be aware of who's injecting you. And I think somebody else
25:50at the first panel said, look for the aesthetic you're interested in. Like my aesthetic is the
25:54natural aesthetic. So, you know, if you see people that you trust and love that look great and then
26:00you go to their person, you're going to get that kind of outcome.
26:02Kat, I heard the Hollywood Reporter recently published the list of top doctors and practitioners.
26:09So I would just stick with them.
26:10Stick with the Bible.
26:12That's great.
26:12I agree 100%.
26:13That's right.
26:16So good. And we'll take it even one step further. Speaking of the best doctors,
26:21we have some receipts for you guys to talk. You were all talking about the whole picture,
26:26right? The whole picture. And we are going to bring up a special guest who's
26:30basically a billboard for evidence of that. Do you want to do the introduction or do you want
26:34me to do the introduction?
26:35So I'm very proud that my dear friend and patient Chloe Fineman is here. And for those of you
26:42who may, who may not watch her every Saturday night as I do, even in person, she's the epitome
26:48of natural beauty, but also this important principle, like that you should be able to emote,
26:54you should be able to move your face, be your natural self, and yet look absolutely gorgeous.
26:59So, Chloe, you've been a patient of Dr. McGrina's for how long?
27:02Uh, God, like five years.
27:04Five years.
27:04Yeah. A lot of the girls at SNL look really good. The producers and, and, um, a lot of women
27:10in New
27:11York on the D. I feel like there's like a secret group of us who share who we go to.
27:15Everyone's
27:15getting shit in their face. I agree. Yeah. And I think like there is a new trend, like what you
27:21guys were saying, where we're more open about it, but she's been number one recommended. And I,
27:26yeah, I really can move my face. You were explaining that, that she is evidence of
27:32your whole philosophy, which is what? That it is possible. We've achieved it in my lifetime,
27:38which I'm shocked about, which is that we can restore the skin back to its pristine state before
27:43it starts to accumulate mutations. So we were all 18 once moved our faces and had no wrinkles.
27:49So that goes to show you don't need Botox. What you need is great skin. And that is what we're
27:55doing
27:55through a combination of topical delivery of active ingredients, injectable active ingredients,
28:01or stimulators, regenerative aesthetics, or wavelengths devices, whether be they actual
28:07lasers, which are specific waves for specific chromophores. For example, I can get rid of a
28:11brown spot. I can get rid of a broken capillary, or I can deliver energy through radio frequency or
28:17ultrasound to stimulate collagen, elastin, and hyaluronic acid. And that gets us back to the way the
28:24structure was. And that allows her to do the things we love when we watch her on screen,
28:29like move her face. What's your favorite thing that she's done for you? Well, my favorite,
28:33the first time I met you, I had, I didn't know this, but I had, you know, Spock brow,
28:38like, and, and I showed you a picture. I'd like done a carpet. And then you were like,
28:42no, no, no, no, no, no, no, no. You look so much older than you are. And like an hour
28:47later,
28:47everything just softened. And it's, it's having an aesthetic eye, I think is so important. And like what you
28:53guys were saying, go where, go where you like, I had no idea. I looked so bitchy. And so that
29:00was
29:00like, and I was like, I'm in good hands. You look so non bitchy now. You really do.
29:05The bitch is inside. You guys, this is so fascinating. I could do this for another hour,
29:10but we're not allowed to. So thank you. So illuminating on every level. Thank you.
29:14Thank you. Thank you, Liz, for having me today as well. So cool. So fun.
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