Latest / Scalpel and Skin / Why Are There So Many Med Spas? The Truth About Aesthetic Providers | EP 02

Transcript

Why Are There So Many Med Spas? The Truth About Aesthetic Providers | EP 02 · Scalpel and Skin

0:00
SPEAKER_00: You want someone that you need more than they need you.
0:03
SPEAKER_00: Because if they need you more, that could be problematic.
0:06
SPEAKER_02: That means they won't say no.
0:07
SPEAKER_02: They'll do stuff that may not be necessary.
0:10
SPEAKER_02: They'll upcharge you.
0:11
SPEAKER_00: There are plenty of providers out there who it's a side hustle.
0:15
SPEAKER_00: I don't want someone touching my face when it's a side hustle.
0:18
SPEAKER_02: What worries me the most is inexperienced injectors, inexperienced surgeons who don't have a lack of confidence.
0:48
SPEAKER_02: I'm gonna do it every time.
0:49
SPEAKER_02: And oh my god, she's gonna make this peace sign.
0:52
SPEAKER_02: She's gonna make it her thing.
0:58
SPEAKER_02: I quit.
0:58
SPEAKER_02: I'm done.
0:59
SPEAKER_02: I can't do it anymore.
1:00
SPEAKER_02: That's it.
1:00
SPEAKER_02: I'm out.
1:01
SPEAKER_02: So, Mystica, the aesthetics industry has a problem.
1:05
SPEAKER_02: Well, we have multiple problems, but we have one particular problem, and that is why are med spas suddenly everywhere?
1:13
SPEAKER_00: So I read a statistic recently that said that there are now more med spas in the US than there are McDonald's.
1:24
SPEAKER_00: Yes, that's a that's a real statistic.
1:27
SPEAKER_00: And that is that's that's the problem.
1:31
SPEAKER_00: That is the problem because I can tell you factually, there are not that many skilled aesthetic providers that should be running a business and running running an aesthetics practice.
1:43
SPEAKER_00: And I think the reason that this has happened is because the the world of of being a healthcare worker in the US is really difficult.
1:53
SPEAKER_02: It's terrible.
1:54
SPEAKER_02: It's terrible.
1:55
SPEAKER_02: We are in we're in a bubble uh in the aesthetics industry.
1:59
SPEAKER_02: Being successful in the aesthetics industry, we're in a bubble.
2:02
SPEAKER_02: I have so many friends who are doctors of other sorts, and they're all miserable.
2:09
SPEAKER_02: Literally miserable.
2:10
SPEAKER_02: They all hate their job.
2:11
SPEAKER_02: They I have a friend who's an ER doctor.
2:13
SPEAKER_02: He's he's 50.
2:15
SPEAKER_02: He's like, I'm done.
2:16
SPEAKER_02: I got one year left and I'm out.
2:18
SPEAKER_02: Like, what the heck's he gonna do for the rest of his life?
2:21
SPEAKER_02: He's like young adult.
2:22
SPEAKER_00: Yeah, I I have some friends who obviously are PAs, friends that I went to PA school with, and I catch up with them every once in a while.
2:31
SPEAKER_00: And this girl I went to PA school with, she works in trauma surgery.
2:36
SPEAKER_00: Oh, and she was telling me her schedule.
2:39
SPEAKER_00: She has two young kids like I do, and she works 60 hours a week.
2:44
SPEAKER_00: And it's just it's too much.
2:46
SPEAKER_00: And then the the nurses, let's that's a whole episode in and of itself, how how how it is being an inpatient nurse these days with sh with staffing shortages and such.
2:57
SPEAKER_00: So, so what I think has happened is that people want a better lifestyle, they want a better work-life balance, they want to enjoy work.
3:07
SPEAKER_00: So they start to try to figure out how they can get into aesthetics.
3:12
SPEAKER_00: So they'll take a course here and there, learn the basics of operating a syringe, and then they just they either open a med spa or they start working for one and that med spa grows.
3:24
SPEAKER_00: So that's really, I think, a big reason that things have exploded.
3:29
SPEAKER_02: Absolutely right.
3:30
SPEAKER_02: Uh it's all of those things.
3:32
SPEAKER_02: It's the thought that, you know, it's a better life, better lifestyle.
3:35
SPEAKER_02: And and it is, it is a better lifestyle than being a floor nurse or being a trauma PA or being a urologist.
3:45
SPEAKER_02: I'm thankful for urology and I'm thankful for OBGYN and I'm thankful for all of those things that they exist, and I'm thankful that I'm not one.
3:52
SPEAKER_02: And that is just um it's tough to manage insurance companies and to manage hospital administration.
4:00
SPEAKER_02: Um, if if a hospital administrator or hospital gives me a hard time, I just chuckle and move on because I I'm done.
4:08
SPEAKER_02: I'm not doing that anymore.
4:10
SPEAKER_02: I run multiple businesses of my own.
4:12
SPEAKER_02: Others that have that problem, they have to move.
4:15
SPEAKER_02: They have to leave the area, they have to uproot their entire family and go somewhere else.
4:19
SPEAKER_02: And it's just a terrible idea.
4:20
SPEAKER_02: Well, you know, this is we're gonna go into this, all of that in more detail.
4:24
SPEAKER_02: But you know, let's talk a little bit about social media and how that has changed aesthetics.
4:28
SPEAKER_00: Oh, it's totally changed the industry.
4:30
SPEAKER_00: I it really has because now patients have instant access to learn about these things.
4:37
SPEAKER_00: It it's they can learn about how do I treat the jowls.
4:41
SPEAKER_00: They can go on social media and type in jowl treatment and figure out how to how you know what treatment options are.
4:47
SPEAKER_00: There's more education about Botox and fillers.
4:51
SPEAKER_00: So there's more access to information and more people are seeking cosmetic work.
4:58
SPEAKER_00: They just are.
4:59
SPEAKER_00: There was there's actually some studies after the pandemic about how the cosmetic industry exploded because people were working remotely more and seeing their faces on computer screens and kind of picking out what they what they didn't like necessarily.
5:15
SPEAKER_00: And so it led them to seek cosmetic care.
5:18
SPEAKER_00: I I remember right after the pandemic, I thought we were, I thought my world was done.
5:23
SPEAKER_00: I thought it was doing treating rashes and doing skin cancer screenings the rest of my life, but things just exploded.
5:31
SPEAKER_00: Things just exploded in a set.
5:33
SPEAKER_02: It was the exact opposite.
5:34
SPEAKER_02: So, fun fact, let's uh let's go back to 2020.
5:37
SPEAKER_02: I went from becoming a from being a busy plastic surgeon to nothing, to not being able to do anything.
5:45
SPEAKER_02: And I had my own practice.
5:46
SPEAKER_02: So I was just sitting there not doing anything stressed for this again, the same thing, thinking, well, I'm done.
5:52
SPEAKER_02: I'm I'm not gonna be able to do anything.
5:54
SPEAKER_02: And I actually like, I'm like five hours from New York City on a slow day.
5:59
SPEAKER_02: And I decided to, I reached out to some of those hospitals in New York City who were getting crushed saying, Hey, you know, can I come volunteer and work there and put myself in COVID, put in lines and and like manage patients, do whatever I can do to help th to help out.
6:15
SPEAKER_02: And I couldn't even get a call back because I was a plastic surgeon.
6:18
SPEAKER_02: They didn't want me because I don't do a lot of critical care.
6:20
SPEAKER_02: I don't do, you know, that type of thing.
6:22
SPEAKER_02: And and you know, I couldn't get a call back.
6:24
SPEAKER_02: And I it was very humbling.
6:26
SPEAKER_02: Thankfully, it only lasted a few weeks.
6:28
SPEAKER_00: It's true.
6:29
SPEAKER_00: They didn't want you even just to help with like hand traumas.
6:33
SPEAKER_02: They didn't want anybody extra, right?
6:35
SPEAKER_02: Yeah.
6:36
SPEAKER_02: Well, they didn't want any plastic surgeons extra anyway.
6:38
SPEAKER_02: And I would have done it for free.
6:40
SPEAKER_02: I was just, you know, I just I wanted to help.
6:42
SPEAKER_02: But yeah, I couldn't get a call back.
6:43
SPEAKER_02: I tried, I reached out to that like red cross, that white ship with the red cross on it, and then New York Presbyterian Hospital and some other hospital.
6:50
SPEAKER_02: And no, yeah, I couldn't get a call back.
6:51
SPEAKER_02: So that happened, but we're good now.
6:53
SPEAKER_02: We're we're great now.
6:54
SPEAKER_02: So do we think the industry is better or worse now than when we started?
7:00
SPEAKER_02: Again, we both started in 2010, myself as a plastic surgeon and you as a in 2010, a new grad PA in dermatology.
7:10
SPEAKER_00: Mm-hmm.
7:10
SPEAKER_00: Cosmetic dermatology.
7:12
SPEAKER_00: Yeah.
7:12
SPEAKER_00: Right.
7:12
SPEAKER_02: We were doing rashes and stuff back then in 2010.
7:15
SPEAKER_00: Yeah, some medical derm, but but really strong cosmetic base.
7:20
SPEAKER_02: So is the industry better or worse?
7:22
SPEAKER_00: I think it's better in some ways.
7:24
SPEAKER_00: I I definitely think it's better in some ways, but it's worse in some ways too.
7:29
SPEAKER_00: I mean, there's there's just too many people out there who think they can do it, and then they they cause problems for complications for patients.
7:40
SPEAKER_00: And and you know, I I say that a lot, and someone will inevitably say back to me, well, you should, you should be, you should be glad that there are people who who aren't skilled and don't know what they're doing.
7:52
SPEAKER_00: And I, that is the last thing I am is glad.
7:55
SPEAKER_00: Those are the those are the providers who are out there causing issues, making people look crazy, making people look weird.
8:05
SPEAKER_00: And it's just bad for the industry.
8:07
SPEAKER_00: It's it's bad for the industry.
8:08
SPEAKER_00: That's what gives the industry a bad name.
8:11
SPEAKER_00: So I am always an open book.
8:16
SPEAKER_00: I get a lot of questions from new injectors, people want to shadow me, and I'm I'm always happy to help because if if everybody learns the right way to do things, we all win.
8:29
SPEAKER_02: Right.
8:30
SPEAKER_02: I have a saying that I've been saying uh since very early on, and that is do the right thing for the right patient at the right time.
8:38
SPEAKER_02: And if you can't do those things, the the right answer is to do nothing, is to send the patient to somebody else or just flat out tell them no.
8:47
SPEAKER_02: I I just I had a patient yesterday and she wanted a breast reduction.
8:52
SPEAKER_02: She it looks like she's got approval through insurance.
8:55
SPEAKER_02: And I went and I looked at her, and um she's lost over a hundred pounds.
9:02
SPEAKER_02: And in those cases, and we'll go with this another another time, but when someone loses more than 100 pounds or a massive weight loss, they very often still see the bigger person.
9:15
SPEAKER_02: They don't see what I see.
9:16
SPEAKER_02: If someone comes in weighed 350 pounds, they weighs 150 pounds.
9:20
SPEAKER_02: I see 150 pounds with loose skin, they still see 350 pounds.
9:25
SPEAKER_02: So when I saw her yesterday, I said, geez, you know, I I can I can do a breast reduction on you, but to do it through the insurance, you're going to have almost no breast tissue left.
9:37
SPEAKER_02: Like flat, next to nothing.
9:40
SPEAKER_02: Your your belly skin is going to be loose and hanging, and you're gonna have no chest.
9:45
SPEAKER_02: So I really want you to think really hard about this before going through with it.
9:50
SPEAKER_02: She's in her 50s, and so she's old enough to kind of, she should be old enough to understand what that means.
9:58
SPEAKER_02: But I I'm I'm going to really encourage her to really think hard about it.
10:03
SPEAKER_02: And that's what I like to do.
10:05
SPEAKER_02: Like, I only do stuff that is high yield 100%.
10:09
SPEAKER_02: If something is medium yield, I'll tell you, you know, this is good.
10:12
SPEAKER_02: You'll get some improvement for it.
10:14
SPEAKER_02: And if something's low yield, like I don't even do it.
10:17
SPEAKER_02: I say, you know what, this is not worth your money.
10:19
SPEAKER_02: The only thing you're gonna do here is give me more money and you're not gonna get anything from it.
10:25
SPEAKER_02: And and I don't, I don't have any, I don't get any joy from that.
10:29
SPEAKER_02: And this is part of the, this is part of the problem in the med spa industry as well.
10:35
SPEAKER_02: What worries me the most is what we've kind of talked about is we have inexperienced injectors, inexperienced surgeons who don't have a lack of confidence.
10:45
SPEAKER_02: Okay.
10:45
SPEAKER_02: Let me repeat that again.
10:46
SPEAKER_00: Exactly.
10:47
SPEAKER_02: Inexperienced people who don't have lack of confidence.
10:50
SPEAKER_02: There are med spas and and plastic surgery practices who have tons of expenses, who have tons of debt month to month before they get any patients.
11:01
SPEAKER_02: So as soon as they get patients, they see cash registers, right?
11:04
SPEAKER_02: And they won't say no.
11:05
SPEAKER_02: Right.
11:06
SPEAKER_02: It's a terrible thing.
11:07
SPEAKER_02: When we first started, when we, I'm sorry, when we first started Skin Lab, again, let's go, let's talk about that briefly.
11:13
SPEAKER_02: I've been in practice 16 years.
11:15
SPEAKER_02: You were in practice for 13 years.
11:17
SPEAKER_02: We were both in practice for 13 years when we started Skin Lab, which is our med spa.
11:21
SPEAKER_02: We first started, we had a we had a place, we had a build out, we had a practice, and you had a lot of patients who were willing to move over from your other practice to be treated here.
11:31
SPEAKER_02: When we started, we did we had skin pen, we had um tox filler, and we had uh I gave you a hand-me-down laser that was that was great, and that you used the hell out of it until it recently died.
11:46
SPEAKER_00: Yep.
11:47
SPEAKER_02: Until it recently died.
11:48
SPEAKER_02: And and so we had really no debt beyond uh our monthly rent, uh health and uh not health insurance, but like uh malpractice insurance.
11:56
SPEAKER_02: We had basic expenses, right?
11:57
SPEAKER_02: Expense like household expenses, and that was it to start.
12:01
SPEAKER_02: There are people that they buy a hundred and fifty thousand dollar laser before they have a patient, and that's a terrible idea.
12:08
SPEAKER_00: I know people who have done that.
12:10
SPEAKER_02: Yes, I do too.
12:12
SPEAKER_00: Too many people, and then the pressure is on for them to make revenue.
12:17
SPEAKER_00: What I would say to patients out there who are listening, one thing that you always want to look for in an aesthetic provider or an aesthetic practice in general is you want someone that you need more than they need you.
12:31
SPEAKER_00: Because if they need you more, that could be problematic.
12:33
SPEAKER_02: Right.
12:34
SPEAKER_02: That means they won't say no.
12:35
SPEAKER_02: That means they'll do stuff that is kind of marginal, they'll do stuff that that may not be necessary, they'll upcharge you.
12:42
SPEAKER_02: I hate the upcharge.
12:44
SPEAKER_02: So when I do a tummy tuck, for example, every patient that I do a tummy tuck on gets lipo in certain areas to create curve shape and contour and definition.
12:56
SPEAKER_02: Every patient gets a muscle repair, every patient gets the three-day numbing shots or pain ball.
13:04
SPEAKER_02: Every patient gets a mons lift, which means you lift kind of the bottom part up to make that look, to make I say Gina, to make Gina look pretty.
13:11
SPEAKER_02: And and all of that is included in my my price because I want to be able to do it.
13:17
SPEAKER_02: There are people who charge extra to lift the mons up.
13:21
SPEAKER_02: The mons is kind of the upper pubic area.
13:23
SPEAKER_02: That is part of a tummy tuck.
13:25
SPEAKER_02: I couldn't.
13:27
SPEAKER_00: Why would they want why would they want their patient walking around without a perfect result?
13:33
SPEAKER_02: Because they don't care.
13:34
SPEAKER_02: Because they don't care, because they don't care.
13:37
SPEAKER_02: They got the money.
13:38
SPEAKER_02: Patient, good luck.
13:39
SPEAKER_02: Sorry, see ya.
13:40
SPEAKER_02: They don't do the liposuction.
13:42
SPEAKER_02: The liposuction is what gets you the curves.
13:45
SPEAKER_02: They they they charge extra for that.
13:47
SPEAKER_02: They charge extra for the Monslift, they charge extra for the muscle repair, they charge extra for the expirel.
13:52
SPEAKER_02: All of that's included.
13:53
SPEAKER_02: And and and that's what you need to get the best result.
13:56
SPEAKER_02: Don't cheat your patients.
13:57
SPEAKER_02: Don't try to nickel and dime them.
13:59
SPEAKER_02: Don't you hate to be nickel and dimed when you buy a new car, buy a house, buy anything.
14:04
SPEAKER_00: I say no more than I say yes, honestly.
14:06
SPEAKER_00: I really do.
14:08
SPEAKER_00: I I really do.
14:09
SPEAKER_00: And I don't mean like a frank, no, I'm not doing that.
14:13
SPEAKER_00: I mean, like, for instance, just yesterday, I had a patient who we've been doing upper face botox, disport forever.
14:23
SPEAKER_00: And she's like in her mid-30s, and she asked me about her her lower face, her jowls, and if she needs anything there yet.
14:33
SPEAKER_00: And I said, no, you're not ready for anything there yet.
14:35
SPEAKER_00: We we we don't need to do that yet.
14:37
SPEAKER_00: Check in in a year.
14:38
SPEAKER_02: Yep.
14:39
SPEAKER_02: I've seen you do that a lot, actually.
14:41
SPEAKER_02: Yeah.
14:42
SPEAKER_00: Yeah.
14:42
SPEAKER_00: So it's not like a it's like and it's not like a no, I'm not doing it, but it's a you don't need to do it right now.
14:48
SPEAKER_02: I saw a patient within the last six months who wanted something, wanted a facelift.
14:55
SPEAKER_02: She had previously had two neck liposuctions and a cool sculpting.
14:59
SPEAKER_02: And the the last of those was like the month before she saw me for a facelift.
15:03
SPEAKER_02: And I said, Don't let anybody touch your face for a year.
15:06
SPEAKER_02: And let's not do a facelift for several years.
15:09
SPEAKER_02: Let's let everything else settle out, see how it goes.
15:12
SPEAKER_02: Uh, I got a call.
15:13
SPEAKER_02: My staff, she called my staff on uh earlier this week and was like, Hey, I need to see Dr.
15:18
SPEAKER_02: Labraska right away.
15:19
SPEAKER_02: Why?
15:20
SPEAKER_02: Well, uh, I I want I want him to take a look at my neck and see if I need a facelift yet.
15:25
SPEAKER_02: And they went and they looked at those.
15:26
SPEAKER_02: They said, Well, he said to not let anybody see you for uh or do anything to your neck for for a year at least, or in a facelift for several years.
15:35
SPEAKER_02: And she said, Well, I'm on for a microneedling in on Wednesday and I need to be seen tonight or tomorrow.
15:42
SPEAKER_02: And no, no, right, no, I I already told you.
15:47
SPEAKER_02: Yeah, uh, I already told you what to do, and you already didn't listen.
15:51
SPEAKER_02: So that that's what we that's what we deal with all the time.
15:53
SPEAKER_02: You know, so Mystica, what what's something that that worries you about where the industry is headed?
15:58
SPEAKER_00: The trends are getting pretty wild.
16:01
SPEAKER_00: Yeah, the trends are getting out of control and that and social media, which I love social media.
16:06
SPEAKER_00: It's we all love it, but it's part of it because there's just the people are just doing crazy shit.
16:15
SPEAKER_00: And salmon sperm?
16:16
SPEAKER_02: Do you ever do salmon sperm?
16:18
SPEAKER_02: No, no.
16:20
SPEAKER_00: As my as my aesthetician and good friend Melissa says, don't put salmon jizz on your face.
16:27
SPEAKER_00: Was that too?
16:28
SPEAKER_00: Good idea.
16:28
SPEAKER_00: Thank you, Melissa.
16:29
SPEAKER_00: Way to go.
16:30
SPEAKER_00: High five.
16:31
SPEAKER_00: Shout out to Melissa.
16:32
SPEAKER_00: It's true.
16:33
SPEAKER_00: I mean, it's it's it's true.
16:34
SPEAKER_00: Is there a little bit of you know, evidence that maybe there's some benefit?
16:38
SPEAKER_00: Sure.
16:39
SPEAKER_00: I there's there's a little bit of evidence for everything.
16:41
SPEAKER_00: I mean, let's the other thing is like some of the crazy stuff, like putting Botox in your kneecaps because your skin is wrinkly in your kneecaps.
16:51
SPEAKER_00: I mean, come on.
16:52
SPEAKER_02: Oh, oh, I gotta you remember.
16:54
SPEAKER_02: So this is something that's um, it's a few years.
16:57
SPEAKER_02: Here's a trend that I think is gone.
16:59
SPEAKER_02: Barbie Botox.
17:00
SPEAKER_02: Do you remember that?
17:01
SPEAKER_00: No, it's not gone.
17:02
SPEAKER_00: It's not?
17:03
SPEAKER_00: No, don't talk about it anymore.
17:05
SPEAKER_00: No one's like going crazy posting about it anymore, but it's not gone.
17:10
SPEAKER_02: All right, so let's talk about what that is.
17:11
SPEAKER_02: So a couple of years when the Barbie movie was out, people started saying trapezius talks.
17:17
SPEAKER_02: So they call it a Barbie Botox, which is like the shoulder area here for those of you people that are that are listening, it's like your where your neck meets your shoulder, that that kind of upper back area where a lot of people hold tension.
17:29
SPEAKER_02: And they said 10 units of Botox in each trapezius will make your trapezius, will make your shoulders smaller and will relax tension, blah, blah, blah, blah, blah.
17:42
SPEAKER_02: So that is a huge, thick muscle.
17:46
SPEAKER_02: To give you an idea, these very same people were saying 60 units of Botox in your upper face.
17:53
SPEAKER_02: Tiny, tiny, tiny muscles, little tiny baby muscles that move your eyes.
17:59
SPEAKER_02: Okay.
18:00
SPEAKER_02: The trapezius is a giant muscle that helps move your entire arm.
18:05
SPEAKER_02: Okay.
18:06
SPEAKER_02: No, that is a terrible trend.
18:07
SPEAKER_02: We there were good who we thought were like good plastic surgeons, good injectors, going, oh yeah, Barbie Botox, Barbie Botox.
18:14
SPEAKER_02: And Mystic and I behind the scenes were like, well, that's freaking stupid.
18:18
SPEAKER_02: That is the dumbest thing I ever we were going nuts about it, right?
18:22
SPEAKER_00: And and so one thing I'll say though is that if someone truly has really bad tension in their shoulders, it can actually help.
18:32
SPEAKER_00: But that is for symptomatic relief of muscle tension.
18:38
SPEAKER_00: And it's not 10 units, it's like 30 units per size.
18:42
SPEAKER_00: And and I I have one person that does it, but I'm not doing it to make her her nose.
18:48
SPEAKER_02: Those of you listening, you should see the face I'm making right now.
18:52
SPEAKER_00: It does make her feel better, though.
18:53
SPEAKER_00: It does.
18:54
SPEAKER_00: I mean, it does it relaxes.
18:55
SPEAKER_02: Placebo.
18:55
SPEAKER_02: It's placebo.
18:56
SPEAKER_00: It's it's gotta be placebo.
18:58
SPEAKER_00: I I think it works.
18:59
SPEAKER_00: I I think it works for that, but I think to do it to make your your shoulders smaller and your neck longer is is a waste of money.
19:10
SPEAKER_02: What's something uh other than that, what's another trend that you'd like to see disappear?
19:14
SPEAKER_00: Oh gosh, let me think.
19:16
SPEAKER_00: I don't like PDO threads.
19:17
SPEAKER_00: I'm sorry.
19:17
SPEAKER_00: I don't there are some very skilled aesthetic providers out there who do PDO threads and I respect them.
19:28
SPEAKER_00: And I think they do beautiful work with fillers and such, but I just don't like PDO threads.
19:34
SPEAKER_00: They post the immediate after, which does look good.
19:38
SPEAKER_00: Yeah.
19:39
SPEAKER_00: It does.
19:39
SPEAKER_00: Yep.
19:40
SPEAKER_00: But it probably doesn't look like that two weeks later.
19:42
SPEAKER_00: For sure.
19:42
SPEAKER_02: As soon as they go home and lay on their side, lay on their, you know, unless you sleep on your back upright like a vampire, you know, it's just not gonna work.
19:50
SPEAKER_02: So a history is so whenever I was training in plastic surgery in 2008 to 2010, my program director, Dr.
19:58
SPEAKER_02: Bruce Chow, he said these threads, they had another name at the time.
20:03
SPEAKER_02: I can't even remember what it was.
20:04
SPEAKER_02: These threads have come and gone twice already.
20:07
SPEAKER_02: And that was by 2008, 2009.
20:10
SPEAKER_02: And so what happens, and it they've come and gone two or three times in the last 15 years as well.
20:16
SPEAKER_02: So, what happens is these young injectors come out and some company markets them with this bullshit, and they say, Oh my God, yes, let's do it.
20:26
SPEAKER_02: And then they start doing threads.
20:27
SPEAKER_02: You remember just a couple of years ago, you'd look at these Instagrams, and these people had like 50 threads in their face and then show it.
20:35
SPEAKER_02: Um, and it just looked ridiculous.
20:37
SPEAKER_02: And then, like, show me two weeks later.
20:39
SPEAKER_02: We never saw two weeks later, we never saw a month later.
20:42
SPEAKER_02: And then you have these threads in your face.
20:44
SPEAKER_00: They paid thousands.
20:46
SPEAKER_00: Two grand, probably thousands.
20:47
SPEAKER_00: Thousands, yes.
20:48
SPEAKER_00: Really expensive.
20:49
SPEAKER_02: And it makes it harder to for me to do a facelift, you know, down the road, even 10 years down the road, like you can feel the scarring from that.
20:59
SPEAKER_02: And it sucks.
20:59
SPEAKER_02: I hate it.
21:00
SPEAKER_00: Right.
21:00
SPEAKER_00: The other thing is the the complication rate of those is is pretty high.
21:04
SPEAKER_00: I think it's something like 20%.
21:06
SPEAKER_02: Oh, for sure.
21:07
SPEAKER_00: That's a significant complication rate.
21:09
SPEAKER_02: It it really is.
21:10
SPEAKER_02: It it it absolutely is.
21:12
SPEAKER_02: You talked about some injectors that you love, some uh it's people that that do a like a really good job.
21:17
SPEAKER_02: What makes somebody a great provider?
21:19
SPEAKER_02: Like what what's something that you admire in all the good ones?
21:23
SPEAKER_02: Not not why, not you know, not why you're different than others, but like what what's the thing that that we should look for?
21:30
SPEAKER_00: Are we asking about skill or are we asking about if someone is out there?
21:35
SPEAKER_00: If someone is out there shopping for a provider, yeah.
21:38
SPEAKER_02: Yeah, yeah.
21:39
SPEAKER_02: Like what what are the skills that you look for other than you know, uh experience?
21:43
SPEAKER_02: What what are the things like what would make you let's peel back the curtain a little bit here.
21:48
SPEAKER_02: What are you looking for in in somebody else?
21:50
SPEAKER_02: What are the things that you like to emulate?
21:52
SPEAKER_00: I think that there is definitely an artistic quality to what we do.
21:57
SPEAKER_00: There really is.
21:58
SPEAKER_00: There's there's you have to Sort of blend the science of it and understanding the anatomy of the face, and as importantly, why the face ages and what is happening under the skin to the artistic side of the brain that you can then transform the face into something that appears more youthful.
22:24
SPEAKER_00: And you have to blend the science and the artistic side.
22:29
SPEAKER_00: And I think that not everyone inherently has that skill.
22:33
SPEAKER_00: I I think that I think that inherently there has to be, you have to be able to do that.
22:40
SPEAKER_00: And you can certainly learn, you can certainly learn some techniques and things like that.
22:44
SPEAKER_00: And you can read every book and take every every training course and probably get pretty good.
22:51
SPEAKER_00: But there's also just that artistic side of things that you can't necessarily learn.
22:58
SPEAKER_02: Every day I draw pictures and then I show the people what I draw.
23:01
SPEAKER_02: And I'm like, listen, I'm better on skin than I am on paper.
23:05
SPEAKER_02: Because what I draw what I draw on paper looks terrible.
23:09
SPEAKER_02: Again, I'm a I'm a I'm a doctor, so my handwriting is awful.
23:12
SPEAKER_02: Uh, you know, some of the things that I look for uh artistry, honesty, integrity, and experience.
23:19
SPEAKER_02: All of those four things are super important to me.
23:22
SPEAKER_02: And for me, personality also plays a role, too.
23:25
SPEAKER_02: But I would rather have an asshole um who has all of those other four qualities than have someone who is missing the artistry but is funny.
23:36
SPEAKER_02: Thankfully, I'm I'm artistic and funny.
23:38
SPEAKER_00: I the other thing I I want to mention too, and this is going to make some other providers out there mad.
23:45
SPEAKER_00: This is this is totally gonna trigger some people.
23:47
SPEAKER_00: This is a career for me.
23:49
SPEAKER_00: This is what I do day in and day out.
23:52
SPEAKER_00: I do it five days a week, and I've been doing it for 16 years.
23:56
SPEAKER_00: There are plenty of providers out there who it's a it's a side hustle.
24:01
SPEAKER_00: And so it's just, it's not their career.
24:04
SPEAKER_00: They're not doing it day in and day out.
24:07
SPEAKER_00: So they don't have necessarily the experience.
24:10
SPEAKER_00: And and they're not necessarily, is it fair to say maybe they're not as passionate about it?
24:15
SPEAKER_00: It's probably not fair to say that because some maybe are, and maybe they don't have the opportunity to do it full time.
24:21
SPEAKER_00: I don't know.
24:22
SPEAKER_00: But the but what it comes down to is there it needs to be something they're doing every single day.
24:28
SPEAKER_00: I I don't want someone touching my face when it's a side hustle.
24:31
SPEAKER_00: I just don't.
24:32
SPEAKER_00: Sorry, sorry, guys.
24:33
SPEAKER_00: I'm sure some of you are really good, but most of you uh probably need more experience.
24:39
SPEAKER_02: You know, it for someone that's doing it one day a week or two days a month or whatever, you know, what I would say is maybe you'll be great in the future, but I'm I'm not giving you my face yet, right?
24:49
SPEAKER_02: Correct.
24:49
SPEAKER_02: You know, like somebody, you know, some there, there's uh someone a couple of hours from here, and she used to do family medicine.
24:57
SPEAKER_02: Um, and then she got really good at lips, and um she's excellent now.
25:03
SPEAKER_02: Uh, she's uh in Altoona.
25:04
SPEAKER_02: We talk uh we talk about her.
25:07
SPEAKER_02: Yeah, yeah, we love her.
25:08
SPEAKER_02: She's she's Devin, uh Devin in Altoona, you do a great job.
25:12
SPEAKER_02: She she started doing family or urgent care or something like that.
25:16
SPEAKER_02: And now she does aesthetics full-time and she's excellent.
25:19
SPEAKER_00: Yeah, and she I think she owns her practice too.
25:21
SPEAKER_00: Yeah, and she owns her practice now.
25:22
SPEAKER_00: Yeah, yeah, yeah.
25:23
SPEAKER_02: It's become her career.
25:24
SPEAKER_02: Yep.
25:25
SPEAKER_00: Um, my Nicola Lowry, who is one of the best injectors in the world.
25:31
SPEAKER_00: I um I actually spent a couple of days with her last year.
25:35
SPEAKER_00: She's in LA, but she did a post a few months ago.
25:40
SPEAKER_00: She made a post um that was a joke.
25:42
SPEAKER_00: It was like it's supposed to be a funny post.
25:45
SPEAKER_00: And it basically the the crux of the post was that someone who is not as experienced at injecting is just not going to be as good as someone who has experience.
25:58
SPEAKER_00: And she got crushed.
26:00
SPEAKER_00: She got crushed in the comments for posting that.
26:02
SPEAKER_00: However, I give her so much credit because she doubled down.
26:06
SPEAKER_02: Where's the lie?
26:07
SPEAKER_00: There's no lie.
26:08
SPEAKER_00: There's no lie.
26:09
SPEAKER_00: She was like, you know what?
26:10
SPEAKER_00: I thought about taking this post down and then I didn't because it's true.
26:17
SPEAKER_02: Would you rather have a pilot that's been at it for six months or or 10 years?
26:22
SPEAKER_00: Right.
26:23
SPEAKER_00: Exactly.
26:24
SPEAKER_02: Right.
26:25
SPEAKER_00: So that's for everyone listening, for for all three of you who are listening to our second episode.
26:31
SPEAKER_02: Hi, family.
26:33
SPEAKER_00: Yeah.
26:34
SPEAKER_00: Hi, Dad.
26:35
SPEAKER_00: Probably not even dad.
26:37
SPEAKER_02: No, he tuned out by now.
26:39
SPEAKER_00: Yeah.
26:40
SPEAKER_00: Melissa's listening.
26:41
SPEAKER_02: Thanks, Melissa.
26:43
SPEAKER_02: And and and shout out me, because I'm probably listening again too.
26:46
SPEAKER_00: Yeah.
26:48
SPEAKER_02: So we've talked about it.
26:50
SPEAKER_02: So what excites you the most for what's coming or what or what gets you up and gets you excited every day?
26:57
SPEAKER_00: So, well, I just, I mean, I love going to work every day.
27:00
SPEAKER_00: It's the best thing ever.
27:01
SPEAKER_00: My patients, I love my patients.
27:03
SPEAKER_00: I think they're the they're always the best part of my day.
27:06
SPEAKER_00: But where I think the industry is headed is I think regenerative medicine is where the industry is headed.
27:13
SPEAKER_00: So regenerative meaning hacking your body to anti-age itself.
27:19
SPEAKER_00: So building collagen and elastin.
27:22
SPEAKER_00: And how do we do that?
27:23
SPEAKER_00: We do that with lasers.
27:24
SPEAKER_00: We do that with microneedling, biostimulators like sculptra, PRP, PRF injections, where we draw your blood and harvest your growth factors.
27:35
SPEAKER_00: I think that that is where the industry is headed, for sure.
27:39
SPEAKER_02: I agree.
27:40
SPEAKER_02: Do you think that uh that our tradition are more traditional things that we've been using for a long time, like dermal filler, talks, do you think those still have a role in the future?
27:50
SPEAKER_00: Absolutely.
27:50
SPEAKER_00: Those are never gonna go away.
27:51
SPEAKER_02: Never gonna go away.
27:52
SPEAKER_00: And fillers, fillers are getting better and better.
27:56
SPEAKER_00: The technology for how these companies create the products and the fillers is getting better because they really have figured out how to make them look and move naturally and not degrade as much under the tissue.
28:12
SPEAKER_00: So that's only going to get better too.
28:14
SPEAKER_00: And that those will never go away.
28:15
SPEAKER_00: They just won't.
28:16
SPEAKER_02: I agree.
28:16
SPEAKER_02: What do you think?
28:17
SPEAKER_02: So you think that aesthetics in 10 years is gonna look like that?
28:21
SPEAKER_02: Biohacking, uh, hacking your body, uh regenerative medicine, et cetera.
28:26
SPEAKER_02: You think that?
28:26
SPEAKER_02: Is there anything that you that you only think about in your head that isn't there yet that you'd like to see?
28:34
SPEAKER_00: In terms of treatments that exist?
28:36
unknown: Yeah.
28:36
SPEAKER_02: What would you like?
28:37
SPEAKER_02: What what do you think, what do you think the future of that?
28:41
SPEAKER_02: I don't know.
28:41
SPEAKER_02: I don't know how to how to say it.
28:43
SPEAKER_02: Like I imagine stuff in my head.
28:44
SPEAKER_02: So I watched, I read a lot of comic books whenever I was a kid, and you know, and so uh, so those I I think about like what isn't invented yet that I'd like to see.
28:54
SPEAKER_02: You know, and I think that for me, there are going to be treatments for us, I guess, that that do actually to a degree replace surgery.
29:07
SPEAKER_00: Yeah, I was I was thinking the same thing.
29:09
SPEAKER_00: I was thinking the same thing.
29:10
SPEAKER_00: I think that, and I hope probably not in my career.
29:14
SPEAKER_00: For my sake, for for my sake, getting older, but also my patient's sake, that that lifting tissue becomes non-invasively becomes better.
29:25
SPEAKER_00: So because all of us, we all worry about our jowls, lower face, neck.
29:30
SPEAKER_01: Yeah.
29:31
SPEAKER_00: And there just isn't anything that you can reliably do um that's not surgery for that.
29:38
SPEAKER_02: There are some things that that are okay, but not super predictable yet.
29:44
SPEAKER_02: You know, being predictable, being able to get the get a good result every time is just not there yet.
29:51
SPEAKER_00: Right.
29:52
SPEAKER_00: So, so that that I think will come down the pipeline.
29:56
SPEAKER_00: And I hope that it does because I'm gonna need it.
29:59
SPEAKER_00: Because I'm gonna be 50 in 10 years, 51.
30:03
SPEAKER_00: Already 10 years.
30:06
SPEAKER_02: 10 years.
30:07
SPEAKER_02: So at the end of the day, patients, they don't really care about the newest laser, the newest filler or surgery, whatever.
30:13
SPEAKER_02: They want to know is this gonna help me?
30:15
SPEAKER_02: If I get it, am I gonna regret it?
30:17
SPEAKER_02: And most importantly, is it worth it?
30:19
SPEAKER_02: Which is exactly what we're gonna talk about in the next episode.
30:22
SPEAKER_02: Is it worth it?
30:24
SPEAKER_00: We will be investigating and talking about on future episodes.
30:28
SPEAKER_00: We're gonna break things down and we're gonna cut out the bullshit and tell you if it's worth it.
30:34
SPEAKER_02: Scalpel and skin is going to be talking about different treatments and are they worth it?
30:38
SPEAKER_02: Please join us for the next episode.
30:40
SPEAKER_02: Let's go.
30:41
SPEAKER_02: Please.
30:42
SPEAKER_02: Please.
30:43
SPEAKER_02: Hi, Dad.
30:45
SPEAKER_02: That's it for today's episode of Scalpel and Skin.
30:48
SPEAKER_02: Follow the show wherever you listen and come find us on social media.
30:51
SPEAKER_02: Send us the treatments, trends, or questions you want us to break down next.
30:55
SPEAKER_02: This is Scalpel and Skin.
30:57
SPEAKER_02: Let's go.