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Peptide Safety Warning: What You Need to Know Before Buying · Aesthetics Unscripted

• 0:06
  SPEAKER_01: Leads us right into the conversation of I've seen almost like an epidemic level of peptides that are coming in from even if they're compounded here that are just not supplying what we think they say in the vial.
• 0:23
  SPEAKER_01: And um there's even been reports lately that up to 70% of some of these compounded peptides are not what is supposed to be inside the vial.
• 0:33
  SPEAKER_01: It's just filler ingredients.
• 0:35
  SPEAKER_01: And also with neurotoxins in specific coming in from all different parts of the world that are counterfeit.
• 0:43
  SPEAKER_01: So help me unpack that for the viewers because I find that it's extremely alarming that we're getting into this rapid perception of the general public saying this doesn't need to be medically supervised.
• 0:58
  SPEAKER_01: Peptides are just supplements, and if I can get a neurotoxin inject myself, it's easy.
• 1:03
  SPEAKER_01: I just watch the video on YouTube.
• 1:05
  SPEAKER_01: Oh my god, please help me with this because to me it's a nightmare.
• 1:09
  SPEAKER_01: And there are things that have to be medically supervised for your own safety.
• 1:13
  SPEAKER_01: It's for your own safety.
• 1:15
  SPEAKER_01: Please, please listen.
• 1:16
  SPEAKER_00: The problem sometimes in aesthetics and a regenerative medicine is it can feel like the Wild West.
• 1:21
  SPEAKER_00: That's the thing, is that there's so much, so many new things that push the field forward, but there's also a lot of things that kind of circumvent the regulatory process of going through clinical trials.
• 1:33
  SPEAKER_00: These clinical trials are what sometimes make drugs really expensive, but it's the same thing that keeps people safe.
• 1:39
  SPEAKER_00: And even with those clinical trials, we know that medications years later can create problems.
• 1:45
  SPEAKER_00: So, what's to say that these compounds and all these different types of peptides and different elements that aren't being tested for years, that aren't treated at a global level, aren't going to create some major issues down the road.
• 1:58
  SPEAKER_00: And there's really where you end up with some really big issues is that it's the long-term effect of this.
• 2:04
  SPEAKER_00: Where are they being sourced, how are they being used?
• 2:06
  SPEAKER_00: No one's saying that they're not going to be incredibly valuable and could make huge changes and make big strides in preventative disease, of regeneration of tissues, of rapid recovery and tendon growth and skin re-elastosis repair, all these really exciting things, but we don't really know because no one's actually studying them formally and tracking them and taking tissue biopsies and looking at serology labs and all the crazy things that we have to do for a new Botox.
• 2:34
  SPEAKER_00: You know, that's been around for how many years?
• 2:36
  SPEAKER_00: But we have to take samples, those samples of blood stay around for years in databases to track it, to make sure that if there was a problem, who was that patient?
• 2:45
  SPEAKER_00: Why did they form those antibodies?
• 2:46
  SPEAKER_00: There's a million things that go into these peptides.
• 2:48
  SPEAKER_00: So safety is a huge consideration.
• 2:51
  SPEAKER_00: They're exciting.
• 2:53
  SPEAKER_00: It's great to think.
• 2:54
  SPEAKER_00: I'd love to take something if I could get injected with it that's gonna make me feel and look years younger.
• 2:59
  SPEAKER_00: But am I really willing to risk that without any great data or human trials or actually follow-through?
• 3:07
  SPEAKER_00: I wouldn't put my liver or kidneys on the line for it.
• 3:10
  SPEAKER_01: Knowing what we know from our side of the fence, I would never think that it's a good idea to get a like a neurotoxin, a neuromodulator, or any kind of injectable that wasn't specifically from a reputable, well-known company because of everything that you just said with the testing and everything that goes behind making sure that this product is technically safe for what we're using it for.
• 3:34
  SPEAKER_01: But when it comes to peptides, um my caution for the viewers, whether you're a provider or you're a patient, is that I was astounded because of the level of intricacy that goes with the peptides.
• 3:47
  SPEAKER_01: I find that where patients at home or the general public might be making a big mistake is that when you go on your AI search or your Google search, you'll see like page one, the first couple paragraphs is all the wonderful things about what the peptide does.
• 4:01
  SPEAKER_01: You have to go deeper into like page two of that same information, and that's where it starts telling you this one has to be injected sub Q.
• 4:09
  SPEAKER_01: This one has to be injected maybe more shallowly or deeper.
• 4:13
  SPEAKER_01: This one cannot be injected at night.
• 4:15
  SPEAKER_01: It has to be only during the daytime, the other one is only at night.
• 4:18
  SPEAKER_01: These three cannot be injected if you're using those two.
• 4:21
  SPEAKER_01: It becomes very intricate.
• 4:23
  SPEAKER_01: And what are you basing it on, right?
• 4:24
  SPEAKER_01: Shouldn't you be starting this with a blood test first?
• 4:27
  SPEAKER_00: Again, unknowns, and like we said, the Wild West.
• 4:29
  SPEAKER_00: So I think that's where safety, monitoring, studies, trials, those are needed before I'm going to subject my patients, my family, my friends, or myself to any of these.
• 4:40
  SPEAKER_01: Absolutely.
• 4:41
  SPEAKER_01: I mean, if you want to throw darts, go to your local bar.
• 4:43
  SPEAKER_01: Don't do this on yourself.
• 4:44
  SPEAKER_01: Okay, I'd love to ask you about our Ozempic face issues.
• 4:49
  SPEAKER_01: I'm not a Debbie Downer.
• 4:51
  SPEAKER_01: I might sound like I'm venting about a lot of issues today.
• 4:54
  SPEAKER_01: However, um, I do have an issue with, again, non-medically supervised accelerated weight loss.
• 5:02
  SPEAKER_01: So there are so many outlets now that you can just plug in your information.
• 5:07
  SPEAKER_01: You don't actually even get on the phone with a doctor, and they just write you a script based on a couple of questions that you plugged in.
• 5:16
  SPEAKER_01: And I think this is quite the biggest reason behind the osempic face and osempic body, osempic ears, osempic scrotum.
• 5:24
  SPEAKER_01: I've seen osempic everything when it comes to this extreme laxity that happens when you lose weight so quickly.
• 5:31
  SPEAKER_01: And we know that happens when you lose weight quickly in a natural way, but especially with a GLP1.
• 5:37
  SPEAKER_01: So when a person wants to start GLP1, what would you suggest is the best route to start?
• 5:44
  SPEAKER_01: Who do you look for?
• 5:45
  SPEAKER_01: How do you begin?
• 5:46
  SPEAKER_01: And then taking it afterwards, if you do experience that weight loss laxity of your skin, uh, what can you do surgically?
• 5:55
  SPEAKER_01: What can you do non-surgically?
• 5:57
  SPEAKER_00: Well, we could first of all have an entire series on just GLPs.
• 6:01
  SPEAKER_00: So if we're thinking about it, look, these have exploded onto the scene.
• 6:05
  SPEAKER_00: They are a peptide in their own right, but a studied one.
• 6:08
  SPEAKER_00: And even with them being studied in millions of patients who were diabetics, right?
• 6:14
  SPEAKER_00: A lot of people don't understand that these were medications pretty much prescribed for people that have diabetes.
• 6:18
  SPEAKER_00: And it was from that they started to realize maintenance of blood sugar levels, maintenance and sort of improvement of their hemoglobin A1C, which is a marker for what your sort of 60, 90 day status is of blood sugar, and then watching these patients maintain weight and lose weight.
• 6:34
  SPEAKER_00: So then it was like, wow, this is an opportunity.
• 6:36
  SPEAKER_00: What if we do this in healthy patients?
• 6:37
  SPEAKER_00: What happens?
• 6:38
  SPEAKER_00: Now, even with those studies in healthy patients, we know that things can happen.
• 6:43
  SPEAKER_00: And this is just another example of what are some of the risk-reward benefits.
• 6:48
  SPEAKER_00: On the whole, this new class of drugs seem to be incredible and are a boom for the plastic surgery industry, but they're also a boon for people that wanted to lose weight in somewhat of a controlled manner that are just challenged in dealing with the food noise and cravings and over satiety and not eating and eating way too much, all those different things.
• 7:11
  SPEAKER_00: Fast forward, what do we do about it now?
• 7:13
  SPEAKER_00: Once we started to see a lot of patients on these medications and losing the weight, we've got this whole concept of osempic this, osempic that, because that's kind of the first one.
• 7:21
  SPEAKER_00: Like you said, the face, the neck, the this and that.
• 7:24
  SPEAKER_00: A youthful face is a volume-restored face with the appropriate skin and soft tissue envelope redraped over it.
• 7:32
  SPEAKER_00: So if we look at a young face, it's got a good healthy amount of volume.
• 7:36
  SPEAKER_00: It's not gaunt.
• 7:37
  SPEAKER_00: We have strategic fat pads, superficial and deep fat pads that are well studied in the face.
• 7:43
  SPEAKER_00: As we age, there's a predictable pattern of where some of them atrophy or get smaller, or some of them hypertrophy or get bigger.
• 7:50
  SPEAKER_00: And so this is going to accelerate the atrophy element where things are gonna get smaller very quickly.
• 7:56
  SPEAKER_00: So at first, people look really, really good and they're thin and they're all this thing, and they're really excited about it.
• 8:01
  SPEAKER_00: And then a few months later you recalibrate and you're like, okay, now I look a little gaunt.
• 8:06
  SPEAKER_00: People are asking me, like, wow, you got something, you look great, but you look a little tired.
• 8:09
  SPEAKER_00: You look, I've never felt better.
• 8:10
  SPEAKER_00: What do you mean?
• 8:11
  SPEAKER_00: And you start to realize, well, my under eyes are hollow, my temples are hollow, my skin's getting loose, which takes you down an entire treatment paradigm.
• 8:19
  SPEAKER_00: They need, for example, your help with non-invasives and minimally invasive tightening treatments.
• 8:24
  SPEAKER_00: There's a limitation to how much you can do that.
• 8:26
  SPEAKER_00: Well, now I need surgery, I need a facelift or a necklift and some volume restoration with fat.
• 8:31
  SPEAKER_00: I don't want fillers, but I need fillers, I don't want this, but I want that.
• 8:34
  SPEAKER_00: So basically, the whole thing is once you go on these medications, they are excellent at helping managing again the food noise and the cravings.
• 8:44
  SPEAKER_00: They can be really beneficial, but just understand that there's going to be certain, as we say, sequela or other things that are going to develop that you may need to address to still look your best now that you're feeling a lot better.
• 8:56
  SPEAKER_01: Absolutely.
• 8:57
  SPEAKER_01: And I think when you're medically supervised, which is your physician checking in with you on a regular basis, then you can control the way you're titrating up and down.
• 9:06
  SPEAKER_01: You won't lose weight at such a tremendous rapid rate.
• 9:10
  SPEAKER_01: So your skin just doesn't start to fall off.
• 9:12
  SPEAKER_01: Everything starts to shrink together naturally.
• 9:15
  SPEAKER_01: Because, like you said, there is a limitation to non-surgical regenerative processes like soma cell, like lasers for texture, whether you're using an ultrasound instead of soma cell to try to tighten connective tissue layers.
• 9:30
  SPEAKER_01: There's a there's a limit.
• 9:32
  SPEAKER_01: And then with surgery, there's going to also be a limit.
• 9:35
  SPEAKER_01: And I think what the general public forgets is that not every patient is a surgical patient.
• 9:40
  SPEAKER_01: You're not, you might be contraindicated for various reasons.
• 9:43
  SPEAKER_01: And if you don't want filler, maybe you're not a fat transfer patient.
• 9:47
  SPEAKER_01: And if you are a fat transfer patient, do you have enough fat now?
• 9:50
  SPEAKER_01: Which leads me into talking about something very, very new and exciting.
• 9:55
  SPEAKER_01: I'm all for it.
• 9:56
  SPEAKER_01: Aloclay.
• 9:57
  SPEAKER_01: Can you please explain to our viewers what is alloclay?
• 10:01
  SPEAKER_01: How are we using it right now?
• 10:03
  SPEAKER_01: And why is it such a huge leap forward as opposed to just harvesting your own fat?
• 10:08
  SPEAKER_00: Aloclay is the world's first and only um, well, and other products are not going to go, is the world's first off-the-shelf cataveric fat product.
• 10:17
  SPEAKER_00: And for those who are like, wait, did you just say cadaver?
• 10:19
  SPEAKER_00: Yes, it could sound a little bit scary, but it's actually not.
• 10:22
  SPEAKER_00: If you tore your Achilles tendon and you didn't want to have a graft of your tendon from another part of your body, you could literally, the orthopedic surgeon would use cataveric tendon graft.
• 10:33
  SPEAKER_00: If you needed a new lens for your eye after cataract, they'd use a cataveric lens graft.
• 10:38
  SPEAKER_00: If you need a heart valve, they could use a dead animal's heart valve.
• 10:42
  SPEAKER_00: If you need cartilage grafting, we can use cadaveric rib graft.
• 10:45
  SPEAKER_00: If you go to the oral maxillofacial surgeon and you need some work done on your gums or your bone grafting, they'll use cadaveric bone graft.
• 10:53
  SPEAKER_00: Cadaver grafts are not anything new in plastic surgery or medicine.
• 10:57
  SPEAKER_00: But what is new is the ability to stabilize a fat cell.
• 11:01
  SPEAKER_00: As stubborn as fat is, it's actually a very fragile tissue.
• 11:04
  SPEAKER_00: When we do a fat transfer, we lose a substantial percentage of the fat.
• 11:09
  SPEAKER_00: If I suction your flanks and inject it into your butt or into your boobs, for example, you are likely going to only get anywhere from 40 to 70% retention.
• 11:19
  SPEAKER_00: And that's because the fat is actually quite fragile.
• 11:22
  SPEAKER_00: So with alloclay, we have the DNA content removed or minimized to a very safe threshold, no transfer of genetic information, and the ability to literally open a sterile syringe of fat and create volume.
• 11:37
  SPEAKER_00: So we're doing this everywhere from non-implant breast augmentation to treating the hip dips to giving someone a little bit more pop in their butt, correcting post-liposuction contour irregularities.
• 11:50
  SPEAKER_00: So this has been a huge, huge innovation in aesthetic medicine and become a really big addition to our practice amongst several others from around the country.
• 12:01
  SPEAKER_00: So it's it's pretty special and it's exciting to see where it's gonna go.
• 12:04
  SPEAKER_01: I think so too.
• 12:05
  SPEAKER_01: I think it's wildly exciting, and for our viewers, we're not digging up bodies in Potter's Fields.
• 12:10
  SPEAKER_01: The fat has actually come from donated cadavers and triple sterilized, I believe.
• 12:17
  SPEAKER_00: Yeah, so it's terminally sterilized, it has light gamma radiation, all these basically scientific things that we geek out on to basically say that we have a sterile product.
• 12:25
  SPEAKER_00: So it's not just something that, you know, that that's just liposuctioned out and then you're injecting it in.
• 12:31
  SPEAKER_00: Um these are tissue products that are gifted in kind by people who knew that long after they're off the planet, so to speak, or they've passed away, whatever your spiritual beliefs are, um, that their body could be used to help others in some way, shape, or form.
• 12:45
  SPEAKER_00: And it's not just to plump something up.
• 12:48
  SPEAKER_00: We have patients that are coming to us from all over the world that have had poorly done liposuction, that they were tissue has been burned, they're missing fat because of something else that's happened in a traumatic accident or an injury, a ski accident, led a hematoma, fat necrosis.
• 13:04
  SPEAKER_00: There's nothing that can replace that other than having major surgery.
• 13:06
  SPEAKER_00: Well, now we can do a minor procedure and restore them.
• 13:09
  SPEAKER_00: So this isn't just about vanity for those that are watching.
• 13:12
  SPEAKER_00: They're like, oh my gosh, I wouldn't inject that for that.
• 13:14
  SPEAKER_00: We actually have so many different sort of restorative and reconstructive applications as well.
• 13:20
  SPEAKER_01: Absolutely.
• 13:20
  SPEAKER_01: It's like stem cells for longevity, using stem cells, um, different forms of stem cells, whether they're somatic or mesenchymal or an allograph sheet, however, we're incorporating that into the longevity space, it's actually coming from all of your traumatic wounds healing.
• 13:37
  SPEAKER_01: So, yes, it's not elective isn't always just completely selfish.
• 13:41
  SPEAKER_01: We're getting the science from actually having healed people from traumatic wounds, diseases, and the like.
• 13:48
  SPEAKER_01: Dr.
• 13:48
  SPEAKER_01: Sasheen, can you please share with our viewers also it's never too late, but it's never too early to start as long as you're an active adult.
• 13:55
  SPEAKER_01: I'm not talking about a preteen coming in asking for an upper bluff, um, unless there was some kind of deformity that if you're an actual adult, I feel like prevention is wonderful, but then also like we have had, I know in your practice and in mine, uh, we've both had patients that come in in their 70s, they're just starting skincare.
• 14:15
  SPEAKER_01: They're just asking you, what can I do?
• 14:17
  SPEAKER_01: From the surface to the underlying layer, what can I do surgically, what can I do non-surgically?
• 14:23
  SPEAKER_01: So, what's your advice when it comes to prevention, and also no matter how old you are?
• 14:27
  SPEAKER_00: Look, preventative is a huge element because we're learning so much about these technologies.
• 14:32
  SPEAKER_00: And prevention usually doesn't require major intervention.
• 14:36
  SPEAKER_00: Um, it's it's about maintenance, it's about identifying a problem or knowing kind of where things are headed based on looking at your parents or others that are in the family and genetically realizing that, you know, I look a lot like mom.
• 14:47
  SPEAKER_00: I looked at pictures of what I looked like when I was that age.
• 14:50
  SPEAKER_00: Mom really loved the son, I love the son, and look at her skin at 50 and look at mine at 25.
• 14:56
  SPEAKER_00: You know, these are the types of things.
• 14:57
  SPEAKER_00: So I think maintenance and prevention are key.
• 15:00
  SPEAKER_00: It's really about being in the hands of a provider that understands what it is that you're hoping to achieve, that you can trust, right?
• 15:09
  SPEAKER_00: Trust is a big thing.
• 15:11
  SPEAKER_00: Um, I was taught this at Johns Hopkins by my mentor, Dr.
• 15:15
  SPEAKER_00: Paul Manson, who is the chief of our division of plastic surgery.
• 15:19
  SPEAKER_00: And Dr.
• 15:19
  SPEAKER_00: Manson told me when I was moving to New York, he looked at me and he said, Sachin, you're gonna make a living based on who you take care of, but you're building your reputation based on who you say no to.
• 15:30
  SPEAKER_00: And that is always still stuck with me.
• 15:33
  SPEAKER_00: I'm not afraid to tell a patient no.
• 15:36
  SPEAKER_00: If I don't think that I can actually help them or there's something valuable here, or something that we can really make a big impact on, the answer is no.
• 15:44
  SPEAKER_00: So I think making sure that you're not just dealing with someone who just says yes all the time.
• 15:48
  SPEAKER_00: We see this with celebrities.
• 15:50
  SPEAKER_00: People like, oh my gosh, they have all the money in the world, they can go to the best people in the world.
• 15:54
  SPEAKER_00: Well, some of the best people in the world, we've said no to them, but they didn't like hearing no because they're surrounded by everyone who tells them yes.
• 16:01
  SPEAKER_00: So they went somewhere else down the street, and someone's so excited to take care of blah blah blah, multi-oscar-winning actor or actress, and all these things, and we'll just be like, sure, of course, whatever you want, because they don't want to say no and they want to be the person that takes care of them, regardless of what impact that ends up having on that person.
• 16:19
  SPEAKER_00: So back to the element of prevention and starting too early.
• 16:22
  SPEAKER_00: It's I look rhinoplasty on a 15 or 16-year-old, sure, that's not unreasonable.
• 16:28
  SPEAKER_00: We have facial skeletal maturation.
• 16:31
  SPEAKER_00: If there's emotional maturation of the patient and the family is supportive, wonderful.
• 16:39
  SPEAKER_00: We have 17-year-olds that could run a whole household and take care of themselves, and you've got 35-year-olds that are literally a child, right?
• 16:48
  SPEAKER_00: So it's all about understanding the patient, their maturity, and the actual physical uh element that we're trying to prevent or treat, in which case we can get started early.
• 16:58
  SPEAKER_01: Well, that that is absolutely fantastic advice.
• 17:01
  SPEAKER_01: And thank you so much for coming today.
• 17:04
  SPEAKER_01: When patients have questions, or even if it's another provider and they're looking for a masterclass with you, how do they get in touch with you?
• 17:10
  SPEAKER_01: Um let everybody know, please.
• 17:12
  SPEAKER_00: Yeah, absolutely.
• 17:13
  SPEAKER_00: I think finding us on our social channel is definitely the best.
• 17:16
  SPEAKER_00: Our Instagram is Sachin Shridharani MD.
• 17:19
  SPEAKER_00: Um, and we are very, very responsive there.
• 17:21
  SPEAKER_00: So I think that's a really great avenue.
• 17:23
  SPEAKER_00: And also just reaching out to our clinic and talking to one of our team members.
• 17:26
  SPEAKER_00: We have an amazing team, not just for the patient care part, but to educate our patients, to educate other providers so we're easy to get a hold of in today's world.
• 17:36
  SPEAKER_00: So whether it's from the convenience of your phone or your laptop or your iPad, whatever it is, we're accessible and available at all times.
• 17:43
  SPEAKER_01: Thank you so much.
• 17:44
  SPEAKER_01: It's always such an incredible honor.
• 17:46
  SPEAKER_01: I could listen to you talk all day long, and you know that.
• 17:48
  SPEAKER_01: I have a million questions always, and I can just listen to your answers, and you're like, I'm too busy, Kim.
• 17:54
  SPEAKER_01: I'll answer you, and I gotta go.
• 17:56
  SPEAKER_01: So that's the mark of a great surgeon.
• 17:58
  SPEAKER_01: He doesn't have time to stand still.
• 18:00
  SPEAKER_01: But thank you again.
• 18:01
  SPEAKER_01: It's a true honor to be a colleague, to have come across your path years ago, and to watch you grow and explode the way you have on so many different levels of expertise.
• 18:13
  SPEAKER_01: Is to me, it's just like I'm gobsmacked.
• 18:15
  SPEAKER_01: It's fantastic.
• 18:16
  SPEAKER_01: So thank you so much for being here today.
• 18:19
  SPEAKER_00: Well, thanks, Kim.
• 18:19
  SPEAKER_00: It's been a privilege to be able to work with you.
• 18:21
  SPEAKER_00: We've grown together in so many different ways with our practices and knowing one another.
• 18:26
  SPEAKER_00: So um it's you know, cheers for the next 10 years again, and uh congratulations.