Latest / Skin Anarchy / Beyond Fillers: The Future of Regenerative Aesthetics with Dr. Shino Bay Aguilera

Transcript

Beyond Fillers: The Future of Regenerative Aesthetics with Dr. Shino Bay Aguilera · Skin Anarchy

• 0:00
  SPEAKER_00: Hey guys, welcome back to another episode of Skin Anarchy.
• 0:02
  SPEAKER_00: I am so so excited about this episode.
• 0:04
  SPEAKER_00: We have a true icon with us today.
• 0:07
  SPEAKER_00: I am so excited to be hosting him.
• 0:08
  SPEAKER_00: He is such an influential figure in aesthetic medicine.
• 0:12
  SPEAKER_00: He is truly a leader in the space and you know really understands, in my opinion, aesthetics in a way that very rarely we see in how things are playing out these days.
• 0:21
  SPEAKER_00: So without further ado, please welcome Dr.
• 0:23
  SPEAKER_00: Shino Be Aguiler.
• 0:24
  SPEAKER_00: Welcome, Dr.
• 0:25
  SPEAKER_00: Aguiler.
• 0:25
  SPEAKER_00: So honored to host you.
• 0:27
  SPEAKER_01: Thank you.
• 0:27
  SPEAKER_01: The honor is mine.
• 0:28
  SPEAKER_01: Thank you for having me.
• 0:30
  SPEAKER_00: No, it's it's so wonderful to host you because I have so many questions for you.
• 0:34
  SPEAKER_00: First of all, um, you know so much.
• 0:36
  SPEAKER_00: And um, you know, I I want to dive into that, but I would love to start by learning about you because your story is so unique and you know how you've established your career, how you've built your career.
• 0:45
  SPEAKER_00: What made you go into medicine?
• 0:46
  SPEAKER_01: Oh, well, since I was five years old, I knew I wanted to be a doctor.
• 0:51
  SPEAKER_01: I uh I grew up in Panama, City Panama, on the poverty and terrible conditions.
• 0:56
  SPEAKER_01: I also had asthma as a child.
• 0:58
  SPEAKER_01: So I think I almost died three times because on my asthma attack happened like in the middle of the night, like two, three in the morning.
• 1:06
  SPEAKER_01: And uh we we don't have money, so we have to wait for the bus to get me to the hospital.
• 1:11
  SPEAKER_01: You know, at three in the morning, the the bus, they're not operating as fast, or the schedule is not as frequent as during the day because there's nobody on the street at that time.
• 1:22
  SPEAKER_01: So, you know, we had to wait for the bus.
• 1:24
  SPEAKER_01: And I remember having days where I had this what we call agonic breathing that I was with my head on the window and I was, you know, gasping for air, just so weak.
• 1:34
  SPEAKER_01: And then I remember that every time, you know, they got me in the emergency room, they would rush me in and they gave me a shot of adrenaline, which it opened my bronchios, but my heart started racing.
• 1:45
  SPEAKER_01: I I feel this horrible fear, but it was the adrenaline, but it was such a weird feeling.
• 1:50
  SPEAKER_01: But and then I just admired that kind of work and how great I would feel after they gave me oxygen and kept me in the hospital.
• 2:00
  SPEAKER_01: And then uh I also, because of hygiene, when you grow poor, hygiene is not as high, I guess.
• 2:07
  SPEAKER_01: I would get boils and abscesses on my face, and and then um that's when I learned that how the way my skin looked like it dictated the way I would feel that day.
• 2:20
  SPEAKER_01: And how people would treat me.
• 2:22
  SPEAKER_01: So I remember having these boils on my face, carbonko for uncles.
• 2:28
  SPEAKER_01: And I grew up poor, so when you pour, they send you to the cafeteria, and I hated that because even though I was poor, I didn't feel poor, and I didn't want anybody to treat me poor.
• 2:37
  SPEAKER_01: Or know that was poor.
• 2:39
  SPEAKER_01: I don't know.
• 2:39
  SPEAKER_01: I just grew up, you know, I always see this meme in social media of this baby just recently born, and he's looking with the eye like, what the hell did I recognise into?
• 2:51
  SPEAKER_01: Like, I don't belong here.
• 2:53
  SPEAKER_01: I think that was me.
• 2:54
  SPEAKER_01: Because it was little, I just felt like I don't belong here.
• 2:58
  SPEAKER_01: I don't think, you know, I didn't even speak like other people.
• 3:01
  SPEAKER_01: I was always very refined.
• 3:03
  SPEAKER_01: So I just remember going to the cafeteria with my boils, and people would look at me with disgust.
• 3:10
  SPEAKER_01: And then they would move away from the table.
• 3:12
  SPEAKER_01: And I couldn't blame them.
• 3:13
  SPEAKER_01: So I understood because I also was disgusted with myself, but but it still hurt my feelings, and I would feel so miserable and so horrible.
• 3:23
  SPEAKER_01: And I just said, I want to be the kind of doctor that can help people physically and emotionally.
• 3:29
  SPEAKER_01: I would say that being very young, but I didn't know what that meant until medical school.
• 3:35
  SPEAKER_01: I took my first class in dermatology, and then I felt like I arrived.
• 3:41
  SPEAKER_01: Like this is who I was meant to be all these years.
• 3:44
  SPEAKER_01: So I prepared myself.
• 3:46
  SPEAKER_01: My grandma lived behind bookstore, and they would throw articles and drama and the Journal of America in medicine, and then I would see the world UCLA, UCLA.
• 3:57
  SPEAKER_01: So I say, I'm gonna go to the United States and go to UCLA.
• 4:00
  SPEAKER_01: That's my dream.
• 4:02
  SPEAKER_01: And I just prepare myself since age five to be a doctor from the United States.
• 4:07
  SPEAKER_00: Wow, that is so inspiring.
• 4:09
  SPEAKER_00: That like, I mean, it's like I I feel like when you ask doctors like what got you into medicine, it's like there's this like something happens in their life, you know, and that's so inspiring to hear.
• 4:19
  SPEAKER_00: Like you knew, like a part of you always knew, like I meant to do this.
• 4:23
  SPEAKER_00: That's really inspiring.
• 4:24
  SPEAKER_00: And you know, it what you said really resonates with me about how people like what you look like, it affects so much here, and it affects so much of like what we do in the world.
• 4:35
  SPEAKER_00: And I would love for you to speak about this because this is a part of aesthetics that I think never gets spoken about, right?
• 4:40
  SPEAKER_00: Is this idea of like the true psychology of aesthetics and what makes consumers make the decisions that we make, what makes us go and get the aesthetic treatments that we get.
• 4:50
  SPEAKER_00: I would love your insight here.
• 4:51
  SPEAKER_00: It's like when you when you talk to patients, like what do you think is really driving them?
• 4:55
  SPEAKER_01: We, you know, we have evolved, but we still have this reptilian primitive brain that always scan for the best genetics for to have offsprings that are going to thrive in the world.
• 5:09
  SPEAKER_01: And we don't think about it, but our subconscious minds always thinking about that.
• 5:14
  SPEAKER_01: And I learned that when I was doing dermatology, and there's a branch that we had to study called genodermatosis.
• 5:21
  SPEAKER_01: And there are different diseases like Pachionica congenital and things that you don't even hear anymore.
• 5:28
  SPEAKER_01: And from time to time, at least I had the opportunity to see a few of these cases of genodermatosis that you just read in books, but they don't exist anymore because evolution has weak them out by natural selection.
• 5:40
  SPEAKER_01: So, but interestingly, all these diseases that you can pass on genetically to your offsprings, they all have very similar characteristics.
• 5:51
  SPEAKER_01: It's like they all look kind of alike.
• 5:53
  SPEAKER_01: It's like the only one that we can recognize now and people will disturb is Down syndrome.
• 5:59
  SPEAKER_01: No matter what race you are, you look at a child and you could see that they have these certain faces or characteristics, facial, and in the heart, and all the things that you just at glance you could say, oh, this is a kid that has Down syndrome.
• 6:14
  SPEAKER_01: Um, well, this other genodermates, they have problem with the way the skin looks, the way the hair looks like kinky hair, peck teeth, nails.
• 6:23
  SPEAKER_01: So that's why hair, nails, skin, teeth industry, a multi-billion dollar industry, because our reptilian brain is always looking at the skin, at your hair, at your nails to get messages of your health and you not only your physical health, but what you have that can pass on to our offspring.
• 6:47
  SPEAKER_01: Even though you're not thinking, oh, I want to have sex with this person, I have kids with that.
• 6:50
  SPEAKER_01: No, but we for us skin is so important, and hair is so important because it advertised youth, beauty, and fertility.
• 6:59
  SPEAKER_01: So that's why it's a multi-billion dollar industry.
• 7:02
  SPEAKER_01: So the skin is so important, and and you know, like I remember when I got older and I came to the United States, I worked as a male model just to make money.
• 7:11
  SPEAKER_01: I mean, I have all the od jobs, like I washed dishes, I was a male model, work in the work in the morgue, work in a histology lab.
• 7:18
  SPEAKER_01: I did everything and multiple jobs because I had to support myself through school.
• 7:23
  SPEAKER_01: I mean, I didn't have scholarships, I didn't have uh my parents who helped me, so everything.
• 7:28
  SPEAKER_01: I did it on my own.
• 7:29
  SPEAKER_01: So yeah, I worked for there was no Photoshop.
• 7:31
  SPEAKER_01: So if you go to a casting and there's 20 guys and there's five Dar Latino like me, and I have pimped, it costs money to retouch photos.
• 7:41
  SPEAKER_01: It's not like now you could use AI or Facebook.
• 7:44
  SPEAKER_01: At that time, people would do it by hand.
• 7:46
  SPEAKER_01: So, of course, they're not gonna pick the guy that is gonna cost extra money.
• 7:50
  SPEAKER_01: They get the guy with good skin.
• 7:52
  SPEAKER_01: So, you know, I remember being sent to cast it, but I would just skip it because I go, I cannot show my face like that.
• 7:59
  SPEAKER_01: And I would get a big pimple on my nose before a date.
• 8:03
  SPEAKER_01: And of course it had to happen before a date, and then it ruined my whole life was ruined because I could not go, you know, to a date with a pimple on my nose on the middle of my face.
• 8:13
  SPEAKER_01: So I learned really quickly that the way my skin looked like affected my mood and it dictated my whole day.
• 8:21
  SPEAKER_01: And it's it wasn't vanity, it's like we cannot escape from that because we feel that we are getting judged by the quality of our skin.
• 8:29
  SPEAKER_01: And guess what?
• 8:30
  SPEAKER_01: We are being judged by the quality of the skin.
• 8:33
  SPEAKER_01: Whether it is conscious or subconsciously, people are looking at your skin.
• 8:38
  SPEAKER_01: That's why if you see somebody with super beautiful skin, immediately you're like, wow, look at the skin.
• 8:44
  SPEAKER_01: I wish I had a skin.
• 8:46
  SPEAKER_01: What are you using?
• 8:48
  SPEAKER_01: It is, you know, we care what our skin looks like.
• 8:51
  SPEAKER_01: And the same thing with my hair.
• 8:52
  SPEAKER_01: I mean, I think I spend most of my money on my hair because my hair does not look like this.
• 8:58
  SPEAKER_01: I have pinky curly hair.
• 9:00
  SPEAKER_01: And I I work hard in keeping it looking shiny and healthy, but because I he also I feel like it's my superpower.
• 9:08
  SPEAKER_01: If my hair looks good, I feel that I look good, you know?
• 9:10
  SPEAKER_00: Yeah, no, I really like I like your view on this because I think sometimes people just they say things like, you know, it's all vanity and aesthetics, and you know, it's all about, but it's like, it's not.
• 9:21
  SPEAKER_00: Like, we're all thinking this.
• 9:23
  SPEAKER_00: Like, you know, let's be honest for a minute and stop pretending like we don't look in the mirror, you know what I mean?
• 9:29
  SPEAKER_00: Like, and I and I hear this argument and just makes me go, like, come on, you know, like, uh, yeah, okay, it's a billion-dollar industry, but at the same time, it's because we want it to be a billion-dollar industry.
• 9:38
  SPEAKER_00: It's not because it's it's random, you know?
• 9:40
  SPEAKER_00: So that's very interesting what you're saying.
• 9:42
  SPEAKER_00: I I like your honesty there.
• 9:43
  SPEAKER_00: But I want to ask you because you are at the absolute forefront of, you know, innovation in this industry.
• 9:50
  SPEAKER_00: I mean, you really are, I think, you know, everybody understands that you are a leader in the space and you understand that there are so many emerging technologies right now, more than ever before, things like biotechnology, things like regenerative aesthetics, you know, so much is coming up, longevity is coming up.
• 10:04
  SPEAKER_00: What are your thoughts on where we're headed in aesthetics?
• 10:07
  SPEAKER_00: Do you think a lot of it is hype, or do you think that there is a lot of science that is just being it's not understood yet, but there's a lot of potential?
• 10:14
  SPEAKER_01: Oh, yeah, I mean, I mean, there's tons of science.
• 10:17
  SPEAKER_01: Uh, it's evolution.
• 10:18
  SPEAKER_01: Like everything evolves.
• 10:19
  SPEAKER_01: I give a lecture, it talks about the history of bioreative medicine, which started 300 BC with the Egyptians.
• 10:27
  SPEAKER_01: I mean, the earliest recollection of lactic acid, which is basically what's called tra S, it was with Cleopatra, with her lac milk bath.
• 10:36
  SPEAKER_01: So she had the most beautiful skin of anyone during that era because lactic acid is a good exfoliant and the milk had lepids that probably nourish the skin.
• 10:46
  SPEAKER_01: So, of course, you compare her with somebody that was out there carrying the rocks to make the pyramids, she probably had the most beautiful skin.
• 10:54
  SPEAKER_01: Moves forward with Dr.
• 10:56
  SPEAKER_01: Chushutra, who is the father of surgery in India, 600 BC.
• 11:02
  SPEAKER_01: He actually created this technique that to this day we use in dermatology, those people that do most surgery, which is the frontal flap, where they take the skin from your forehead and twist it and attach it to your nose because it will reconstruct the nose.
• 11:17
  SPEAKER_01: We do that technique on people that lose their nose from skin cancer.
• 11:21
  SPEAKER_01: Um, so it's still used and it's 600 BC, invented by Dr.
• 11:26
  SPEAKER_01: Chuchutra in India.
• 11:27
  SPEAKER_01: In India, if you did something bad, one of the punishments was that they would cut your nose.
• 11:32
  SPEAKER_01: So you know that doctors, true doctors, true healers, the ones that get into medicine because they have a calling, uh, not because mom and dad wants you to be one or because you can make good money or you have a good status.
• 11:44
  SPEAKER_01: Good healers do compassionate things.
• 11:46
  SPEAKER_01: And he was a true healer.
• 11:48
  SPEAKER_01: So he created this technique to help those people that were mutilated for something that they did wrong in the past to give him to remove that deformity and give him a better sense of pride and feel better about themselves when they show up out in public.
• 12:03
  SPEAKER_01: So then you move to the 1800s where doctors were trying to play with fat grafting and skin crafting because they saw a need for that, but the techniques were not that great, you know.
• 12:15
  SPEAKER_01: 1800, they're not gonna get great techniques and technology to make that survive.
• 12:20
  SPEAKER_01: Then during World War I, then a lot of doctors were pushed to be able to find techniques to help these 18-20-year-old kids that went to war and got mutilated or the face blow blown up by a bomb.
• 12:33
  SPEAKER_01: So there's a lot of people during that era that is starting to get great results with fat grafting and using prosthesis and stuff like that out of necessity.
• 12:44
  SPEAKER_01: And then we kept moving forward and moving forward, and then we find later, like 1981, this the embryonic temp cell first, and then we move to 2003, and then we have Restalin.
• 12:57
  SPEAKER_01: And then 2006, when they found the pluripotent cells, you know, the same year they launched Juvenil.
• 13:03
  SPEAKER_01: And then I feel like at least in aesthetics, after 2006, until very recently, we, very smart people, decided that it was a great idea to replace every single human tissue on the face that was imploding with the passing of time because aging is an implosion of tissue.
• 13:24
  SPEAKER_01: Replace it with a synthetic gel that came out of a machine and expect people to look normal after 5, 10, 20 years of using it.
• 13:34
  SPEAKER_01: So that's why since 2009 I've been very vocal.
• 13:37
  SPEAKER_01: I'm not a hypocrite, I use fillers, and it's my bread and butter, but I use it for beautification, enhancement, and structural support, not to replace all of the human tissue.
• 13:49
  SPEAKER_01: And to this day, there was such a resistance to it that to this day you go to a met spot and that's all they have to offer.
• 13:56
  SPEAKER_01: Gels, not fat matrices and collagen stimulator and preserve the architecture of the bone, which I've been doing since 2009.
• 14:05
  SPEAKER_01: Um but this is I feel like this is my time because back in the day I feel like I was just a lone star with a few colleagues all around that believe in what I believe, which using a sculpt to preserve the architecture of the bone and stimulate fat.
• 14:20
  SPEAKER_01: But since we're clinicians, we are not scientists, we did not have a way to speak intelligently about.
• 14:28
  SPEAKER_01: I can only report what I was seeing.
• 14:29
  SPEAKER_01: And there was not a lot of work on this subject.
• 14:32
  SPEAKER_01: Now we can tell you at a gene level and string gene analysis, everything that happens when you inject scultra in a tissue can be explained.
• 14:41
  SPEAKER_01: Anything that you see clinically, I can explain it to the cellular and genetic level.
• 14:47
  SPEAKER_01: So we live in different times where there's science.
• 14:50
  SPEAKER_01: So I'm just so grateful that now we have this opportunity to get younger instead of just fake younger for a finite period of time before you start looking weird.
• 15:01
  SPEAKER_01: Because you cannot look human if all you have in your head is a synthetic gel to replace every single tissue.
• 15:08
  SPEAKER_01: You don't need to be this rocket scientist to know that it I call that transhumanism in aesthetics, where we replace everything with synthetics.
• 15:17
  SPEAKER_00: Yes, I would love for you to speak more about that because that is the real conversation.
• 15:22
  SPEAKER_00: No one wants to talk about this.
• 15:24
  SPEAKER_00: And you know, this multifactorial approach to aesthetics, I mean, it's it's like as if we're reinventing, people are acting like we're reinventing something or not not reinventing, we're inventing something for the first time.
• 15:34
  SPEAKER_00: But if you look at medicine, exactly what you said across disciplines in medicine, it has to be this holistic approach.
• 15:40
  SPEAKER_00: You have to understand, like you said, the bone, all of the tissues, all of the different layers.
• 15:44
  SPEAKER_00: And if you don't understand that, if you don't understand muscles, and you keep there's no way, you know, there's no way you can understand the human body.
• 15:51
  SPEAKER_00: And so, I mean, I would love for you to talk a little bit more, if you don't mind, about this understanding.
• 15:55
  SPEAKER_00: And where do you think we're lacking with the education component when it comes to teaching our future physicians?
• 16:01
  SPEAKER_01: Well, so I think that just understanding that aging is architectural changes and they are changes that are predictable according to what decade you are.
• 16:09
  SPEAKER_01: So I just I'm in charge of three important meetings and the medical director, one is Beauty to Science, Stockholm, Sweden.
• 16:16
  SPEAKER_01: Uh, I have two co-directors of your RC from Israel and Patricia Ogebit from Munich, Germany.
• 16:22
  SPEAKER_01: We do a great job creating a very strong scientific program.
• 16:26
  SPEAKER_01: I mean, everybody wants to speak there, but not everybody gets to speak at Beauty to Science because usually it's the best of the best in each country, and it is really hard every year to give the opportunity, but I scout brilliant people out there uh to bring to E the BTS.
• 16:41
  SPEAKER_01: And now in the United States, I have Genesis.
• 16:43
  SPEAKER_01: Uh, that this was his third year.
• 16:46
  SPEAKER_01: And uh in Genesis, I invite scientists and I invite the whole industry as well because I want them to be in the room, everyone.
• 16:53
  SPEAKER_01: I made it like a giant advisory board for industry so we all learn together because my agenda is to move the industry together as a community where we can support each other and learn from each other because the benefit is for the patient, right?
• 17:09
  SPEAKER_01: That's the whole idea.
• 17:11
  SPEAKER_01: So, what we see is that if you can predict what happened in certain decades, then you can be a few steps ahead of these changes.
• 17:18
  SPEAKER_01: So from 80 to late 30s or 40s, you lose endogenous hyaluronic acid.
• 17:24
  SPEAKER_01: Endogenous hyaluronic acid then affects the production of collagen because hyaluronic acid is a family, it's not just one entity of all these sugars that is on the skin.
• 17:35
  SPEAKER_01: And it's not for hydration only or structural support.
• 17:39
  SPEAKER_01: According to the size of it, it is a signaling molecule that attaches to receptors on cells.
• 17:45
  SPEAKER_01: So if you are a large molecule with hyaluronic acid, you cannot say, everybody, quiet, everything's perfect, make collagen, may lost the fiber, we're doing great.
• 17:54
  SPEAKER_01: If you are a small, tiny molecule of hyaluronic acid, it's an alarm.
• 17:58
  SPEAKER_01: Oh my god, we need immune cells here.
• 18:01
  SPEAKER_01: It's just it creates inflammation.
• 18:04
  SPEAKER_01: So depending on the size, it communicates something.
• 18:06
  SPEAKER_01: It's a signaling molecule.
• 18:08
  SPEAKER_01: So if as you're getting older and you're not having enough of the signaling molecules that is hyaluronic acid, then your fibroblasts are not thriving, and then you you lose about 1 to 2% of collagen a year.
• 18:20
  SPEAKER_01: By the time you're 40, 45, you lost 25% of the collagen on your skin, and that's why you see saggy skin.
• 18:26
  SPEAKER_01: That's like you don't do anything.
• 18:28
  SPEAKER_01: If you take care of yourself, you will not see that so early.
• 18:31
  SPEAKER_01: Then you enter the 40s, and the 40s now there's a different implosion.
• 18:35
  SPEAKER_01: You know, the first one implosion was skin dermis.
• 18:38
  SPEAKER_01: Now we start losing the fat on our face.
• 18:40
  SPEAKER_01: Then you don't look as fresh as 30s and 20s, but you don't look elderly.
• 18:45
  SPEAKER_01: You just look gone, sickly, tired, like an osempic face now, right?
• 18:50
  SPEAKER_01: Then you enter the 50 and then you get bone loss, bone remote.
• 18:54
  SPEAKER_01: The bones start to shrink from the inside out.
• 18:58
  SPEAKER_01: And when that happens, you start looking more elderly.
• 19:01
  SPEAKER_01: You start looking like the elderly version of yourself.
• 19:05
  SPEAKER_01: And then you get to 60, and everything that I mentioned happened, but also you fashion against looser and looser.
• 19:10
  SPEAKER_01: And that's why you need a facelift.
• 19:12
  SPEAKER_01: So, for example, at Genesis, we had this great longevity doctor.
• 19:16
  SPEAKER_01: He explained it this way: when you're getting older, you and he used the analogy of a train, you know, a choo-choo train with cards.
• 19:24
  SPEAKER_01: And he said, when you as you age every year, you jump to a different cart and you move to another cart.
• 19:30
  SPEAKER_01: But there's two sports of rapid aging, from 40 to 45 and from 60 to 65.
• 19:36
  SPEAKER_01: So in the first sport, 40 to 45, you jump five cars instead of one.
• 19:41
  SPEAKER_01: That's why you're like, oh my god, what the hell happened to me?
• 19:44
  SPEAKER_01: And then at 60 to 65, you jump another five car, and you see yourself, you at the bureau, you're not recognizing yourself if you didn't do anything.
• 19:54
  SPEAKER_01: So that's why, like, this year I'm 58.
• 19:56
  SPEAKER_01: At 59, I'm gonna do this.
• 19:58
  SPEAKER_01: So I wanna dodge the.
• 20:00
  SPEAKER_01: I don't wanna jump five cars, I just wanna jump one.
• 20:03
  SPEAKER_02: Yeah, yeah.
• 20:04
  SPEAKER_01: I know what's coming, you know.
• 20:05
  SPEAKER_01: But I've been doing sculptures to preserve the architecture of my bone since I was 37, and pretty much I have changed very little.
• 20:13
  SPEAKER_01: And so have every patient that believed me around that time, 2004-2009, that if they chose to do sculptures with me on the bone, the technique that I developed, and were patient because there we go, but my friend Susie, just the fillers, and she looks good now.
• 20:29
  SPEAKER_01: I wanna look good now, not in two months.
• 20:32
  SPEAKER_01: And I will say, you have to trust me.
• 20:34
  SPEAKER_01: And if you trust me, I'm not doing this for two months from now or two years from now, I'm doing this for 20 years from now.
• 20:40
  SPEAKER_01: And if you do this 20 years from now, you're still gonna look pretty much what you look like right now.
• 20:46
  SPEAKER_01: And guess what?
• 20:47
  SPEAKER_01: I deliver.
• 20:48
  SPEAKER_01: Now I have the photos, I have the my patients' testimonials, the way they look, the way my family looks, my friend looks.
• 20:55
  SPEAKER_01: We all look 15 to 20 young years younger or chronological age.
• 21:00
  SPEAKER_01: And we don't do much, we don't do much.
• 21:02
  SPEAKER_01: We just do once a year's cultural bone, and now I did fat uh matrices, renewables because you know, I started to lose the fat on my face because I'm closer to 60, you know, so it happens.
• 21:13
  SPEAKER_00: Yeah, that's so fascinating because that's like the definition of longevity.
• 21:17
  SPEAKER_00: And I feel like right now, when I look at the industry, right, I look at the longevity space and especially with aesthetics.
• 21:23
  SPEAKER_00: A lot of people are talking about, okay, bombard your body with a bunch of supplements, you know, like take like glutathione and take the CoQ10 and take all of these things.
• 21:32
  SPEAKER_00: But no one's talking about what you just explained.
• 21:35
  SPEAKER_00: They're not explaining that there are these phases where you're losing different tissues and you have to kind of get ahead of that curve.
• 21:42
  SPEAKER_00: I would love to get your advice for somebody who's say 25 years old.
• 21:45
  SPEAKER_00: What do you think the most beneficial thing you can do in your 20s is that's going to preserve you when you hit that 40 year mark?
• 21:52
  SPEAKER_01: Well, the number one thing is don't do what I did as a young person that tried to be proactive.
• 21:58
  SPEAKER_01: The first thing is when you're 20.
• 22:00
  SPEAKER_01: You are young.
• 22:02
  SPEAKER_01: Being proactive is not trying to do things that you don't need.
• 22:07
  SPEAKER_01: So that's why you need to go to a provider that is honest, that's gonna guide you through the journey.
• 22:13
  SPEAKER_01: I mean, I say back in the day, most of my patients are not that young.
• 22:17
  SPEAKER_01: The young patients go to the young doctors, but I I trained them.
• 22:21
  SPEAKER_01: So yeah, the first thing you should do as a 20-year-old, don't think that being proactive means that you need to start doing fillers and sculptra and everything that I teach and talk about if you don't need it.
• 22:34
  SPEAKER_01: At that age, you heard me, you have architecture changes of the skin.
• 22:38
  SPEAKER_01: So please protect your skin, stimulate the skin, have the skin look better with treatments.
• 22:46
  SPEAKER_01: You don't need anything that is very aggressive, a control in your aggressive gentle things if your skin is breaking out, you know, find a dermatologist, do things that is going to give you the best skin you have.
• 22:59
  SPEAKER_01: If by any chance genetically or you decided to run, or now we've seen this young, uh, you were an over you were overweight and you've been doing uh GLP once and your face has lost volume and you look older and gone.
• 23:13
  SPEAKER_01: Yes, you do need, you know, injectable fillers or or bioreactive techniques, but only if you need it.
• 23:19
  SPEAKER_01: But if you look young and everything looks beautiful, just use them to enhance your beauty, but not to replace your tissue.
• 23:26
  SPEAKER_01: So that's number one.
• 23:28
  SPEAKER_01: But they need to be taking care of the skin.
• 23:30
  SPEAKER_01: Don't abuse the sun, don't smoke, get good rest.
• 23:33
  SPEAKER_01: Things that will be beneficial for the skin.
• 23:36
  SPEAKER_01: Your skin, your skin at 50 will thank you what you did during your 20s.
• 23:41
  SPEAKER_00: That makes sense.
• 23:42
  SPEAKER_00: And you know, this is a perfect segue because I have so many questions about skincare.
• 23:46
  SPEAKER_00: And I know that right now, skincare is booming.
• 23:48
  SPEAKER_00: You know, we have so many ingredients, so many biotech ingredients.
• 23:51
  SPEAKER_00: I'm sure you've seen the exosome buzz.
• 23:53
  SPEAKER_00: You know, everybody wants to understand exosomes.
• 23:55
  SPEAKER_00: What do you think is the most promising emerging ingredients right now in skincare?
• 24:00
  SPEAKER_00: Um, especially for like the topical everyday use.
• 24:03
  SPEAKER_01: Well, there's that mean there's so many things I can't tell you.
• 24:06
  SPEAKER_01: There's new new hyaluronic acid that are conjugated with this protocol.
• 24:13
  SPEAKER_01: Can I say brands?
• 24:15
  SPEAKER_00: Yeah, of course.
• 24:15
  SPEAKER_00: Of course.
• 24:16
  SPEAKER_01: Okay, so it's from skin better called AMPRA.
• 24:19
  SPEAKER_01: And AMPRA is conjugation of alpha-lipoic acid with hyaluronic acid.
• 24:23
  SPEAKER_01: By doing this, you have this ambivalent molecule that works as both hyaluronic acid that penetrates the skin and antioxidant.
• 24:32
  SPEAKER_01: So it prevents the breakdown of the hyaluronic acid and it allows for the production of u endogenous on hyaluronic acid.
• 24:40
  SPEAKER_01: I find that molecule very interesting and incredible.
• 24:43
  SPEAKER_01: There is heparum sulfate.
• 24:44
  SPEAKER_01: You know, everybody talks about hyaluronic acid, but the before hyaluronic acid, there is heparum sulfate, which is a different molecule of glycosaminoglycase that has similar functions.
• 24:57
  SPEAKER_01: It provides hydration, work as a signaling molecule, give structural support.
• 25:01
  SPEAKER_01: That molecule is so large, so they created a version of it that's needle-like, that penetrates the skin through like as it's a needle, and it provides all this amazing moisturization to the skin.
• 25:14
  SPEAKER_01: The two products that I'm really excited about right now that exist because there are some of them that exist, but they haven't they're coming down the pipeline.
• 25:23
  SPEAKER_01: I'm talking about as uh products that work rescuing all their cells to become zombie cells, sense cells.
• 25:31
  SPEAKER_01: And we'll talk about that uh in a little while because I'm very passionate about this subject of zombie cells.
• 25:36
  SPEAKER_01: I don't know, you see me in social media that I create a huge production with thriller.
• 25:41
  SPEAKER_01: I'm about to to do the second part of that, which is called zombie boy.
• 25:46
  SPEAKER_01: I like to bring, I don't know, it's not a lot of people say, well, you're doing this to bring attention to you.
• 25:51
  SPEAKER_01: No, I don't like attention.
• 25:52
  SPEAKER_01: I like to be creative and I like to make a lecture come alive.
• 25:56
  SPEAKER_01: And I want everybody to feel it, to understand it even before I get up and hit them with all the signs.
• 26:03
  SPEAKER_01: And I get criticized a lot for doing that, but you know what?
• 26:06
  SPEAKER_01: I don't care because I enjoy the process and I know that when people are in the room and experience that, I feel the joy, and I feel that they're getting it and that they get me.
• 26:16
  SPEAKER_01: So let the critics criticize me.
• 26:19
  SPEAKER_01: I think the whole process is something that I enjoy from the creation of the PowerPoint to big bring the whole lecture alive with real zombies in the audience and dance, and you know, I like that process.
• 26:34
  SPEAKER_01: So there's a product called Riku, and the ingredient is RLX201, and it rescues our cells from turning into zombie cells.
• 26:44
  SPEAKER_01: And that's one of the products that the most excited.
• 26:47
  SPEAKER_01: And the other one is a product created by two dear friends, Sabrina Favy, she's a dermatologist, and Dr.
• 26:52
  SPEAKER_01: Steve Diane, plastic surgeon, and his XOMD.
• 26:56
  SPEAKER_01: And they send me, they send it to me.
• 26:58
  SPEAKER_01: I was skeptical.
• 26:59
  SPEAKER_01: It has an oxytoxin like molecule and it has pheromones.
• 27:02
  SPEAKER_01: And they sent it to me to try, and of course, like okay, oxytocin pheromone.
• 27:06
  SPEAKER_01: It sounds great.
• 27:07
  SPEAKER_01: Everybody loves a nice hug feeling, but they claim that it made people treat you differently, and and also you see yourself more attractive.
• 27:16
  SPEAKER_01: So I tried it as an experiment, not expecting anything, and it does work.
• 27:21
  SPEAKER_01: I think when I wear it, I get so much attention, and even I think that I look good on photo.
• 27:27
  SPEAKER_01: I go, wow, I really look.
• 27:29
  SPEAKER_01: So I love the product, it is incredible, and they compare it to estrogen cream, yeah, and it performs equally to estrogen cream because a lot of patients are using estrogen cream, but you know, estrogen cream biodential, they're usually supposed to put one centimeter and rub it.
• 27:47
  SPEAKER_01: We I know patients that they get and they rub the whole face, neck, and chest.
• 27:51
  SPEAKER_01: That's a large area to use a hormone.
• 27:54
  SPEAKER_01: So we worry about potential bad side effects with cancer.
• 27:59
  SPEAKER_01: So breast cancer for abusing it.
• 28:01
  SPEAKER_01: No, they're not using one centimeter to do all this area, they're putting more than they're supposed to.
• 28:05
  SPEAKER_01: So it's nice to have an alternative that works just as good as estrogen cream, but it's safe.
• 28:11
  SPEAKER_01: Also makes you feel cute and attractive, and everybody else around you, you know.
• 28:16
  SPEAKER_01: I just was hit on by five little 18-year-olds in Panama.
• 28:20
  SPEAKER_01: I thought they were after my two nephews that are very good looking, and they're 22 and 19.
• 28:25
  SPEAKER_01: No, they wanted to know who I was.
• 28:27
  SPEAKER_01: And I go, I could be your grandpa.
• 28:29
  SPEAKER_01: I could, I could literally have a 35-year-old son right now, and you could be my grandchild.
• 28:34
  SPEAKER_01: So you go and talk to these boys right here.
• 28:37
  SPEAKER_01: So those are the two the two ones that I enjoy.
• 28:40
  SPEAKER_00: I love that.
• 28:40
  SPEAKER_00: No, I know I know the brands you're talking about.
• 28:42
  SPEAKER_00: XOMD is amazing.
• 28:43
  SPEAKER_00: Like I am obsessed with the brand.
• 28:45
  SPEAKER_00: We gave them uh science of skin this year because it's just it's just such a good brand.
• 28:50
  SPEAKER_00: So much like well-thought-out science.
• 28:52
  SPEAKER_00: So I love that you gave that shout-out.
• 28:53
  SPEAKER_00: I I know exactly what you mean.
• 28:55
  SPEAKER_01: I love it.
• 28:55
  SPEAKER_01: I love it.
• 28:56
  SPEAKER_01: I love the way I feel when I'm wearing it, and I love the attention that I get when I when I wear it.
• 29:01
  SPEAKER_01: So I I don't want to waste it at night.
• 29:04
  SPEAKER_01: Usually I don't want to waste it with the bed.
• 29:07
  SPEAKER_01: Nobody's gonna see me unless something magical is gonna happen in the bedroom.
• 29:11
  SPEAKER_01: I don't want to use it.
• 29:13
  SPEAKER_00: I like that.
• 29:14
  SPEAKER_00: I like that answer.
• 29:15
  SPEAKER_00: No, I you know, I I want to ask you because I know, I mean, you see so many brands, right?
• 29:19
  SPEAKER_00: Like you you've seen uh so many brands, so many technologies that come out.
• 29:23
  SPEAKER_00: In your experience, what do you think it takes these days for a product to really stand out in the market?
• 29:29
  SPEAKER_00: Because we have so much now, you know, like the the market is saturated more than ever, especially for consumer products.
• 29:36
  SPEAKER_00: And you know, I always wonder, like from the your perspective, like where when do you pause and say, okay, you know, this is interesting science?
• 29:44
  SPEAKER_00: Like I haven't seen this one before.
• 29:45
  SPEAKER_00: Like, like, what are those moments like for you?
• 29:48
  SPEAKER_01: Yeah, I mean, I'm grateful that because my time in the industry, um, me being very vocal about bioriented telecomedicine since 2009, I get invited a lot to advisory boards.
• 30:00
  SPEAKER_01: I mean, literally every day I don't even have lunch anymore because I have a meeting at 12:30 with companies.
• 30:06
  SPEAKER_01: Everybody pitched me their products, everybody wants me to be in the advisory boards and talk, and uh what starts out is innovation, molecules that are different.
• 30:17
  SPEAKER_01: It's not something that is being just recycled with a different spin.
• 30:22
  SPEAKER_01: I want something truly new, noble, and it has the science behind it.
• 30:27
  SPEAKER_01: So it needs to have studies to support, and I want to see before and after, and I want to see histology slides and anything ultra sound.
• 30:36
  SPEAKER_01: I wanna see everything that tells me that I am not just biostimulating.
• 30:43
  SPEAKER_01: The difference before the between biostimulation and bioregeneration.
• 30:47
  SPEAKER_01: I want bioregeneration, I want to see the skin looking like a normal, functional, healthy, younger version of itself.
• 30:57
  SPEAKER_01: I don't want to see an arrow collagen and it doesn't look like normal skin.
• 31:01
  SPEAKER_01: And there's things that I can look on a slide, a histological slide.
• 31:04
  SPEAKER_01: For example, somebody young, uh, they have these imaginations on the skin, though, where the skin cells are, we call keratin cells.
• 31:11
  SPEAKER_01: We call that red regions.
• 31:12
  SPEAKER_01: It's just to the imagination.
• 31:13
  SPEAKER_01: Somebody might age there is flat.
• 31:15
  SPEAKER_01: It's like this, like a knob all throughout the skin.
• 31:18
  SPEAKER_01: And if you see that you get those imaginations again, well, that skin has gotten younger because you don't expect to see that.
• 31:25
  SPEAKER_01: Somebody my age.
• 31:27
  SPEAKER_01: Uh, does it look normal or does it look like tons of collagen everywhere?
• 31:31
  SPEAKER_01: Are they going the right direction?
• 31:33
  SPEAKER_01: You know, an isotropic with cold.
• 31:34
  SPEAKER_01: So all these things are important for me.
• 31:36
  SPEAKER_01: So I want to see anything that they can show me on slides.
• 31:40
  SPEAKER_01: And now I want to see gene upregulation.
• 31:43
  SPEAKER_01: Like, I don't just want to see a histological slide.
• 31:45
  SPEAKER_01: Let me see what gene you upregulate.
• 31:48
  SPEAKER_01: Uh expensive, but if the company is willing to invest that kind of money to show upregulation, what genes got turned on and which one get turned off.
• 31:56
  SPEAKER_01: We can do that now.
• 31:57
  SPEAKER_01: I I look for that.
• 31:58
  SPEAKER_01: Companies that spend the money to give me all those answers.
• 32:02
  SPEAKER_01: I want to see more done before and after of a clinical picture.
• 32:05
  SPEAKER_01: Those are important.
• 32:06
  SPEAKER_01: I like to see them, but I want to see what that looks like under the skin with different uh methods and way to measure all these improvements on the skin.
• 32:18
  SPEAKER_01: So that's what I look like.
• 32:19
  SPEAKER_01: There's so many different in there's another product that I'm looking at my eyes.
• 32:24
  SPEAKER_01: Uh they gave me some samples, and I really love is Invo.
• 32:27
  SPEAKER_01: Uh it's a soup of different exosomes from different places, not just one, like bone marrow and this and that.
• 32:35
  SPEAKER_01: And it's like a soup of really good stuff.
• 32:37
  SPEAKER_01: I used 10 and I really saw a bit different on my skin.
• 32:40
  SPEAKER_01: There's plated too.
• 32:42
  SPEAKER_01: I like that exosomes.
• 32:43
  SPEAKER_01: Deepiderm has different types of exosome plates from platelet-derived exosomes.
• 32:48
  SPEAKER_01: I switch between that and the deep derm exosomes that come from the wartons, jelly.
• 32:53
  SPEAKER_01: There's so many good brands, but again, for me to bring it into my clinic, first I have to use it and I have to see a change on my skin.
• 33:00
  SPEAKER_01: After that, I want them to come and educate us.
• 33:03
  SPEAKER_01: And that's where I ask the hard questions and I want proof of what their claims are.
• 33:09
  SPEAKER_01: They need to be supported by studies.
• 33:11
  SPEAKER_01: And if they don't have a study, then I'm not interested to bring it into the clinic.
• 33:16
  SPEAKER_00: That makes sense.
• 33:16
  SPEAKER_00: And I'm I'm so happy to hear you say that because I feel like a lot of times, like, you know, people ask, like, should you go to your dermatologist or your c your plastic surgeon's office and buy skincare there?
• 33:27
  SPEAKER_00: Because they have a, you know, like you're vetting products, like, you know, before you carry them in your clinic or you suggest them to your patients.
• 33:33
  SPEAKER_00: And it's just like the industry has so many mixed opinions now.
• 33:36
  SPEAKER_00: But I'm still, I still subscribe to that idea of like, yeah, you know, if if a plastic surgeon is getting behind a product, like they've vetted it.
• 33:43
  SPEAKER_00: Like they have tried to understand the science, you know?
• 33:46
  SPEAKER_00: So yeah, it makes sense what you're saying.
• 33:48
  SPEAKER_00: I want to ask you though, because I think right now we're in a really interesting place.
• 33:51
  SPEAKER_00: You know, I think a lot of people, like you were talking about earlier, are getting fillers.
• 33:55
  SPEAKER_00: They're getting, you know, Botox, they're doing their like maintenance aesthetic care, but they also are doing the skincare.
• 34:01
  SPEAKER_00: So where do you think that balance is between doing the aesthetic procedures, but you're still keeping up with your skincare?
• 34:07
  SPEAKER_00: I mean, is there a is there a happy place or a balanced place?
• 34:10
  SPEAKER_01: Sometimes I feel it gets out of balance, but I think the the integrative skincare is important.
• 34:17
  SPEAKER_01: Integrative skincare is like if I do a procedure for you, let's say I do a chemical pill, as a dermatologist, I should tell you what you should use and give you the right product.
• 34:28
  SPEAKER_01: Because studies have shown that 80% of the time, if you don't, they go to Sephora or to the pharma, local pharmacy, and they buy whatever they think they could use and it may create an adverse reaction.
• 34:39
  SPEAKER_01: Maybe it has an acid or it's too dry and then they blame you.
• 34:43
  SPEAKER_01: So I think if you are in the aesthetic industry, you should practice integrated skincare and your patients wants you to recommend something.
• 34:51
  SPEAKER_01: Um as a doctor, I used to have a big problem talking about selling something.
• 34:56
  SPEAKER_01: When you are a true healer, me, if I could do what I do for free every day, like if my bills are paid and my family bills are paid, and I'm not gonna die poor, I will do this for free.
• 35:07
  SPEAKER_01: Like I'm a burner, I go to burning man, I've been going a while, but I believe in that.
• 35:12
  SPEAKER_01: Like I do all my services for free, and then you will do your services for free.
• 35:16
  SPEAKER_01: Maybe you cut hair, I go cut my hair for free, I do your feelers for free, and if the whole world would be like that, it would be utopia.
• 35:22
  SPEAKER_01: But that's not realistic.
• 35:24
  SPEAKER_01: But it is important to keep that in mind that when we're doing these treatments, it is our duty to recommend something, but I always feel uncomfortable.
• 35:33
  SPEAKER_01: Like the the doctor in me feel uncomfortable.
• 35:36
  SPEAKER_01: I don't want to be a salesperson, I want to be a doctor.
• 35:38
  SPEAKER_01: One of my nurses, she trained me, and I she really did.
• 35:42
  SPEAKER_01: She, every time we're in the room and she goes like this, is to remind me that I should talk.
• 35:47
  SPEAKER_01: And I'll be at the beginning of, and she gets, and I go and it took it took a long time.
• 35:53
  SPEAKER_01: And I'll be like very shy, like, you know, you did this procedure, you know, you have to use this to massage the sculptra to not only because it will massage it, but it gets rid of the old gunk that is in your dermis.
• 36:08
  SPEAKER_01: So you you knew collagen have fruit too, right?
• 36:11
  SPEAKER_01: So now when she goes like that, I'm comfortable telling the patient what they should get.
• 36:16
  SPEAKER_01: And guess what?
• 36:17
  SPEAKER_01: 100% of the time they get it.
• 36:20
  SPEAKER_01: And they say, Oh, I'm so grateful that you told me to buy this because I was thinking about that.
• 36:25
  SPEAKER_01: And I started thinking, oh my god, old, it took me 20 years to learn this.
• 36:30
  SPEAKER_01: That I should tell my patients, guide them on what integrated skincare.
• 36:36
  SPEAKER_01: I'm talking about a skincare that goes with the procedure because the procedure needs to be supported with something that's going to make that investment excel.
• 36:46
  SPEAKER_01: Remember, they're spending a lot of money for doing renewal, matrix, or radius or sculptur, and you want them to get the best results.
• 36:55
  SPEAKER_01: So you gotta tell them a skincare that is going to add just a few extra dollars, but it's gonna make sure that that investment, that they just invested a lot of money, is going to excel and perform and give them better results.
• 37:08
  SPEAKER_01: So if you think it that way, then you don't think it like, oh gosh, I'm a salesperson trying to sell uh a cream or a moisturizer.
• 37:15
  SPEAKER_01: So I think I learned a lesson, took 20 years, so now I educate my patients.
• 37:21
  SPEAKER_01: But you know what?
• 37:21
  SPEAKER_01: What helped is that before also we didn't have all this skincare that has so much science behind.
• 37:28
  SPEAKER_01: What am I talking about?
• 37:28
  SPEAKER_01: What am I gonna talk about?
• 37:30
  SPEAKER_01: Now I can tell you all these things in an excited way.
• 37:32
  SPEAKER_01: It's gonna help the fibroblasts and it's gonna prevent the fibroblasts from turning into zombie cells and it rescues them because I always tell my patient my cells are 58 years old.
• 37:41
  SPEAKER_01: So when you do a laser, when you do a sculpt, when you do growth factors, when you do microneur, you're forcing my 58 years old cell to perform.
• 37:52
  SPEAKER_01: Guess what's gonna happen?
• 37:53
  SPEAKER_01: Soms are gonna recover, some are not, and it's gonna turn into zombie cells.
• 37:57
  SPEAKER_01: And when you have an accumulation of zombie cells, that's where the frustration comes.
• 38:01
  SPEAKER_01: That you're coming and you're paying good money and you're buying space and cream and doing everything right, you still see your skin age.
• 38:08
  SPEAKER_01: I use my neck as an example.
• 38:10
  SPEAKER_01: I have access to everything.
• 38:11
  SPEAKER_01: And my neck started to show my age, and I got obsessed with it.
• 38:14
  SPEAKER_01: And I started doing the lasers and the threads and the discs, and it was getting worse and worse and worse and worse until I learned about senescence on a lecture that I decided to create.
• 38:25
  SPEAKER_01: And as I got deep in the rabbit hole into this senescence zombie cells, I realized that oh my god, I'm doing everything wrong.
• 38:34
  SPEAKER_01: I'm exhausting my fabulous, I'm contributing to zombie cells.
• 38:37
  SPEAKER_01: And I'm so grateful that RLX 201 came the RQ, that I was able to step back, use exosome polynucletides to optimize my extracellular matrix, and then use the RIQ and just back off, she knows you you you're asking way too much out of 57-year-old cells.
• 38:56
  SPEAKER_01: There are no you 20-year-old cells that can run three marathons.
• 38:59
  SPEAKER_01: Back off.
• 39:00
  SPEAKER_01: And I I did.
• 39:01
  SPEAKER_01: And my neck, everybody notice my neck is getting younger and younger because I stopped being so obsessed with it and doing everything wrong.
• 39:11
  SPEAKER_01: I was demanding some most typical human.
• 39:13
  SPEAKER_01: Gimme, gimme, gimme, gimme, gimme, gimme collagen.
• 39:15
  SPEAKER_01: Without ever thinking, how am I fibroblasts today?
• 39:18
  SPEAKER_01: Are they well nourished?
• 39:19
  SPEAKER_01: Do they have the vitality to be able to withstand this control injury that I giving it?
• 39:25
  SPEAKER_01: No.
• 39:26
  SPEAKER_01: But now that's why I create a genesis and that's why I used to be the bioreactive guy.
• 39:32
  SPEAKER_01: I'm no longer the bioreactive guy.
• 39:34
  SPEAKER_01: I'm pasta.
• 39:35
  SPEAKER_01: That's so 2009, 26.
• 39:38
  SPEAKER_01: I am the functional static medicine doctor, the one that is the voice of those who have no voice, in this case, fibroblasts.
• 39:46
  SPEAKER_01: I want cell-centric treatments.
• 39:49
  SPEAKER_01: I want every one of my colleagues before they injure the skin with anything, before they put a foreign substance to biostimulate, they need to know the age of the tissue and the cells on the tissue and do more than just ask for stimulation.
• 40:05
  SPEAKER_01: We want cell-centric treatment.
• 40:07
  SPEAKER_01: Think about what you're doing to those cells at the moment that you're doing a treatment and think what you can do to prevent exhaustion of cells or block senescence and work with senescent cells instead of trying to eliminate them completely.
• 40:22
  SPEAKER_01: So all these things are things that can only be happening in a setting like Genesis where I drag everybody that is very smart.
• 40:31
  SPEAKER_01: Remember, I'm a clinician, I'm not a scientist, but I'm learning so much from them by having them come to this meeting and my colleagues, and we share what we see as clinicians and what they know as scientists and bring everybody together, including longevity doctors.
• 40:46
  SPEAKER_01: Because we were laughing, you know, longevity doctors they know a lot and we need to learn from them.
• 40:51
  SPEAKER_01: But they need to learn from us because most of them they look terrible.
• 40:54
  SPEAKER_01: They look terrible, they don't look young.
• 40:57
  SPEAKER_01: I mean, they they talk, they talk.
• 40:59
  SPEAKER_01: My biological clock says I'm 25, but I go, your face doesn't say you're 20.
• 41:04
  SPEAKER_01: So you need to do what we do and we need to know what you do.
• 41:08
  SPEAKER_01: Because I want the longevity, but I want this face.
• 41:12
  SPEAKER_01: And they need to learn too because it's not vanity.
• 41:15
  SPEAKER_01: Because when you feel good about what you look like, trust me, every cell in your body is saying hallelujah and staying on for you because when you are honing on you, the things that are happening to your face with the passing of time, if it's creating stress and your cortisol levels are high because you don't like what you see on your face, that's edging you.
• 41:36
  SPEAKER_01: That's aging you because you're constantly thinking about that and it consumes you.
• 41:40
  SPEAKER_01: I see it, I leave it.
• 41:42
  SPEAKER_01: So, what we do matters too.
• 41:44
  SPEAKER_01: I wanna have the longevity, but I also want to feel good about myself when I look myself in the mirror.
• 41:50
  SPEAKER_01: The best version of myself for the age I am.
• 41:52
  SPEAKER_01: I don't wanna look 25.
• 41:54
  SPEAKER_01: When I wanna do my deep plain facelift, I I I I have it very clear to the doctor.
• 41:59
  SPEAKER_01: I don't wanna look any different than I look right now.
• 42:01
  SPEAKER_01: I think really good for my age.
• 42:03
  SPEAKER_01: I just don't want this to hang, and I wanna extend this look for the next five to ten years.
• 42:08
  SPEAKER_01: I'll be happy because by then I'll be 70, and maybe my priorities are gonna be something else.
• 42:13
  SPEAKER_01: Maybe I'll become like so wise that I will not care.
• 42:17
  SPEAKER_01: You know, let me just be as one of those sages, you know, like almost enlightenment.
• 42:22
  SPEAKER_01: Yeah, let me be, you know, so I don't know, maybe, maybe not, but it is important to look good, it is important to feel good about yourself.
• 42:31
  SPEAKER_01: And I like to share that beauty and age are energies that you share with people.
• 42:37
  SPEAKER_01: A lot of people think like it has to do with physical beauty.
• 42:41
  SPEAKER_01: I I'm past that.
• 42:42
  SPEAKER_01: No, physical beauty.
• 42:43
  SPEAKER_01: I I know being in the industry when I was younger with models, there were people that were so physically beautiful, they were so intimidating to me.
• 42:50
  SPEAKER_01: And but the minute they opened their mouths, like, oh yeah.
• 42:53
  SPEAKER_01: There was no beauty anymore.
• 42:55
  SPEAKER_01: And same thing with youth.
• 42:56
  SPEAKER_01: You know, I have friends that are on their 20s and 30s, and I run circles around it.
• 43:01
  SPEAKER_01: I stay out late, I get up early, I enjoy life.
• 43:06
  SPEAKER_01: You know, I'm just I want to do more.
• 43:08
  SPEAKER_01: And they're like so boring that I say, yeah, you guys are 20 something and you are old.
• 43:15
  SPEAKER_00: You're sleeping all the time.
• 43:16
  SPEAKER_01: Like you're yeah, let's go, you know.
• 43:20
  SPEAKER_00: You know, it's funny that you say that because I always like, and I'm not trying to offend anybody, but I make fun of Gen Z because I'm like, you guys are like 10 years older than your actual age.
• 43:28
  SPEAKER_00: Like when we were, I'm a millennial.
• 43:30
  SPEAKER_00: So I'm like, when I was when I was like that age, I was partying all the time.
• 43:34
  SPEAKER_00: Like you couldn't stop me.
• 43:35
  SPEAKER_00: You know what I mean?
• 43:36
  SPEAKER_00: Even now, and they're like all sleeping, they don't drink alcohol, they don't do anything, they just you know, they're inside all the time.
• 43:43
  SPEAKER_01: So those are experiences, whatever you transmit is what people are gonna read out of you.
• 43:49
  SPEAKER_01: So and and physically beautiful, like that's not the goal.
• 43:53
  SPEAKER_01: Physically beautiful is not the goal because you could be physically beautiful and be a shrinked violet, very shy, very, or you could be a Jerk or a mean girl, and that makes you ugly right off the back.
• 44:04
  SPEAKER_01: The goal is to be attractive, and that's what we do.
• 44:08
  SPEAKER_01: I make people feel attractive because when you feel attractive, you walk through that door and you feel like you're on because you feel good, and everybody's going to feel that and see you attractive and know that you're attractive.
• 44:22
  SPEAKER_01: And that's why I want my patients to learn that these are energies.
• 44:26
  SPEAKER_01: So if you wanna be attractive, be attractive.
• 44:29
  SPEAKER_01: If you wanna feel attractive, if you say, Oh, I wanna be hot, well, be hot, dress hard, walk through that room hard, and we're all gonna see hotness.
• 44:37
  SPEAKER_01: You know, the physical part, you know, it helps, but just the first three seconds until you open your mouth.
• 44:43
  SPEAKER_00: Yeah, no, it's so true.
• 44:45
  SPEAKER_00: It's so true.
• 44:46
  SPEAKER_00: And I love how you explain things.
• 44:48
  SPEAKER_00: I can I just say that.
• 44:49
  SPEAKER_00: Like it's just it's magnetic.
• 44:50
  SPEAKER_00: Like, I I honestly could listen to you for hours.
• 44:53
  SPEAKER_00: It's so cool to like just have that perspective because no one says these things.
• 44:56
  SPEAKER_00: You know what I mean?
• 44:57
  SPEAKER_00: Like, this is the truth, and like it is about the energy, it's about the vibe, it's like how you make other people feel around you.
• 45:03
  SPEAKER_00: And that is the true meaning of like, if you do get some work done, it's okay.
• 45:07
  SPEAKER_00: You're doing it because you feel like you feel better, and then you make everybody around you feel so much better.
• 45:12
  SPEAKER_00: So, I mean, I couldn't agree with you more.
• 45:14
  SPEAKER_00: It's it's it's really truly wisdom, you know what you're saying.
• 45:17
  SPEAKER_00: But you know, just closing, closing question for you.
• 45:19
  SPEAKER_00: I would love to get your um advice and some words of wisdom for the aspiring physicians of tomorrow.
• 45:24
  SPEAKER_00: I know a lot of people are going into medicine right now, and some of them are not, you know, they're not as excited, I feel like.
• 45:31
  SPEAKER_00: What are you what is your advice for somebody who wants to go into dermatology or cosmetic, you know, or plastic surgery or something, like in terms of career?
• 45:39
  SPEAKER_01: Well, I mean, you have to love it because when you love something, then you have passion.
• 45:43
  SPEAKER_01: And when you have passion, is it is not work.
• 45:46
  SPEAKER_01: I mean, I spend most of my day I'm the last person to live sometime here until two in the morning, doing things, writing articles, uh, creating PowerPoints, creating, making a lecture to come to life.
• 45:56
  SPEAKER_01: Um I just love what I do, and I love being in the room with my patients and injecting them and knowing about their life.
• 46:02
  SPEAKER_01: So for me, this is not work.
• 46:04
  SPEAKER_01: This is my life, this is my enjoyment.
• 46:06
  SPEAKER_01: I mean, I have no hobbies, you know?
• 46:08
  SPEAKER_01: This is like this is great.
• 46:10
  SPEAKER_01: So you need to love it because especially getting into dermatology, it's very hard to get into dermatology.
• 46:16
  SPEAKER_01: So if you are interested in dermatology, you have to start very early.
• 46:20
  SPEAKER_01: I have high school kids that come here that already decided that they want to be a dermatologist.
• 46:25
  SPEAKER_01: They're about to go on the first year of college.
• 46:27
  SPEAKER_01: One of my sons wants to do that.
• 46:29
  SPEAKER_01: He already helped collaborate and I write paper to write.
• 46:32
  SPEAKER_01: He already has volunteered and worked in a dermatology clinic and from every job from front desk to assist the doctor in the room, doing biopsy, everything.
• 46:42
  SPEAKER_01: I had a young girl here, the daughter of one of my patients that wants to be a dermatologist.
• 46:47
  SPEAKER_01: I said, I need to coach you.
• 46:48
  SPEAKER_01: So she's spending time with me on her free time, her vacation before going to college.
• 46:52
  SPEAKER_01: I'm introducing her to my residence, to my fellows.
• 46:55
  SPEAKER_01: Hey, this is a good networking, so you can tell them if they need to do resource, so you can write papers with them.
• 47:03
  SPEAKER_01: So this is what you need to do this day because dermatology is so competitive.
• 47:08
  SPEAKER_01: You need to start earlier than you think.
• 47:10
  SPEAKER_01: Not everybody thinks that, but you do.
• 47:12
  SPEAKER_01: You need to start meeting people.
• 47:15
  SPEAKER_01: Go to the AD as a student, meet residents.
• 47:18
  SPEAKER_01: That's important.
• 47:19
  SPEAKER_01: Now, plastic surgery may be a little bit different, but I expect the same, you know, it's very competitive.
• 47:26
  SPEAKER_01: If you just want to do aesthetics, you don't have to be a dermatologist or be a plastic surgeon to do aesthetics, right?
• 47:33
  SPEAKER_01: In other countries, they have a residency for aesthetics.
• 47:37
  SPEAKER_01: I used to get people for I'm in faculty in Colombia, they had a program for aesthetics only, and it is a very strong program.
• 47:45
  SPEAKER_01: But if you want to do aesthetics, then uh there's different ways to get there.
• 47:49
  SPEAKER_01: You could finish your family practice internal medicine and then trying to take courses on the side, go to meetings, go to congresses and get somebody to mentor you, take master classes and get good at it.
• 48:04
  SPEAKER_01: That is for somebody that just wanna get into aesthetics and that didn't get into dermatologist.
• 48:10
  SPEAKER_01: If your goal is to do aesthetics, you don't need to do it as a dermatologist.
• 48:14
  SPEAKER_01: You could do it as a regular doctor these days, but you need to love it.
• 48:18
  SPEAKER_01: Yeah, you need to have a lot of patience.
• 48:20
  SPEAKER_01: I mean, you're somebody that you you don't have patience when women think, oh but my hair is so dry and I have this, and you just want to strangle them, this is not for you because you want to get a lot of that, you know.
• 48:31
  SPEAKER_01: So they I have friends like that say, she know they do general dermatology.
• 48:34
  SPEAKER_01: I don't know how you do it.
• 48:36
  SPEAKER_01: I could never do that.
• 48:37
  SPEAKER_01: If somebody tells me one more time that this wrinkle keeps them up at night, I I I will kill myself.
• 48:43
  SPEAKER_01: You know, I have to listen to that every day.
• 48:46
  SPEAKER_00: You're immune to it now, yeah.
• 48:48
  SPEAKER_01: You know, but but for me, it's like I understand or I try to understand what is important to someone and what is not important.
• 48:55
  SPEAKER_01: So just you need to love it.
• 48:57
  SPEAKER_01: I mean, if you love it, but again, you don't need to be a dermatologist, so you to do you have more prestige, people think, because you consider core.
• 49:04
  SPEAKER_01: But I have tons of key opinion leaders, friends of mine, that uh were internal medicine or family practice, but they're so good at it, they're so good at it that they became famous and they do good work and they teach.
• 49:18
  SPEAKER_01: So it's what you want to make it to be.
• 49:21
  SPEAKER_00: Yeah, I love that.
• 49:22
  SPEAKER_00: That's really great advice.
• 49:23
  SPEAKER_00: Thank you so much.
• 49:23
  SPEAKER_00: But Dr.
• 49:24
  SPEAKER_00: Aguilera, this has been so amazing.
• 49:26
  SPEAKER_00: I could literally talk to you for hours, and it's truly an honor to have you on the show.
• 49:30
  SPEAKER_00: Um, for everyone listening, I hope you guys learned as much as I did.
• 49:33
  SPEAKER_00: But thank you so much.
• 49:34
  SPEAKER_00: This was wonderful.
• 49:34
  SPEAKER_01: Thank you, and have a blessed night.
• 49:36
  SPEAKER_00: You too.
• 49:37
  SPEAKER_01: Ciao.