Latest / Scalpel and Skin / Are Cosmetic Lasers Worth It? Skin Resurfacing, Downtime, and What Patients Should Know | EP 04

Transcript

Are Cosmetic Lasers Worth It? Skin Resurfacing, Downtime, and What Patients Should Know | EP 04 · Scalpel and Skin

• 0:00
  SPEAKER_01: One of the fastest ways to age yourself is to just do Botox.
• 0:04
  SPEAKER_01: I am talking to you.
• 0:06
  SPEAKER_01: You just do Botox.
• 0:08
  SPEAKER_01: Get your ass in the laser chair.
• 0:10
  SPEAKER_00: I like you doing lasers.
• 0:12
  SPEAKER_00: I don't like doing lasers.
• 0:13
  SPEAKER_00: There's not enough blood.
• 0:14
  SPEAKER_01: Fair, which is why I like it.
• 0:16
  SPEAKER_01: We're talking about cosmetic lasers.
• 0:18
  SPEAKER_01: Are they worth it?
• 0:19
  SPEAKER_00: Are they worth it?
• 0:33
  SPEAKER_01: Welcome to episode four of Scalpel and Skin.
• 0:36
  SPEAKER_01: I'm Mystica Labraska, and I am joined by my big brother, Dr.
• 0:41
  SPEAKER_01: Algie Labrasca.
• 0:43
  SPEAKER_00: Hi, what's happening?
• 0:44
  SPEAKER_00: Are you ready to go?
• 0:45
  SPEAKER_01: I'm ready.
• 0:46
  SPEAKER_01: We're talking about my love language today, which is lasers.
• 0:51
  SPEAKER_00: Oh my God, that's so great.
• 0:53
  SPEAKER_00: You know, I feel like you've grown since the last time we did this because you didn't start this episode off with a peace sign.
• 1:02
  SPEAKER_01: I mean, I was just getting to that.
• 1:04
  SPEAKER_01: Thanks for giving it away.
• 1:08
  SPEAKER_00: All right.
• 1:08
  SPEAKER_00: Well, this is your love language.
• 1:11
  SPEAKER_00: This is, you're gonna teach me all kinds of stuff today, which is a big change because usually I have to carry you through everything in life and you know, et cetera.
• 1:22
  SPEAKER_00: But okay.
• 1:23
  SPEAKER_00: So um, where do you want to start?
• 1:25
  SPEAKER_00: What do you want to talk about first?
• 1:26
  SPEAKER_01: Well, I mean, I could talk about lasers all day.
• 1:29
  SPEAKER_01: So we're we're talking about cosmetic lasers.
• 1:32
  unknown: Yeah.
• 1:33
  SPEAKER_00: So are they worth it?
• 1:34
  SPEAKER_00: Are they worth it?
• 1:35
  SPEAKER_00: Right.
• 1:35
  SPEAKER_01: I'm not gonna, I'm not gonna, I'm not gonna show all my cards yet, but I'm pretty sure you can already tell how I feel about it.
• 1:43
  SPEAKER_00: Yeah, well, don't give it away, okay, that you think it's worth it, because you know, people might not know, you know, they might not know what a love language is.
• 1:52
  SPEAKER_00: So yeah, so here's the thing.
• 1:53
  SPEAKER_00: People come into the office and they say, I want a laser, okay?
• 1:57
  SPEAKER_00: But that's like walking into a pharmacy and saying, Give me medicine.
• 2:01
  SPEAKER_00: I want medicine.
• 2:02
  SPEAKER_00: Like, because the the question is, like, what what do you want?
• 2:05
  SPEAKER_00: Like, what is your thing?
• 2:06
  SPEAKER_00: And so I think that today we're gonna we're gonna break down the cosmetic lasers.
• 2:10
  SPEAKER_00: What do they do, what they're for, what hurts, uh, what uh downtime, and you know, what treatments are are worth it, and are there any that aren't worth it?
• 2:20
  SPEAKER_00: And I'll bet there are, even though you love everything.
• 2:22
  SPEAKER_00: You know, by the end of the episode, I think we should know that not every laser is the same.
• 2:27
  SPEAKER_00: And I think that we need to know like the difference between a couple of lasers.
• 2:31
  SPEAKER_00: So you're like, you're someone who's doesn't really know about lasers, but you think, hey, you know what, I don't like this.
• 2:38
  SPEAKER_00: Maybe I need a laser for it.
• 2:39
  SPEAKER_00: And and so you want to come in and you want to have at least a little bit of knowledge about it and and understand that lasers potentially have complications as well, just like anything does.
• 2:49
  SPEAKER_00: So I think that's kind of important to talk about.
• 2:51
  SPEAKER_00: Absolutely.
• 2:52
  SPEAKER_00: So people come in and they come to Skinlab, which is our med spa mostly run by you, and they say, What do they say?
• 2:58
  SPEAKER_00: What's the they they walk in and they say, What?
• 3:01
  SPEAKER_01: Most people don't walk in and say, I want a laser treatment.
• 3:05
  SPEAKER_01: They walk in with a concern.
• 3:07
  SPEAKER_01: If it's a concern that we can correct with lasers, which many we can, that's where the conversation would lead.
• 3:15
  SPEAKER_01: I I would say by far, most people want to treat skin texture like wrinkles and pores and what we call reds and browns.
• 3:27
  SPEAKER_01: Reds and browns.
• 3:28
  SPEAKER_01: Color.
• 3:28
  SPEAKER_01: Yep.
• 3:29
  SPEAKER_01: Color.
• 3:29
  SPEAKER_01: Sunspots, brown spots, broken blood vessels.
• 3:33
  SPEAKER_01: As the skin gets older, it gets, it can sometimes get more of a reddy appearance.
• 3:38
  SPEAKER_01: Sometimes that's from rosacea, sometimes that's from sun damage.
• 3:41
  SPEAKER_01: Most of the time when we see pigmentation on the skin, it's from sun damage or a condition called melasma, which is hormonally driven pigmentation, which mostly women get.
• 3:50
  SPEAKER_01: Um, and it's also exacerbated in the sun.
• 3:53
  SPEAKER_01: So these are these are the things that people come in that they want to work on.
• 3:58
  SPEAKER_01: And many of these things are very amendable to lasers.
• 4:03
  SPEAKER_00: So I come in and I uh you have told me many times I have a bunch of browns on my face.
• 4:08
  SPEAKER_00: Okay.
• 4:09
  SPEAKER_00: Can we please treat it?
• 4:11
  SPEAKER_00: Well, we would like to treat it.
• 4:13
  SPEAKER_00: However, every time I come to Skin Lab, we have to make you look pretty.
• 4:18
  SPEAKER_00: And there's no time for me.
• 4:21
  SPEAKER_00: Uh, you know, the last time I was there, what was it two weeks ago?
• 4:24
  SPEAKER_00: And we finished the day, and all of a sudden there were like 14 different syringes of different things that I was putting in your face.
• 4:33
  SPEAKER_01: Literally, I think there were, I think that there were like 14 things.
• 4:36
  SPEAKER_00: So yeah, so it would be nice if if we could treat me.
• 4:40
  SPEAKER_00: However, we always have to treat you first because you're the baby sister and you're, you know, dad's favorite.
• 4:47
  SPEAKER_00: Uh, you know.
• 4:48
  SPEAKER_01: If you would just put some retinol on your face at night, I would love to laser your face, but I can't even get you to do that.
• 4:58
  SPEAKER_01: Are you still washing your face with shampoo?
• 5:00
  SPEAKER_01: You are wash.
• 5:01
  SPEAKER_02: It's body wash.
• 5:03
  SPEAKER_01: Oh my god, I'm gonna have a heart attack.
• 5:05
  SPEAKER_01: All right, moving on.
• 5:11
  SPEAKER_00: It's body wash.
• 5:13
  SPEAKER_00: Okay, I don't use the same thing for hair and and body and face.
• 5:17
  SPEAKER_00: Like, you know, there is there is a thing for for face in my shower.
• 5:22
  SPEAKER_01: You know, it's kind of cobwebs in it.
• 5:24
  SPEAKER_01: I'm sure it's like a$50 cleanser, too.
• 5:26
  SPEAKER_00: Oh, it's at least a$50 cleanser.
• 5:28
  SPEAKER_01: Yeah.
• 5:28
  SPEAKER_00: For sure.
• 5:29
  SPEAKER_00: Uh, you know, there are perks to this industry.
• 5:31
  SPEAKER_00: Uh so you know, so I've got browns on my face.
• 5:34
  SPEAKER_00: You know, like how do we know that my brown spots are just brown spots and they're not cancer?
• 5:41
  SPEAKER_01: That's a very good question.
• 5:42
  SPEAKER_01: So I think the the number one most important thing is assessment.
• 5:48
  SPEAKER_01: The person that you're seeing has to know what they're treating and be able to make an accurate diagnosis.
• 5:54
  SPEAKER_01: So you need to go to someone who knows skin and knows what they're doing.
• 6:01
  SPEAKER_01: I know that in Pennsylvania, you have to see a medical professional, as in a PA, an NP, or a physician to do what's called a good faith exam before you can have any lasers treated or any any laser treatment on your face.
• 6:16
  unknown: Sure.
• 6:16
  SPEAKER_01: Aestheticians are often the ones who end up doing these treatments, but by law, the patient has to be assessed by a medical provider first.
• 6:24
  SPEAKER_01: And that is one of the number one reasons why.
• 6:27
  SPEAKER_00: I mean, you're fine.
• 6:29
  SPEAKER_00: You've got 16 years of derm in you.
• 6:31
  SPEAKER_00: So there are med spas, and there are med spas that do lasers or laser spas, you call it whatever you want.
• 6:38
  SPEAKER_00: But like, not everybody is has 16 years of laser in them.
• 6:44
  SPEAKER_00: And like most people aren't gonna know to be like, how do you know this is not, this is just a brown spa?
• 6:51
  SPEAKER_00: I I feel like this goes all into that, like, there's way too many med spas with way not enough training.
• 6:56
  SPEAKER_00: How does somebody uh you can do laser training, but how how do people get to the point where they can diagnose something dangerous?
• 7:04
  SPEAKER_00: I saw a thing yesterday.
• 7:05
  SPEAKER_00: I think you sent it to me or I sent it to you.
• 7:07
  SPEAKER_01: Oh, yeah, that was crazy.
• 7:08
  SPEAKER_01: Don't I sent it to me?
• 7:09
  SPEAKER_00: It's terrifying.
• 7:10
  SPEAKER_00: There was this, uh, it was from a plastic surgeon, I think.
• 7:12
  SPEAKER_00: No, it's from a dermatologist.
• 7:14
  SPEAKER_00: It was a dermatologist, and it was this little spot on the nose, and it said, Oh, how do we know that's a brown spot or not?
• 7:20
  SPEAKER_00: A and then it zoomed in a couple of times and it was a melanoma.
• 7:23
  SPEAKER_00: And I was like, ah, like that's my that's my greatest fear, right?
• 7:29
  SPEAKER_00: And uh in myself, in you, in our family, and in patients.
• 7:34
  SPEAKER_00: Like, how does someone who's not us, like, how do they stay safe?
• 7:39
  SPEAKER_01: So you're asking from a patient perspective, how do they know if something pigments?
• 7:42
  SPEAKER_00: No, I'm asking, I'm asking from an expert perspective that can't come to you.
• 7:47
  SPEAKER_00: Like, you're how do you give advice to somebody in Walla Walla, Washington?
• 7:52
  SPEAKER_00: Like, how how do you how do sure how does how does a lay person find someone to do laser who isn't just gonna do who isn't just gonna laser a melanoma?
• 8:02
  SPEAKER_01: I think that in general, I in this industry I'm very partial to sticking within a dermatology group or a plastic surgery group.
• 8:12
  SPEAKER_01: We are a, of course, a med spa or a medical aesthetics practice, technically, but I'm coming from 16 years in dermatology.
• 8:20
  SPEAKER_01: So it is essentially like coming to a dermatology practice.
• 8:24
  SPEAKER_01: You are also a plastic surgeon, you practice at the office.
• 8:27
  SPEAKER_01: So we are not your average med spa.
• 8:29
  SPEAKER_01: I think to be absolutely safe, go get a skin check from a dermatologist, get an all-over skin cancer screening, and if they don't do lasers there, have them refer you to a reputable med spa.
• 8:41
  SPEAKER_00: So it's a year to get into a dermatologist.
• 8:44
  SPEAKER_01: Yeah, I know.
• 8:44
  SPEAKER_01: You gotta book a lot of things.
• 8:45
  SPEAKER_00: So you wait a year and then and and then maybe you're okay, and then you and then you go get the laser.
• 8:52
  SPEAKER_00: Uh nobody's gonna do that.
• 8:54
  SPEAKER_00: I mean, 90% of the people aren't gonna do that.
• 8:58
  SPEAKER_00: Well, so what's what's option B?
• 9:00
  SPEAKER_01: Option B is book a uh flight to Pittsburgh and come to Skinlab.
• 9:05
  SPEAKER_01: That that's the that's the best that gone.
• 9:08
  SPEAKER_00: Skinlab pgh.com.
• 9:09
  SPEAKER_00: That's Skinlab by Dr.
• 9:10
  SPEAKER_00: Labraska and Mystica Lebraska.
• 9:13
  SPEAKER_00: Yeah, I so you know, I I don't know.
• 9:16
  SPEAKER_00: I don't have the answer.
• 9:17
  SPEAKER_00: I think the answer is for something like this, you always go a level up over your regular talks and filler med spa, right?
• 9:26
  SPEAKER_00: I I think, I think uh, you know, and and even uh like people maybe they do a laser, but like, so this is a big deal.
• 9:32
  SPEAKER_00: And and and you know, this might be this might be the take-home topic of this entire podcast is how to not dive.
• 9:40
  SPEAKER_00: How do how do us labraskas, you know, save you from getting a uh, you know, from getting your melanoma pigmented off, right?
• 9:48
  SPEAKER_01: That's I that's the scary thing.
• 9:50
  SPEAKER_01: And and I don't, you know, I don't want to create fear, but but it's real, it's reality, it happens.
• 9:58
  SPEAKER_01: If you did potentially have something that is not benign, if it if it is a skin cancer or or precancerous and you had it lasered, you could certainly mask whatever that lesion is for a period of time.
• 10:13
  SPEAKER_01: It it will show its face eventually, but you may have masked it and then potentially delayed diagnosis.
• 10:19
  SPEAKER_01: So so that is definitely a real thing.
• 10:22
  SPEAKER_01: That is scary.
• 10:23
  SPEAKER_01: I think get checked by a dermatologist when you have access to one.
• 10:28
  SPEAKER_01: If you don't have access to dermatology, say you live in a rural area, your PCP is a good second option, not ideal, really, because they're not trained in dermoscopy and detecting skin cancers necessarily as detailed as people in dermatology are.
• 10:47
  SPEAKER_01: It's just like you wouldn't come to me to have your hypertension managed.
• 10:49
  SPEAKER_01: But that's for sure.
• 10:51
  SPEAKER_00: You give me hypertension.
• 10:53
  SPEAKER_01: Definitely not.
• 10:54
  SPEAKER_01: Definitely not.
• 10:55
  SPEAKER_01: But it's better, it's it's certainly better than trying to diagnose it yourself or seeing someone who is not able to diagnose.
• 11:03
  SPEAKER_00: Now that we've freaked everybody out, totally.
• 11:05
  SPEAKER_01: We just like we we we completely just scared everybody.
• 11:10
  SPEAKER_01: Is anyone even still listening?
• 11:11
  SPEAKER_01: Well did everyone, or did everyone just they're all making derm appointments?
• 11:16
  SPEAKER_00: Yeah, they're all making derm appointments.
• 11:17
  SPEAKER_00: They're all making term appointments, which is fine because if if we save a life, yay, you know, high five, right?
• 11:23
  SPEAKER_00: That's that's pretty good.
• 11:24
  SPEAKER_00: You know, melanoma is real, skin cancer, other skin cancers are real.
• 11:27
  SPEAKER_00: Please don't die.
• 11:28
  SPEAKER_00: It's it, you know, it's it's the it's the one that you can see, right?
• 11:32
  SPEAKER_00: Yes.
• 11:32
  SPEAKER_00: It's it's the cancer that you can see.
• 11:34
  SPEAKER_00: What else?
• 11:35
  SPEAKER_00: Well, let's let's talk about okay.
• 11:37
  SPEAKER_00: So you mentioned texture.
• 11:38
  SPEAKER_00: So someone comes in and they don't like their texture.
• 11:41
  SPEAKER_00: What let's go through it.
• 11:42
  SPEAKER_01: That's a that's a big one.
• 11:44
  SPEAKER_01: So someone comes in and say they want to work on some wrinkles.
• 11:50
  SPEAKER_01: Say they've got some wrinkles around their eyes, some wrinkles around their mouth.
• 11:55
  SPEAKER_01: Um, they've already been doing Botox.
• 11:58
  SPEAKER_01: Uh they've maybe even done some filler.
• 12:00
  SPEAKER_01: Maybe they've done nothing.
• 12:01
  SPEAKER_01: They don't want to do any injectables.
• 12:02
  SPEAKER_01: Maybe they are ready to take the next step and start working on building some collagen and banking collagen, as we like to say, because what I always say, I probably say this every day, Botox and disport any type of neuromodulator is just working on the muscle.
• 12:21
  SPEAKER_01: It's relaxing the muscle to soften the overlying skin.
• 12:24
  SPEAKER_01: It is literally doing nothing to actually build collagen and elastin.
• 12:30
  SPEAKER_01: It's just relaxing muscle.
• 12:32
  SPEAKER_01: So we are not building collagen by doing Botox.
• 12:37
  SPEAKER_00: So are you saying don't do Botox then?
• 12:40
  SPEAKER_01: I'm not saying don't do Botox.
• 12:41
  SPEAKER_01: I'm saying don't just do Botox.
• 12:43
  SPEAKER_00: So you're saying do both, do more, do more, do better.
• 12:47
  SPEAKER_01: One of the one of the fastest ways to age yourself is to just do Botox.
• 12:54
  SPEAKER_00: If you are I'm 75 years old and I don't think I look and I just do Botox and shampoo for my face.
• 13:01
  SPEAKER_01: Uh and yeah, you.
• 13:05
  SPEAKER_01: I am talking to you, Dr.
• 13:07
  SPEAKER_01: Labrasca.
• 13:08
  SPEAKER_01: You just do Botox.
• 13:11
  SPEAKER_01: Get your ass in the laser chair.
• 13:13
  SPEAKER_01: You're gonna be crying to me in 10 years.
• 13:15
  SPEAKER_00: You are.
• 13:16
  SPEAKER_00: You know, I'm in, I'm here and I'm going, okay, well, I'm I'm there on a Thursday and I have to operate the next day because I I typically operate on Friday.
• 13:26
  SPEAKER_00: So, you know, can I do that?
• 13:28
  SPEAKER_00: Can I operate on Friday if I have to if I have a laser on Thursday?
• 13:32
  SPEAKER_01: Absolutely.
• 13:33
  SPEAKER_01: I I wouldn't I wouldn't operate if you had a full-blown CO2 laser, like full blown laser resurfacing.
• 13:41
  SPEAKER_01: No, you're not gonna going to operate the next day, but any other laser, 110%.
• 13:46
  SPEAKER_00: So you're telling me that some lasers have more downtime than others.
• 13:50
  SPEAKER_01: Yes.
• 13:51
  SPEAKER_01: Yes, depending on the laser.
• 13:53
  SPEAKER_00: So we have That's what we call a lead-in in this podcast.
• 13:57
  unknown: Thank you.
• 13:59
  SPEAKER_01: I did you do that on purpose?
• 14:00
  SPEAKER_01: I don't believe that.
• 14:01
  SPEAKER_00: Yes, I freaking did.
• 14:02
  SPEAKER_00: Of course I did.
• 14:03
  SPEAKER_00: That's what we call a lead-in.
• 14:07
  SPEAKER_01: So we have non-invasive lasers and we have more invasive lasers.
• 14:12
  SPEAKER_01: We have what we call non-ablative lasers, meaning we are not, we're we're keeping the what's called the epidermis of the skin, the top layer of skin, mostly intact or fully intact, depending on the laser.
• 14:27
  SPEAKER_01: And then we have what we call ablative lasers, where we are causing a lot of disruption to the epidermis and the dermis, the middle layer of the skin.
• 14:37
  SPEAKER_01: And those are the ones that are typically like a CO2 laser.
• 14:40
  SPEAKER_01: Those are the ones that are going to have about a week of downtime.
• 14:45
  SPEAKER_00: Whereas the what did you just say?
• 14:50
  SPEAKER_00: What?
• 14:50
  SPEAKER_00: I know what you're talking about.
• 14:52
  SPEAKER_00: But what?
• 14:54
  SPEAKER_00: What are you talking about?
• 14:55
  SPEAKER_00: The ablative, non-ablative, what what?
• 14:59
  SPEAKER_01: The top layer of skin is called your epidermis.
• 15:01
  SPEAKER_00: Is the oh the top layer of the skin is the epidermis.
• 15:04
  SPEAKER_00: What's underneath?
• 15:04
  SPEAKER_01: I said this.
• 15:05
  SPEAKER_01: I said this.
• 15:06
  SPEAKER_01: The middle layer of skin is the dermis.
• 15:09
  SPEAKER_00: Uh-huh.
• 15:09
  SPEAKER_00: And then what's the what's the the the bottom layer of skin?
• 15:12
  SPEAKER_01: Well, then we're getting into what's called the sub-Q layer, where there's fat and there's muscle even deeper than that, and then there's more fat and there's bone.
• 15:21
  SPEAKER_01: Why are we talking about this?
• 15:22
  SPEAKER_01: Lasers don't go that deep.
• 15:23
  SPEAKER_01: What do you what are you leading into?
• 15:25
  SPEAKER_00: Neither do I.
• 15:25
  SPEAKER_00: Nothing.
• 15:26
  SPEAKER_00: I'm not leading in.
• 15:27
  SPEAKER_00: You were very detailed there and and uh, you know, it's like I told you this is my love language.
• 15:32
  SPEAKER_01: I'm gonna, I'm gonna totally geek out.
• 15:35
  unknown: Okay, let's go.
• 15:37
  SPEAKER_00: All right, let's go.
• 15:38
  SPEAKER_00: So, okay.
• 15:39
  SPEAKER_00: So, why would we consider doing a couple of different treatments versus like one big treatment downtime?
• 15:47
  SPEAKER_00: So a couple of like lesser treatments.
• 15:50
  SPEAKER_00: Like, let's say I can only give you like three days of downtime, but I can do it three times.
• 15:55
  SPEAKER_00: So it can I get close to like one major ablative full face CO2 laser, which you talked about a few minutes ago.
• 16:03
  SPEAKER_00: Can we do that?
• 16:04
  SPEAKER_00: How how how good can we get?
• 16:06
  SPEAKER_00: How much closer can we get?
• 16:08
  SPEAKER_00: Can we get 75%?
• 16:09
  SPEAKER_01: You can get you can get pretty close, I would say.
• 16:13
  SPEAKER_01: So there's a treatment that I do in the office.
• 16:15
  SPEAKER_01: It's called Total Skin.
• 16:18
  SPEAKER_01: That's TM.
• 16:19
  SPEAKER_00: By what company is that?
• 16:20
  SPEAKER_01: TM by the company, um Sinush or Eleutronic.
• 16:23
  SPEAKER_01: They make great, great energy-based devices.
• 16:25
  SPEAKER_01: Yep.
• 16:26
  SPEAKER_01: So this is when we have like four or five of them.
• 16:28
  SPEAKER_01: Yeah.
• 16:29
  SPEAKER_01: This is when we combine radio frequency microneedling, which is technically not laser, but that's for another day with a laser treatment.
• 16:39
  SPEAKER_01: And this is a non-ablative laser.
• 16:43
  SPEAKER_01: And when we combine the two, we stack them, we can reach multiple layers in the skin.
• 16:49
  SPEAKER_01: So we can reach dermis and epidermis and kind of get all the layers of skin and treat all those layers of skin really effectively.
• 16:57
  SPEAKER_01: I've seen some some really beautiful results with a series of three of those.
• 17:02
  SPEAKER_00: Some of the results you get just knock my socks off.
• 17:05
  SPEAKER_00: They're so, so good.
• 17:06
  SPEAKER_00: Like I see that and I'm just like, that's my sister.
• 17:10
  SPEAKER_01: I made you a believer in lasers.
• 17:13
  SPEAKER_01: Yeah, I feel like you didn't even really like lasers before.
• 17:16
  SPEAKER_00: I like you doing lasers.
• 17:18
  SPEAKER_00: I don't like doing lasers.
• 17:20
  SPEAKER_00: I there's not enough blood.
• 17:21
  SPEAKER_01: Fair, which is why I like it.
• 17:23
  SPEAKER_00: Yeah.
• 17:24
  SPEAKER_00: So, you know, so somebody said something about like uh a light resurfacing is kind of like polishing the surface, uh and and a deeper treatment is more like doing a full renovation.
• 17:36
  SPEAKER_00: Does that make sense?
• 17:37
  SPEAKER_01: Absolutely.
• 17:37
  SPEAKER_01: I'm and and some people, the younger people, they can, they don't have as much texture, they don't have as much sun damage, they can get away with doing a lighter treatment and and doing it periodically.
• 17:52
  SPEAKER_01: I think it a good way to think about it is try to do something once a quarter.
• 17:58
  SPEAKER_01: Do one type of skin treatment, skin quality treatment per quarter.
• 18:03
  SPEAKER_01: Okay.
• 18:04
  SPEAKER_01: A lot of them you can do right when you come in for your Botox.
• 18:06
  SPEAKER_01: We do, we do most lasers we can do the same day as your as your quarterly Botox.
• 18:13
  SPEAKER_00: Okay.
• 18:13
  SPEAKER_00: So uh let's uh let's kind of go into um something that you know that may lead into something else.
• 18:21
  SPEAKER_00: Let's talk about skin laxity.
• 18:23
  SPEAKER_00: So someone comes in and like, you know, I I come in and I got you know, little jowls here.
• 18:29
  SPEAKER_00: Ignore the beard, right?
• 18:30
  SPEAKER_00: You know, but like I got little jowls here and it's like saggy neck and everything.
• 18:35
  SPEAKER_00: So what can you do for me?
• 18:36
  SPEAKER_01: We're we're gonna, I'm just telling you, we're about to go off topic if you really want me to get into jowls.
• 18:42
  SPEAKER_00: Go.
• 18:43
  SPEAKER_00: Well, so this is so when we started doing social media, so when she started, I I had done it for years and she was just kind of getting into it.
• 18:51
  SPEAKER_00: And every video she made was like seven minutes long.
• 18:56
  SPEAKER_00: And so what I did is what what do you remember what I told you?
• 19:00
  SPEAKER_00: 30 seconds.
• 19:00
  SPEAKER_00: That's right.
• 19:01
  SPEAKER_00: Not more, no more than 30 seconds because 30 seconds.
• 19:05
  SPEAKER_01: I still hear it in my head.
• 19:06
  SPEAKER_01: 30 seconds.
• 19:07
  SPEAKER_00: Right.
• 19:07
  SPEAKER_00: So you had now 30 seconds.
• 19:09
  SPEAKER_00: Go.
• 19:10
  SPEAKER_01: Oh, come on.
• 19:14
  SPEAKER_01: So jowls happen for multiple reasons.
• 19:17
  SPEAKER_01: So you have to treat multiple causes.
• 19:20
  SPEAKER_01: I treat the downward pull of the muscle from the neck with Botox.
• 19:24
  SPEAKER_01: I treat the skin quality issue, the loss of collagen and elastin with RF microneedling or certain types of lasers.
• 19:32
  SPEAKER_01: I treat the the laxity and the tightening issue with sculptra, like a uh collagen-stimulating injectable treatment or filler.
• 19:43
  SPEAKER_00: Uh-huh.
• 19:44
  SPEAKER_00: Okay.
• 19:44
  SPEAKER_00: So a bunch of stuff for laxity.
• 19:46
  SPEAKER_01: A bunch of stuff.
• 19:47
  SPEAKER_00: A bunch of let's say a 63-year-old woman walks in your door.
• 19:53
  SPEAKER_00: She's a farmer for her whole life, and her husband just died.
• 20:00
  SPEAKER_00: And uh two years ago, they sold the family farm for$9 million.
• 20:05
  SPEAKER_00: So she's got a bunch of money.
• 20:07
  SPEAKER_00: Her husband has just passed, and you know, she's looking to get back on the, you know, back on the uh dating pool.
• 20:16
  SPEAKER_00: So, you know, but she's all wrinkly and and and everything else.
• 20:20
  SPEAKER_00: So where where do we start with her?
• 20:22
  SPEAKER_00: Laser wise.
• 20:23
  SPEAKER_01: Laser wise, I I I mean, quite honestly, if she wants, if she wants a one and done, I would go with a CO2 resurfacing.
• 20:32
  SPEAKER_00: Okay.
• 20:32
  SPEAKER_00: What's that gonna do for for her?
• 20:34
  SPEAKER_01: A little bit.
• 20:35
  SPEAKER_01: I mean, it it's it's going to make her skin look better.
• 20:38
  SPEAKER_01: It's going to make her texture and sun damage, all of that's going to look better.
• 20:42
  SPEAKER_01: So while she's not going to get a ton of tightening for the jowls, the skin's going to look better.
• 20:49
  SPEAKER_00: So it's just Well, I want to look 50 again or 45 again.
• 20:53
  SPEAKER_00: Facelift.
• 20:53
  SPEAKER_00: Oh, okay.
• 20:54
  SPEAKER_00: We should talk about that later on.
• 20:55
  SPEAKER_01: That's usually the first question I ask.
• 20:57
  SPEAKER_01: Is surgery on or off the table?
• 20:59
  SPEAKER_01: Like on the table?
• 21:00
  SPEAKER_00: Right.
• 21:01
  SPEAKER_00: For somebody like that, for sure.
• 21:02
  SPEAKER_00: Now, somebody that's already 45, uh, you know, seems like uh that's a Mystica problem that uh that is just right in your wheelhouse, right?
• 21:12
  SPEAKER_01: I love it.
• 21:13
  SPEAKER_01: I love, I love treating that stuff.
• 21:16
  SPEAKER_00: Now let's be honest, how much improvement can you get in skin laxity with non-invasive devices?
• 21:23
  SPEAKER_01: Devices by itself?
• 21:24
  SPEAKER_00: Just to answer the question.
• 21:25
  SPEAKER_01: We're we're talking, well, it's but it's it's nuanced.
• 21:28
  SPEAKER_01: So if you're asking if we are treating, if you're saying how much how much tightening can we get in gels, if you just do a laser or an energy-based device, I would say it's going to be a modest benefit.
• 21:44
  SPEAKER_01: Okay.
• 21:44
  SPEAKER_01: That's fair.
• 21:46
  SPEAKER_00: Mild to modest.
• 21:47
  SPEAKER_00: Mild to modest.
• 21:48
  SPEAKER_01: Modest benefit.
• 21:49
  SPEAKER_01: Will you be happy?
• 21:51
  SPEAKER_01: Yes.
• 21:53
  SPEAKER_00: I you know, it it it's it's tricky.
• 21:55
  SPEAKER_00: Like that's it, that's the question, right?
• 21:58
  SPEAKER_00: Is that that's the question.
• 22:00
  SPEAKER_00: With everything.
• 22:00
  SPEAKER_00: I I had a woman today who wanted something done that like she has laxity in her love handles area and she wants liposuction.
• 22:15
  SPEAKER_00: And I I I said I could do it, but nobody else is gonna see any difference at all.
• 22:23
  SPEAKER_00: And you might see a difference.
• 22:25
  SPEAKER_00: I said, if I was going to guess, there's a 75% chance that you're not happy and a 25% that you're happy with what I can do with where we at.
• 22:34
  SPEAKER_00: Right.
• 22:34
  SPEAKER_00: And you know, that's that's the the biggest thing is are they happy?
• 22:38
  SPEAKER_00: And you know, can you can you make somebody that's got moderate laxity happy with with laser?
• 22:44
  SPEAKER_01: That's really that's all that matters.
• 22:48
  SPEAKER_01: Really that's all that matters at the end of the day.
• 22:50
  SPEAKER_00: Right.
• 22:52
  SPEAKER_01: If you can make your patient happy, if they're happy, if they feel a little bit better in their skin, then then I'm happy.
• 22:59
  SPEAKER_01: As long as they have reasonable expectations.
• 23:01
  SPEAKER_00: That's right.
• 23:02
  SPEAKER_00: I love it.
• 23:03
  SPEAKER_00: So what happens when you do like let's say you do uh your your your uh total skin?
• 23:10
  SPEAKER_02: Mm-hmm.
• 23:10
  SPEAKER_00: Right where total skin, let's say you do your total skin.
• 23:13
  SPEAKER_00: What what what can I expect?
• 23:15
  SPEAKER_00: Right?
• 23:16
  SPEAKER_00: What's it what's it feel like?
• 23:17
  SPEAKER_00: Does it hurt?
• 23:18
  SPEAKER_00: Am I gonna have pain tomorrow?
• 23:20
  SPEAKER_00: Like, run me through it in general.
• 23:23
  SPEAKER_01: We for a a good amount of laser treatments, depending on what you're doing, there is some some type of topical numbing involved.
• 23:32
  SPEAKER_01: So for that treatment in particular, yeah, yeah, numbing cream.
• 23:36
  SPEAKER_01: So we put we put numbing cream on, it sits on the skin for 30 to 45 minutes.
• 23:41
  SPEAKER_01: Bring a book, bring, you know, your phone, and you can read and just hang out for a little bit, drink some coffee, and then we come in, we wash you off, we do the treatment, you feel next to nothing.
• 23:56
  SPEAKER_01: You some people who are who are a little more sensitive maybe still may feel a little bit of heat, but it's tolerable.
• 24:06
  SPEAKER_01: I've never had anyone quit in the middle of a treatment ever.
• 24:10
  SPEAKER_01: Most people do totally fine.
• 24:12
  SPEAKER_01: And uh the other lasers that we have, the ones that are completely non-invasive, like what we call our vascular lasers when we're treating blood vessels and redness.
• 24:24
  SPEAKER_00: And I've definitely come around on those.
• 24:27
  SPEAKER_01: Yeah.
• 24:27
  SPEAKER_00: Definitely, definitely come around on those.
• 24:30
  SPEAKER_00: Uh, you you do amazing, amazing work with that.
• 24:33
  SPEAKER_00: Amazing work.
• 24:35
  SPEAKER_01: Oh, yeah.
• 24:35
  SPEAKER_01: Those those types of lasers for people with rosacea like me, it's it can be life-changing.
• 24:41
  SPEAKER_01: Yeah, it's it is it is so effective.
• 24:45
  SPEAKER_01: And so those types of lasers don't require any type of topical numbing cream.
• 24:50
  SPEAKER_01: Laser hair removal, no need for numbing cream.
• 24:53
  SPEAKER_01: Very quick and tolerable.
• 24:55
  SPEAKER_00: So my PA Heather, my other PA Heather at my Labrasco surgery practice today, she had a woman who came in for hair and she's had hair uh laser in the past, and she was tan, right?
• 25:10
  SPEAKER_00: She was tan and she and and she said, I just want my armpits done today.
• 25:16
  SPEAKER_00: My armpits aren't tan.
• 25:17
  SPEAKER_00: What do you do?
• 25:18
  SPEAKER_00: Do you just look and see if the armpits are tan, if the armpits are white as heck you you do it, or do you, you know, scold the patient, or like, what do you do?
• 25:25
  SPEAKER_00: She drove an hour to get there.
• 25:27
  SPEAKER_01: If if her armpits truly aren't tan, there's no reason to not do the treatment.
• 25:32
  SPEAKER_00: Right.
• 25:32
  SPEAKER_00: And that's what we did.
• 25:33
  SPEAKER_00: We did it.
• 25:34
  SPEAKER_01: That's that's that's the right thing to do.
• 25:36
  SPEAKER_01: But I wouldn't do her legs, I wouldn't do her face.
• 25:39
  SPEAKER_00: Right.
• 25:40
  SPEAKER_00: So she comes in and and uh she wants bikini done, and you know, she's got a tan line, but she wants inside the the tan line.
• 25:48
  SPEAKER_00: That's okay too.
• 25:49
  SPEAKER_01: Inside the tan line?
• 25:50
  SPEAKER_00: Inside the tan line, yeah.
• 25:52
  SPEAKER_01: Sure.
• 25:52
  SPEAKER_00: Okay, cool.
• 25:54
  SPEAKER_01: I'm I'm not advocating going to get a tan, by the way.
• 25:57
  SPEAKER_00: Right, right, of course not, right?
• 25:59
  SPEAKER_01: But people are gonna do it, people do it, right?
• 26:02
  SPEAKER_00: People do it, you know.
• 26:04
  SPEAKER_00: People want both no hair and a tan.
• 26:06
  SPEAKER_01: Um that's but that but that raises a good point.
• 26:09
  SPEAKER_01: So tan skin is not always laserable, depending on the laser.
• 26:15
  SPEAKER_01: And and the reason, and I'm gonna try not to to totally make this sound like a like a science book.
• 26:24
  SPEAKER_01: Are we ready?
• 26:25
  SPEAKER_01: Yeah, yeah, I'm ready.
• 26:27
  SPEAKER_01: How can I explain this in a way that is not as you say?
• 26:36
  SPEAKER_00: Right.
• 26:37
  SPEAKER_01: So the the reason that uh some lasers, you you cannot be tan is because some lasers are attracted to what's called melanin.
• 26:48
  SPEAKER_01: Melanin is the pigment in the skin, and we all have it.
• 26:51
  SPEAKER_01: Some people have more of it, some people have less of it.
• 26:54
  SPEAKER_01: And when you have a tan, you have more melanin in your skin.
• 26:58
  SPEAKER_01: So what's happening when you're treating skin that is tan with a laser that is attracted to melanin is you've got multiple targets on the skin competing for the energy of the laser.
• 27:12
  SPEAKER_01: And usually the non-target wins.
• 27:15
  SPEAKER_01: So that can cause problems.
• 27:17
  SPEAKER_01: That can cause blisters and scabs and potentially scars.
• 27:21
  SPEAKER_00: So getting laser with a tan can really mess you up.
• 27:24
  SPEAKER_01: Yes.
• 27:24
  SPEAKER_01: Not all lasers.
• 27:26
  SPEAKER_00: Right, right.
• 27:26
  SPEAKER_00: Of course.
• 27:27
  SPEAKER_00: Of course.
• 27:27
  SPEAKER_01: But some lasers.
• 27:28
  SPEAKER_00: Some lasers, right.
• 27:29
  SPEAKER_01: But just don't get tan.
• 27:30
  SPEAKER_00: Like, can we just I'm with you?
• 27:33
  SPEAKER_01: Like, just don't get a tan, standing damage.
• 27:36
  SPEAKER_00: So there was a few years ago when everybody when there was that one, oh, that RF microneedling device that everybody Morpheus.
• 27:45
  SPEAKER_00: Morpheus talked about talked about for like I you know, the Morpheus rep came to my office and she was like, you know, it was like, here's the price.
• 27:58
  SPEAKER_00: Like she, hey, may I come to your office?
• 28:00
  SPEAKER_00: Sure, come on in.
• 28:01
  SPEAKER_00: Here's the price, take it or leave it.
• 28:04
  SPEAKER_00: Uh I was like, well, she's like, well, this device sells itself.
• 28:08
  SPEAKER_00: Um, so you know, uh, so this is it, or or you know, peace.
• 28:14
  SPEAKER_00: Right.
• 28:14
  SPEAKER_00: And I I left it, right?
• 28:16
  SPEAKER_00: And now uh I I haven't heard the word Morpheus in like three or four years.
• 28:21
  SPEAKER_00: I, you know, I don't know.
• 28:22
  SPEAKER_00: Do they have a Morpheus two or whatever?
• 28:25
  SPEAKER_00: So I, you know, I think the important thing here is you want to choose.
• 28:29
  SPEAKER_00: This goes back to where we started.
• 28:31
  SPEAKER_00: This episode was you want to choose your laser.
• 28:35
  SPEAKER_00: You want to choose the provider, you want to choose the PA, the dermatologist, the plastic surgeon, the nurse practitioner.
• 28:41
  SPEAKER_00: You don't really want to choose based on the the product that you saw on TikTok.
• 28:46
  SPEAKER_00: Okay.
• 28:47
  SPEAKER_00: Right?
• 28:48
  SPEAKER_00: Right.
• 28:48
  SPEAKER_00: Because what you see on on Instagram reels may not be the right thing for you, but it if you go to the wrong person, they be like, sure, let's try it.
• 28:59
  SPEAKER_00: Yeah, we'll do it.
• 28:59
  SPEAKER_00: You know, we do we sell this all the time.
• 29:02
  SPEAKER_01: The there is a a trending device.
• 29:06
  SPEAKER_01: I'm I won't say the name, but there is definitely a trending device out there, Smurf.
• 29:12
  SPEAKER_01: And it's every a lot of people are asking about it.
• 29:15
  SPEAKER_01: It's it's what starts with an X, yeah.
• 29:18
  SPEAKER_01: Yeah, it's what Morpheus was a few years ago.
• 29:22
  SPEAKER_01: And I don't know what's going to happen with the device.
• 29:25
  SPEAKER_01: We we we shall see, but I do know of med spas putting up air quotes opening specifically just with this device.
• 29:37
  SPEAKER_01: They buy two or three of them.
• 29:39
  SPEAKER_01: The company puts a medical director in place for them just so that they can operate the device.
• 29:47
  SPEAKER_01: I I I have heard of this happening.
• 29:50
  SPEAKER_01: Um and and and it and this is coming from a company that does make very good devices, but that is a very poor decision on their part.
• 30:02
  SPEAKER_00: Yeah.
• 30:03
  SPEAKER_00: Yeah.
• 30:03
  SPEAKER_01: I inevitably it's it's going to be people operating these devices that that have no experience, shouldn't be doing it, people are gonna have complications, it's gonna lead to poor outcomes, and it's not going to be good for the company.
• 30:15
  SPEAKER_00: Yeah, it'll never live up to the hype if they give it to anybody and everybody.
• 30:20
  unknown: Yes.
• 30:21
  SPEAKER_00: I realize they have a bottom, you know, they they want to, you know, make hay while they can, but well, that's not not that is no bueno.
• 30:31
  SPEAKER_00: So bueno.
• 30:32
  SPEAKER_00: You know, I some questions that that patients should ask when they go in.
• 30:38
  SPEAKER_00: You know, what what are we treating?
• 30:40
  SPEAKER_00: Why this device?
• 30:41
  SPEAKER_00: How many times is it gonna take?
• 30:42
  SPEAKER_00: What's the downtime?
• 30:44
  SPEAKER_00: What's the risk?
• 30:45
  SPEAKER_00: Who does it?
• 30:46
  SPEAKER_00: What happens if there's a complication?
• 30:47
  SPEAKER_00: That's great.
• 30:48
  SPEAKER_00: We haven't talked about complications much.
• 30:50
  SPEAKER_00: Um, what happens if there's a complication?
• 30:53
  SPEAKER_00: And what are the the biggest comp complications and most common complications of a laser?
• 30:59
  SPEAKER_01: Well, funny you should ask because I'm giving a presentation on this.
• 31:05
  SPEAKER_01: You are?
• 31:07
  SPEAKER_01: I am.
• 31:10
  SPEAKER_01: There's a big aesthetic conference in Dallas.
• 31:13
  SPEAKER_01: It's called Aesthetic Next, one of the biggest um conferences in the in the industry.
• 31:19
  SPEAKER_01: And I am super excited to be presenting this year.
• 31:24
  SPEAKER_01: And I am presenting on preventing and managing complications with lasers and energy-based devices.
• 31:30
  SPEAKER_00: So you know a little bit about what I know a thing or two.
• 31:33
  SPEAKER_01: Oh, that's great.
• 31:35
  SPEAKER_01: What would you like to know?
• 31:36
  SPEAKER_00: Yeah.
• 31:37
  SPEAKER_00: So what is the most common complication and and what is the one that scares you?
• 31:42
  SPEAKER_01: Most common complications are blisters and scabs, which those those are burns.
• 31:49
  SPEAKER_01: Those are we call those thermal injury.
• 31:51
  SPEAKER_01: It's it's it's a burn.
• 31:53
  SPEAKER_02: Burn.
• 31:53
  SPEAKER_01: Yeah, it's a burn.
• 31:54
  SPEAKER_01: Yeah.
• 31:55
  SPEAKER_01: Um, those are the most common, I I would say.
• 31:59
  SPEAKER_01: And and a big one with that is treating tan skin.
• 32:02
  SPEAKER_00: Tan skin.
• 32:03
  SPEAKER_00: Yep.
• 32:04
  SPEAKER_01: Or using a device on a skin type that shouldn't have that device.
• 32:10
  SPEAKER_01: Uh skin type that's maybe has a bit too much of its own melanin in it that can cause problems.
• 32:17
  SPEAKER_01: So that's that's probably number one.
• 32:20
  SPEAKER_01: Infection is another one, although it doesn't happen that often.
• 32:23
  SPEAKER_02: Super rare.
• 32:24
  SPEAKER_02: Right.
• 32:25
  SPEAKER_01: Su rare, but it it happens.
• 32:28
  SPEAKER_01: I mean, I have seen it happen.
• 32:30
  SPEAKER_01: Yeah.
• 32:30
  SPEAKER_01: CO2 lasers, when you're when you're removing a lot of of skin, ablating a lot of skin, you're gonna see infection more commonly.
• 32:40
  SPEAKER_01: You can get uh bacterial or viral.
• 32:43
  SPEAKER_01: Either.
• 32:43
  SPEAKER_01: So you can get something called impetigo, which is uh staph infection.
• 32:49
  SPEAKER_01: And you can also get uh a herpes virus.
• 32:52
  SPEAKER_01: So if you're prone to cold sores, sometimes the heat and the trauma from the laser can trigger that to come out.
• 32:59
  SPEAKER_01: So but we but if you go to someone who really knows what they're doing and knows how to use these devices, they are going to take every measure to prevent that from happening.
• 33:10
  SPEAKER_01: And and a lot of times it's uh prophylactically treating you ahead of time so that you so that you don't get an infection.
• 33:17
  SPEAKER_00: So, like you as an expert is gonna give someone who gets cold sores some antiviral in advance, in advance of surgery or of a laser.
• 33:27
  SPEAKER_01: And then another common complication, very common actually, is pigment changes.
• 33:34
  SPEAKER_01: And usually the pigment changes are a direct result from a burn, most of the time, or just using energy that's too high for the skin.
• 33:45
  SPEAKER_01: So the skin can turn darker or lighter, or sometimes it can turn a little bit pink.
• 33:51
  SPEAKER_01: We call that post-inflammatory.
• 33:53
  SPEAKER_01: So what are you doing?
• 33:54
  SPEAKER_01: These these complications, luckily, fortunately, most of the time, they are temporary.
• 34:00
  SPEAKER_00: Even hypopigmented, uh, when they get lighter.
• 34:03
  SPEAKER_01: That's that's the one that that can be permanent, but a lot of times after about a year, the skin can repigment itself.
• 34:12
  SPEAKER_01: Not always, but it can happen.
• 34:14
  SPEAKER_00: Most underrated treatment.
• 34:17
  SPEAKER_01: Gosh, I don't think any, I don't think any lasers.
• 34:20
  SPEAKER_01: I love them all.
• 34:21
  SPEAKER_01: You're making me pick my favorite child.
• 34:24
  SPEAKER_02: We're not going on until you pick something.
• 34:26
  SPEAKER_01: I would, I I think, I think the best place to start for most people is something like the ultra laser.
• 34:35
  SPEAKER_01: So Sinushore Lutronic makes a laser call it ultra.
• 34:38
  SPEAKER_01: It's little downtime, but a lot of reward.
• 34:42
  SPEAKER_01: So it's great for texture and it helps with pigment and pores, and it's great for all ages.
• 34:49
  SPEAKER_01: So if you're new to lasers and you just sort of want to be getting into collagen building and anti-aging, that is a very good place to start.
• 34:59
  SPEAKER_00: What's the most overhyped?
• 35:01
  SPEAKER_00: Did we already go over it?
• 35:02
  SPEAKER_01: I mean, we talked about Morpheus.
• 35:04
  SPEAKER_01: That's not a laser.
• 35:06
  SPEAKER_00: Yeah.
• 35:06
  SPEAKER_01: If I'm um it's an energy-based device, it's an energy-based device.
• 35:10
  SPEAKER_01: Yeah.
• 35:11
  SPEAKER_01: I I think I I like RF microneedling.
• 35:14
  SPEAKER_01: Morpheus has has um has has run its course, I think.
• 35:20
  SPEAKER_01: Okay.
• 35:21
  SPEAKER_00: Very good.
• 35:21
  SPEAKER_00: What's the best for sun damage?
• 35:23
  SPEAKER_01: Any type of laser that's going to target pigmentation.
• 35:27
  SPEAKER_01: And there are many that do it.
• 35:28
  SPEAKER_01: The ultra laser is one of them.
• 35:31
  SPEAKER_01: The the there's a type of laser called an alexandrite laser.
• 35:36
  SPEAKER_01: A lot of different companies make one.
• 35:38
  SPEAKER_01: Very good for pigmentation.
• 35:40
  SPEAKER_01: Pulse, uh, I'm sorry, um, KTP lasers, those are very old, but they're still very, very good for pigment.
• 35:48
  SPEAKER_01: Totally non-invasive.
• 35:49
  SPEAKER_01: RIP XLV.
• 35:51
  SPEAKER_01: R IP.
• 35:52
  SPEAKER_01: That's your old laser.
• 35:53
  SPEAKER_00: So I whenever we started Skin Lab, I I dusted some cobwebs off a laser that I had for a while that was super good, but I never used it because I operate and that's what I do.
• 36:05
  SPEAKER_00: And I gave it to my sister.
• 36:07
  SPEAKER_00: It was, it is the nicest gift I have ever given her.
• 36:11
  SPEAKER_01: Literally.
• 36:12
  SPEAKER_01: And I ran that thing into the ground and it was such a workhorse.
• 36:15
  SPEAKER_00: She ran it to the ground, into the ground.
• 36:18
  SPEAKER_00: She really did.
• 36:18
  SPEAKER_00: I don't know if I I ever got my money out of it, but she definitely got my money out of it.
• 36:23
  SPEAKER_00: And and and I love that.
• 36:24
  SPEAKER_00: And and it died recently.
• 36:26
  SPEAKER_00: So when do I get involved?
• 36:28
  SPEAKER_00: When when do you call me?
• 36:31
  SPEAKER_00: That's the most important part here is when when does Dr.
• 36:34
  SPEAKER_00: Labrasca get involved?
• 36:35
  SPEAKER_01: As in for treating?
• 36:36
  SPEAKER_00: As in for facelifts, it's stuff.
• 36:39
  SPEAKER_01: Yeah, facelifts.
• 36:39
  SPEAKER_01: Face, face, facelift.
• 36:41
  SPEAKER_01: I mean, if someone has a lot of laxity, a lot of jowling, a lot of laxity in the neck, a lot of you know, heavy, heaviness around the mouth and that sort of thing, you're surgical.
• 36:53
  SPEAKER_00: If you can also get laser, because I love someone who gets facelift and and also, you know, oh my god.
• 37:00
  SPEAKER_00: Right.
• 37:00
  SPEAKER_00: That is that is that is the game changer right there.
• 37:04
  SPEAKER_00: Absolutely.
• 37:05
  SPEAKER_00: Um, dual treatment with uh energy based energy-based devices and uh surgery.
• 37:11
  SPEAKER_00: I mean, that'll take uh decades off your face.
• 37:15
  SPEAKER_01: Absolutely.
• 37:16
  SPEAKER_01: I mean, you you can tighten all that skin, but if that skin is covered in sun damage, it's still going to look like old skin.
• 37:22
  SPEAKER_00: Yep.
• 37:23
  SPEAKER_00: So get a laser too.
• 37:24
  SPEAKER_00: What's the best season to get laser?
• 37:26
  SPEAKER_01: I don't adhere to laser season.
• 37:30
  SPEAKER_01: Laser season, a lot of people will say is in the winter time because people aren't getting as much sun exposure.
• 37:36
  SPEAKER_01: Yep.
• 37:36
  SPEAKER_01: But that I think is silly.
• 37:39
  SPEAKER_01: As long as you are not an avid sun worshipper, you're not going to go lay in the sun after you get treated.
• 37:45
  SPEAKER_01: I will cheat treat you year round.
• 37:47
  SPEAKER_01: I mean, what if people in Florida have sun year round?
• 37:50
  SPEAKER_01: They're not, they're they're getting lasers all the time.
• 37:53
  SPEAKER_01: So just just don't don't be stupid and lay in the sun after laser.
• 37:59
  SPEAKER_01: I'll treat you.
• 38:00
  SPEAKER_00: Can lasers erase scars?
• 38:01
  SPEAKER_01: Nothing can erase scars.
• 38:02
  SPEAKER_00: That's the right, of course not.
• 38:04
  SPEAKER_00: But better.
• 38:05
  SPEAKER_00: I I mean we can improve them.
• 38:07
  SPEAKER_00: Yeah.
• 38:07
  SPEAKER_00: I you do a great job improving like my abdominoplasty scars.
• 38:12
  SPEAKER_00: Most of them do great, some of them don't.
• 38:15
  SPEAKER_00: Um, and you have helped in multiple patients who have gotten significant improvement after uh after some laser, right?
• 38:23
  SPEAKER_01: Oh, yeah.
• 38:24
  SPEAKER_01: I love, I think if you can start some non-invasive laser on a fresh surgical scar a couple weeks after suture removal, ultimately you're going to influence the way that it heals for the better.
• 38:38
  SPEAKER_01: So the earlier the better, as soon as your surgeon says it's okay, I would start getting some non-invasive vascular laser on your surgical scars.
• 38:48
  SPEAKER_01: I've had some beautiful outcomes.
• 38:50
  SPEAKER_00: Yeah, you have to start early.
• 38:52
  SPEAKER_00: So lasers, they can shrink pores?
• 38:54
  SPEAKER_01: No, they can't shrink pores.
• 38:56
  SPEAKER_01: Nothing technically can shrink pores.
• 38:59
  SPEAKER_01: But with pores, if you they they sort of get bigger and and widen as you get older.
• 39:06
  SPEAKER_01: So if you can build some collagen around the pores and do some skin, skincare that's going to help keep them decongested, the spore, the pores will look better.
• 39:17
  SPEAKER_01: But you can't really truly shrink your pores.
• 39:20
  SPEAKER_00: Can I get a laser on Amazon?
• 39:21
  SPEAKER_00: Like, can I get like there's those at-home devices, like at home laser hair?
• 39:26
  SPEAKER_00: That's gotta be good enough, right?
• 39:27
  SPEAKER_00: They're like 200 bucks.
• 39:28
  SPEAKER_01: What I mean, do I have to answer that?
• 39:32
  SPEAKER_01: You know what I'm gonna say.
• 39:34
  SPEAKER_01: I really hope people are doing that.
• 39:36
  SPEAKER_01: Why?
• 39:36
  SPEAKER_01: I really hope that's not that.
• 39:37
  SPEAKER_00: Why would somebody not what what would be the downtime?
• 39:40
  SPEAKER_00: Because hey, you know, it's only 200 bucks.
• 39:42
  SPEAKER_00: The console is, you know, might be 200 bucks.
• 39:45
  SPEAKER_00: 75 at Skin Lab.
• 39:47
  SPEAKER_00: It should be 100.
• 39:48
  SPEAKER_00: It's a good round number.
• 39:49
  SPEAKER_00: But uh um, what's the what's the downside to just trying it?
• 39:53
  SPEAKER_01: Well, if if these things were strong enough to be able to do what you wanted them to do, you wouldn't be able to buy it on Amazon.
• 40:02
  SPEAKER_00: Right.
• 40:03
  SPEAKER_00: There you go.
• 40:04
  SPEAKER_00: The it it's not, it's there are regulations, even Timu, right?
• 40:09
  SPEAKER_00: Even Timu, you can buy a little boat on Timu and like uh a little like loader or whatever.
• 40:14
  SPEAKER_01: Like you can buy a boat on Timu?
• 40:18
  SPEAKER_00: Yeah.
• 40:19
  SPEAKER_00: No way.
• 40:20
  SPEAKER_00: You can like I saw him on TikTok a few months ago.
• 40:23
  SPEAKER_00: Little tiny boats that these guys got in, like you'd get in at like like an old school.
• 40:27
  SPEAKER_00: Like a dinghy.
• 40:28
  SPEAKER_00: A dinghy?
• 40:29
  SPEAKER_00: No, about as big as my desk.
• 40:31
  SPEAKER_00: They're about as big as my desk.
• 40:32
  SPEAKER_00: Like a one-person, like something your your kids would have, but maybe like twice as big.
• 40:38
  SPEAKER_01: But they go pretty fast.
• 40:39
  SPEAKER_01: And it has a motor.
• 40:40
  SPEAKER_01: It has a motor.
• 40:41
  SPEAKER_00: Yeah.
• 40:42
  SPEAKER_01: So it's a dinghy.
• 40:44
  SPEAKER_01: I just wanted to say dinghy.
• 40:45
  SPEAKER_01: I just wanted to say dinghy.
• 40:47
  SPEAKER_00: You know, we've we've talked a lot about lasers today.
• 40:50
  SPEAKER_00: Is there anything else you want to talk about?
• 40:52
  SPEAKER_00: About like, did we miss anything?
• 40:54
  SPEAKER_00: No.
• 40:54
  SPEAKER_00: That isn't gonna put me to sleep, right?
• 40:56
  SPEAKER_00: Okay.
• 40:57
  SPEAKER_01: Nope.
• 40:57
  SPEAKER_01: I think that was a great overview.
• 41:00
  SPEAKER_01: We love lasers.
• 41:02
  SPEAKER_01: Are lasers worth it?
• 41:04
  SPEAKER_01: 500%.
• 41:05
  SPEAKER_01: I jumped the gun.
• 41:08
  SPEAKER_01: I jumped the gun.
• 41:09
  SPEAKER_01: So 500% they're worth it.
• 41:11
  SPEAKER_00: So you know, the question then is and and I think Mystic has answered that as she's gushed the entire time.
• 41:18
  SPEAKER_01: I have.
• 41:19
  SPEAKER_00: She has gushed.
• 41:20
  SPEAKER_00: I mean, this is like the when she was 10 or 5 or whatever, she was addicted to Buffy the Vampire Slayer.
• 41:29
  SPEAKER_00: Like, it's like we were talking about Buffy.
• 41:31
  SPEAKER_00: What do you mean was Buffy the Vampire Slayer?
• 41:34
  SPEAKER_01: What do you mean was addicted to Buffy?
• 41:36
  SPEAKER_00: From Christy Swanson, the late 80s, Buffy the Vampire Slayer.
• 41:40
  SPEAKER_01: Currently, currently still into Buffy.
• 41:45
  SPEAKER_00: She used to have she used to get little like sticks and put them in her belt and walk around the house like she was gonna stab a vampire.
• 41:53
  SPEAKER_00: So anyway, that's how that's how much iconic she loves lasers.
• 41:59
  SPEAKER_00: So the official scalpel and skin choice is laser is worth it.
• 42:05
  SPEAKER_00: Yes.
• 42:05
  SPEAKER_00: I'm Dr.
• 42:06
  SPEAKER_00: Elgin Labraska, board certified plastic surgeon here with my sister Mystica Labraska, who is a dermatology PA of 16 years.
• 42:13
  SPEAKER_00: We are scalpel and skin, we are siblings, we're business partners, and somehow we still like each other.
• 42:18
  SPEAKER_00: Boom.
• 42:18
  SPEAKER_00: Let's go.
• 42:19
  SPEAKER_00: That's it for today's episode of Scalpel and Skin.
• 42:22
  SPEAKER_00: Follow the show wherever you listen and come find us on social media.
• 42:25
  SPEAKER_00: Send us the treatments, trends, or questions you want us to break down next.
• 42:29
  SPEAKER_00: This is Scalpel and Skin.
• 42:31
  SPEAKER_00: Let's go.