Beauty on a Budget: The Only Anti-Aging Tips You Need

Dr. Gallus (00:02):
You are listening to another episode of All the B's with me, Dr. G and my scrub tech Bri. Hey everybody. Welcome back. It's Dr. Kat Gallus and you're listening to All the B's, the unfiltered plastic surgery podcast that also covers some celebrity gossip and I'm joined again with Bri. Hey Bri. What's up? Hey, happy Wednesday. Yeah, it feels like that Wednesday. That kind of Wednesday. Yeah. So today we're going to talk about preventative treatments, which are so important.

Bri (00:37):
So important.

Dr. Gallus (00:38):
Please do. You cannot just do nothing and then hit the big red help me button at 65. It's really hard to

Bri (00:46):
Which a lot of people do.

Dr. Gallus (00:48):
People try to do that. I would say at least make friends with sunscreen.

Bri (00:56):
Yeah, somebody, we were talking about it in the office yesterday and one of the girls was like, when would you recommend starting preventative treatments? And I was like, as soon as you got the funds. 18.

Dr. Gallus (01:08):
Yes, as soon as you can afford it, but first let's talk about some important wouldn't be the word I'd use, but some celebrity news. It's important to somebody. The first article I think is entertaining because it's Kathy Griffin, who I'm not sure if, do you know who that is Bri?

Bri (01:24):
I do. She's the redheaded chick, right?

Dr. Gallus (01:27):
Yeah. She's usually surrounded by controversy. Anyway, she's a comedian. She kind of looks insane here. $218,000. She paid two 18 for her facelift, her third, and I was like, I'm not sure she got what she needed out of that, but I mean at

Bri (01:44):
Least $218,000, she better look like she's 21. I mean, did she give the doctor's name?

Dr. Gallus (01:55):
No, I don't think she does. And she says that she said one of her first facelifts was by, well maybe she does. I think she drops Ben Talei's name in there, who I think we've talked about in our OR before. He's a very well-known facial plastic surgeon in Beverly Hills and he can charge kind of whatever he wants. I would say though $218,000 is a hell of a lot, but it's her third facelift, so the risk is incrementally higher every time you go back in there and you gain less each time as well because you can't be as aggressive as that first time. So I think that's, and it's Beverly Hills, so you just triple the cost of what an average person would pay. Honestly,

Bri (02:43):
I feel like I need more Botox because all my facial expressions are still expression listening to this, I just can't believe she's only 65 and she's had three facelifts.

Dr. Gallus (02:54):
Her first facelift was at 38, so

Bri (02:57):
Feel like, which is insane. I assume that was just, I feel like that one doesn't count a skin excision. I'm sure that wasn't a deep plane facelift.

Dr. Gallus (03:04):
Yeah, because it was probably 30 years ago. The second one needed to be the real deal.

Bri (03:09):
Yes. So the third one, I am just a little confused. She looks fabulous of course, but $218,000 and she still looks 65. Sorry.

Dr. Gallus (03:25):
She says that she had heard six or seven surgeons. Six, seven. Six seven in Beverly Hills now charging up to 1 million per facelift. No, I have not heard that. I feel like that's just a rumor, but

Bri (03:40):
I feel like that's what Kris Jenner and possibly Lindsay Lohan did.

Dr. Gallus (03:45):
To deal with them. Yeah, I would want a million dollars I think because it's such a big deal, but I think she went, so she says Ben Talei did her, I always Taleil, it's Talei. Sorry, sorry. Was Kris Jenner's previous surgeon? We all know her current surgeon was Steve Levine and he said, I believe based in Manhattan and charges significantly more, but I don't think so. I think 200 is kind of the up and you're including nursing and hyperbaric and not all the extras. They're not skimping on anything. But anyway, whatever. Yeah, I would say awesome for her. She does say that she has to tell a lot of dick jokes to make that money back, which I get. Yeah,

Bri (04:30):
I love

Dr. Gallus (04:31):
That. Just know that every time you do a facelift, the risk goes up and so choose wisely. She looks crazy there. Alright, moving on to the before and after photos of the Wicked Cast. These

Bri (04:44):
Memes though are so good. The memes of them two and what happened on this movie set is just what? They didn't have a craft table like what the?

Dr. Gallus (04:58):
No food.

Bri (04:58):
Ozempic hit hard. People are making these memes of what their lunches look like on set and they're slicing a millimeter bread and a millimeter cucumber and then putting a millimeter of another slice of bread on top of it and it's like air in a sandwich and that's what they're feeding 'em.

Dr. Gallus (05:18):
It's kind of wild. Is it the stress of the press tour? Yeah.

Bri (05:23):
No, I don't, but that's giving Ozempic no judgment, but I just feel like you don't get that skinny without a little help or something else going on.

Dr. Gallus (05:34):
Yeah, some drugs. Yeah, they all look crazy.

Bri (05:40):
They also came out recently about their relationship together there. Did you see that, I don't want to say this wrong, but their relationship of not being in a relationship but being in a relationship to explore what that relationship might look like. What, yes. They came out together and they said they were in, I'm not going to say this right, but a thank you,

Dr. Gallus (06:05):
A non demi curious, semi binary relationship.

Bri (06:10):
Yes. Which is just exploring what the future might look like together, but not in a relationship, but they came out as that in a relationship.

Dr. Gallus (06:20):
Cool. Which I think is great for that. Pretty sure that relationship's going to end once the movie press tour is over.

Bri (06:27):
M-hmm.

Dr. Gallus (06:28):
That's weird. Also, why wouldn't you just call that being friends? There's just so many other words that could have been a little less confusing. Demi, non demi curious, semi binary relationship. I don't think we have the time to unpack that, so I'm just going to move on. Yeah,

Bri (06:47):
Just say your lovers or friends or partners or besties or

Dr. Gallus (06:51):
Fuck buddies. I don't care.

Bri (06:52):
Yeah.

Dr. Gallus (06:53):
Also, no one cares. Hope they don't break a hip. Always thought. It's not like you looked at Ariana's before pictures and thought she looks fat. She was thin and tiny and then you're like, oh, take off 10 more pounds or something.

Bri (07:09):
She looks so good.

Dr. Gallus (07:10):
She looks scrawny now and then even Erivo. I always thought she looked skinny and not until they compare to previous ones. Are you like, oh

Bri (07:23):
Yeah,

Dr. Gallus (07:23):
She's got that clavicle thing you love.

Bri (07:26):
I know. I just, I guess need to lose 20 pounds.

Dr. Gallus (07:33):
But then your butt disappears, so whatever.

Bri (07:35):
That's true. It's a very fine balance of losing enough weight and not too much to where all my butt is gone. My butt's looking a little saggy. I got to eat a couple burgers,

Dr. Gallus (07:49):
Got to have some goldfish. Yeah, Michelle Yeoh looks good and then looks skinnier. I don't know.

Bri (07:56):
Everyone's just very skinny.

Dr. Gallus (07:57):
Very, very interesting.

Bri (08:00):
I want to know what it was like on set. Was this just a 24/7 movie set where they couldn't eat, couldn't sleep?

Dr. Gallus (08:09):
No, I don't think it was that intense. I mean, I think the press tour might be more intense, but who knows? Probably not going to go see the movie. Are you going to go see it?

Bri (08:20):
So my sister has requested while she is in town that we have to go see it. So I told her I was going to watch the first one and I didn't. So maybe

Dr. Gallus (08:30):
Okay, you'll be able to catch up.

Bri (08:31):
Yeah, that was her one request, otherwise I would not be seeing it.

Dr. Gallus (08:36):
I feel like Zootopia 2 is edgy out over this in terms of things I want to watch. Zootopia is the shit. That is such a good, I love that. I love that movie. I came home the other day, I don't remember when because Bella, my oldest was home and her and Juju were watching it and I'm What is even happening here? And they're just feeling nostalgic for Zootopia. I'm like, okay. My

Bri (09:01):
Kids go so back and forth between, it'll be some super horror movie or Pooh Bear or something, and I'm like, what?

Dr. Gallus (09:12):
Yeah, they're still in that can watch anything. Yeah. Okay. We got to do a little bit about Meghan Markle because why not? I saw this and I thought the unrelenting trolling of her is crazy because even though I think she's annoying, who cares that she was preparing a Turkey without gloves on? She did have jewelry on. I was like, I don't care if she's not wearing gloves. It's her house. But then I guess her jewelry was on. But the fact that you're just preparing a Thanksgiving Turkey and everyone's following you around, you're in the operating room and commenting on your sterile technique is crazy.

Bri (09:57):
I've actually never thought about wearing gloves when preparing a turkey.

Dr. Gallus (10:00):
Nobody wears gloves. When you're preparing food at your own house, you don't work at a rest. It's weird. I mean, you can, okay, I take that back. Actually I do sometimes because I have access to gloves and my hands get, I'm cold all the time, man. So if the meat isn't totally thawed, I'll put gloves on to make meatballs or burgers or something like that. I don't like touching it. So

Bri (10:26):
I touched a lot of things without gloves. We're building immunity.

Dr. Gallus (10:30):
Yeah, it's not a germ thing. I just don't like my hands being cold and it gets greasy and then I'm constantly washing my hands. But the average person does not do that. No. And just who cares?

Bri (10:42):
Yes, nobody

Dr. Gallus (10:44):
Cares. It's funny that people went 890 comments.

Bri (10:48):
Every other thing she does to prepare food for other people, she's not wearing gloves in anything. So why would this be any different when she's laying all these little things down and making cute little cheese boards and snacks? She's not wearing gloves in any of that, so I think,

Dr. Gallus (11:05):
Well, they're just saying it's raw meat, so blah, blah, blah.

Bri (11:09):
Please. We've touched a lot of raw things.

Dr. Gallus (11:14):
Yeah, I feel like it is a little bit overkill, so we'll keep moving on.

Bri (11:20):
I do take off my jewelry though.

Dr. Gallus (11:22):
Right. And so that's her issue is she didn't take off her jewelry,

Bri (11:25):
But only because I don't want

Dr. Gallus (11:26):
To ruin my jewelry.

(11:28):
I don't wear my jewelry because I hate taking it off or this kind of stuff. Then plastic surgeons weigh in on Martha Stewart's youthful massage. She had a, it's a green juice. She always has a glamorous photo shoot. Like what? Good for her. Actually, ironically, the OG Meghan Markle, this is who Meghan Markle aspires to be, but yeah, she's is funny. Is that her photo shoot? No, that's her 2020, which is kind of wild. I feel like they don't even show her now, which is I was going to say you go girlfriend, but that is the kind of, she likes to, I think it might be that.

Bri (12:12):
Oh, she's fabulous,

Dr. Gallus (12:13):
But that's filtered. So filtered. So, okay, wait. Wow. The comments,

Bri (12:24):
Martha learned in prison that eating healthy is very important for youthful skin. She said prison food was okay as long as it was clean shaven.

Dr. Gallus (12:31):
Oh, that's awful

Bri (12:33):
Youthful? Her neck has got more lines than a zebra crossing.

Dr. Gallus (12:36):
Wow. Wow. People are rough. Yes, people are so mean. I think her stand is that she looks great, but she doesn't do plastic surgery, which I think is, we're going to talk about that. This is how celebrities dodge the, I didn't have a facelift, although a hundred percent she did. That's impossible. But she has, again, a lot of filters, a lot of makeup and contouring, but there's no way she didn't do a ton of preventative stuff and maintenance things like lasers, Botox, fillers, microneedling, PRP, facials, like peels, all of that stuff is what we're going to talk about. And so I think that's important to understand that she's not just running around living her best life without sunscreen or skincare.

Bri (13:27):
I just feel like no matter what, even I know a lot of people that do a lot of lasers so forth, eat super clean, they still got wrinkles. They still, it doesn't make you reverse age. This isn't Benjamin Button. Okay. I don't even believe that's just lasers and fillers. No, part of me does.

Dr. Gallus (13:52):
No, a hundred percent. She had a facelift. I just dunno why she doesn't cop to it. It's just not recently. I don't know. Yeah, no one cares. Martha, you look fabulous. Just yeah, it's sort of bothers me when celebrities don't cop to having,

Bri (14:05):
So that gives me $218,000 vibes.

Dr. Gallus (14:10):
That was worth the $200,000.

Bri (14:12):
This was worth it. This is what I'm expecting. Okay.

Dr. Gallus (14:16):
Yeah. It doesn't even look like her to be honest. Those lips, lips look amazing. She looks great.

Bri (14:22):
Even in her unedited photos, she has a great complexion, great skin. Everything is tight. There's no dimpling. And

Dr. Gallus (14:33):
Yeah, if you did a next side by side with her and Kathy Griffin, you'd be like,

Bri (14:38):
And how old is Martha?

Dr. Gallus (14:40):
84?

Bri (14:41):
Yeah, 84 compared to 65.

Dr. Gallus (14:44):
Yeah, that's no question. We can cover the next topic really quickly. Glover, I guess I always only thought it really doesn't have anything to do with plastic surgery except that I like Donald Glover. Hey, we love him. It's fine.

(15:04):
Maybe if you factor in a DVT prophylaxis for elective surgery, we could talk about that. And that's not getting a blood clot. So he basically had a stroke last year and had to cancel his tour. And so he's finally recovered and telling people what happened, which also, ironically, Jamie Fox also had a stroke, but it's interesting because I think he had a blood clot and then the blood clot, a blood clot in your legs should not give you a stroke. The only way it can give you a cerebral stroke is if you have a PFO, which is a hole in your heart. And then a multiple things have to go wrong for that to happen. So it's kind of bizarre, but that's what happened. And so

Bri (15:51):
It's far travel,

Dr. Gallus (15:52):
He's had his PFO closed. I just saw a patient with this and I've seen, I've had relatives have this. So even though it's rare, it happens. But with the patient, I was like, well, don't you want to close the hole in your heart so that it doesn't happen again? And she was like, Hmm.

Bri (16:13):
So woudln't you know if you had a PFO at birth though?

Dr. Gallus (16:17):
A lot of babies do, and it closes, it's like a childhood murmur that goes away. I don't know. I think,

Bri (16:25):
But if you know it doesn't, don't you think you would want to keep checking back on that and seeing if it's the hole in the heart?

Dr. Gallus (16:31):
I think it gets missed. Yeah. I mean I think it's the only way. No one's doing an ultrasound, a check or an echocardiogram to look, so it would just be like a childhood murmur that maybe someone notices later. I don't know. So most people don't know that they have a PFO until you have a problem and you can have really little small ones that are insignificant and larger ones that are problematic.

Bri (16:54):
Are you still a candidate for surgery if you have a PFO? I feel like we had that question the other day.

Dr. Gallus (17:01):
Yeah, so I need clearance from, it depends on the surgery. I need clearance from your primary care and ideally your cardiologist. And it's sort of like you have this risk factor whether or not I put implants in or take implants out or do some sort of surgery. The surgery is a risk factor for developing a blood clot in your legs. We already don't want that because if the blood clot in your legs happens and then it does its normal thing, meaning you don't have a hole in your heart, then it goes into your lungs and then that can cause a pulmonary embolus, which we also don't want because that can kill you. That could be potentially deadly. Often it's not. It's often small. But either way, you don't want to have a pulmonary embolus. This in addition to that risk factor, you throw a clot and it crosses your heart and ends up in your brain, that's even worse.

(17:58):
So the issue is that having surgery puts you at risk for developing a clot in your legs. Some surgeries are riskier than others based on the length of time you're under. Other factors like your age and weight and whether you smoke or not. And then there's things we do in the operating room. Put the squeezers on your legs to help prevent that. All these things are into play, but this is just one more risk factor for having to problem if you develop a clot. So there's a lot of ifs that have to stack up. He probably developed a clot because he was traveling all the time, so he was on planes a lot and sitting and maybe got a DVT in his leg and then through his clot and then it went across his heart and became a stroke. But my responsibility is making sure that we don't create the problem by putting you to sleep to do surgery and then having a new problem.

(18:52):
So I need to know what your risk is and what we can do to mitigate that risk, whether it be a blood thinner or maybe just get the hole in your heart fixed, whatever. I just need to know. So it's not completely a no, but it's a big, we need to evaluate what the pros and cons are. So last but not least, this also random unrelated to plastic surgery story. So you can just skip two minutes ahead if you're not interested is as EsDeeKid, why do we think it might be Timothée Chalamet as I like to call him? I mean why not? The incognito hip hop act has been identified by online sleuth as Chalamet disguise. I love that.

Bri (19:37):
I love that. They're like, thing is the pair even had the same scarf case closed

Dr. Gallus (19:44):
Also that he was in town for this and also the rapper had a show. They're tracking his movements. I love, love. T

Bri (19:54):
That's crazy. Investigative work at its finest.

Dr. Gallus (19:58):
And he loves to rap, apparently.

Bri (20:00):
Oh, really?

Dr. Gallus (20:01):
Yes. You know what? I believe it. I mean, what doesn't Timothée not like to do?

Bri (20:07):
Yeah, I believe it. That's probably why Kylie stays with him because he has this alter ego rapper and you know how she loves her rappers. So maybe, okay. How long has this EsDeeKid been around for?

Dr. Gallus (20:23):
I don't

Bri (20:24):
Know the length of him and Kylie's relationship because maybe he had to be a secret rapper to keep her.

Dr. Gallus (20:30):
He recently got his first top 40 hit in the UK. Of course the guy is in the UK, which is kind of weird. They're the same person. Case closed. Okay. I love that for him.

Bri (20:46):
I love that for too,

Dr. Gallus (20:47):
If you were, I mean, I guess it would be a great gag if that was really it. But otherwise what could possibly motivate Timothée to do that? It gives him something like he's busy, something to live for. He's booked and busy man. Booked and busy. So this is his creative outlet. Okay. Right. Being an actor is not creative. Yeah, not enough. Not enough. Not enough. Okay. All right. Let's continue on and now get to the meat of what we're going to discuss. So thanks for bearing with us with the Donald Glover and which I feel like ended up being tangently educational. And then Timothée. So preventative treatments, what are we talking about?

Bri (21:36):
Botox, lasers, sunscreen, skincare. I know Botox probably wasn't the first one on your list, but it's the first on mine so.

Dr. Gallus (21:43):
It's pretty good. But yeah, let's just, I cannot say enough how important sunscreen is. I just really can't every f---ing day

Bri (21:54):
Put on sunscreen. I put on sunscreen every morning and I literally probably only have it on to drive because most of the time I'm at work before the sun's up and I leave now when the sun's down, I'm in the OR most of the day, or windowless prison.

Dr. Gallus (22:08):
I mean right now there's sun coming in. Come on. Yes, I do agree though.

Bri (22:16):
That's my selfie light.

Dr. Gallus (22:18):
I know there's a window in your room, so get out. So yeah, so sun is hitting the right side of your face right now. And when you go from room to room in our office, aside from the OR, there's sunlight coming in and usually in your drive, aside from daylight savings time, left side of your face, if you drive a car that has the sunroof situation or moonroof situation, which I think we both do,

Bri (22:44):
The entire top of my car is a sunroof.

Dr. Gallus (22:46):
Sun, sun, sun, sun. So just put it on, unless you live in some world where you get from place to place in an underground tunnel, just put it on if it's cloudy, still need sunscreen.

Bri (23:00):
Because then when you do go to do, I feel like we see a lot of people, I'm sure most people do, is a lot of the older generation, I don't know if that was the proper word. They come in and their skin is so sun damage and then you go to do all these treatments and it's just you can't reverse that shit.

Dr. Gallus (23:19):
Yeah. So for example, something like a facelift involves lifting the tissues and the skin. And if the skin has poor quality, it doesn't last as long. It doesn't hold as long. It's sort of like the other big category of patients, which is ozempic, massive weight loss patients. Their skin quality has been stretched out and then doesn't have the same recoil anymore once you've lost the weight. So you put it on stretch and it looks super tight and then it stretches back out because it just doesn't have that resilience. And the same goes for sun damaged skin, aging, genetics, smoking. You can't control the aging, you can't control the genetics, but you can surely stop smoking and you can try to fight the daily UV sun damage that happens. So that is my plea. That should be the first basic step is watch your face and put some sunscreen on.

Bri (24:21):
Okay, second one, get actual medical grade skincare. I feel like that was my biggest change, at least working here. The last office I worked at didn't have any skincare, but I'll have to show you before and after my face if you haven't already seen it. It's taken a lot of work. Don't be like my sister who's 32, sorry, I'm calling you out and uses the St. Ives scrub from Target. That was the only thing. She finally, as of six months ago, started buying still a s--- skincare, but it was still an upgrade. It was the Happy Hippie one from Ulta. I don't know if it's actual shit, but it's like I have sent her stuff too. But yeah, she just reverts back baby steps. We're getting there. But there is something to be said for actual medical grade skincare and not just buying the crap that looks cool. Like my daughter, she buys smell all the crap that looks cool and she literally has broken out so bad because of it. Now she does one thing and that's it.

Dr. Gallus (25:25):
Yeah, I mean everything has all these added ingredients like scents and color and stuff. That's probably not doing you any service, doing you a disservice rather.

Bri (25:38):
And you don't need 15 steps.

Dr. Gallus (25:40):
No. So medical grade skincare, I absolutely advocate for basically a good cleanser because it normalizes a pH on your skin so everything else can work an exfoliator so that you get off the dead skin. So any product you put on your face can penetrate and do what it's supposed to do, frigging sunscreen. And then you need to start adding things that are going to do stuff. So that could be anti-aging or brightening. That's where you start talking peptides and vitamin C and growth factors, but at least start with the basics and then get some professional insight. And then nothing makes your skin more glowy than some legitimate Botox and it doesn't matter. Yeah, the neuromodulator mine's kind of wearing off. I tried a new one. Yours is good.

Bri (26:35):
I knew when my lip flip started kicking in two days ago, I went to spit in the sink and I was like, spit literally was dripping down my shirt. He's like, are you okay? I was like, it's just the Botox kicking in.

Dr. Gallus (26:47):
Yeah, I cannot move.

Bri (26:49):
I'm not having a stroke.

Dr. Gallus (26:51):
Yeah, I always tell, I had some new Botox patient the other day and I said, here are some areas we can treat. She's like, oh, sometimes my friends get here. I was like, if you've never had Botox before, we're going to start up here.

(27:04):
Then the varsity move is to start messing with the lower third of your face because it does change things. And if you're not used to it, you really dip your toe in. Don't go full force because then you might not come back. Also, I don't over Botox people's foreheads their first go round because it does feel weird and can feel heavy. And I learned that over time to just start slow. You can always add more and then up your dose later if you really like the effect. But there is definitely a glowy skin effect of doing neuromodulators Botox. I mean any of 'em. They do give your skin a little bit of an enhanced glow when it kicks in and it's nice. Can you overdo? You can overdo Botox, but usually more of what we see is overdoing injectables, right?

Bri (27:54):
Yes.

Dr. Gallus (27:56):
Too much

Bri (27:56):
Overdoing the filler and having somebody knowledgeable so they don't drop things that aren't supposed to be dropped. I saw this from Botox. Okay. I was like, what? Sorry,

Dr. Gallus (28:12):
Are we dropping the filler on the floor? I'm confused.

Bri (28:14):
I would still use it just like my Thanksgiving stuffing my mom. Sorry, side note. My mom goes to pull the stuffing, which is my favorite part of the Thanksgiving meal out of the oven, straight to the floor, drops it everywhere. And she's like, oh my God. I was like, I'm going to close my eyes. Just pick it up really quickly. Ten second rule. We're building immunity. No gloves.

Dr. Gallus (28:42):
Yeah, nevermind the gloves. We just scrape that shit off the floor. That's the worst. Yeah, you want somebody who knows what they're doing, right? Because you don't want to have one eye closed or something after your Botox. And same thing with filler. There are risks. You can have a vascular occlusion, pretty rare, but possible you can have delayed onset of infectious nodules, nodules. That occasionally happens even in the best hands, best circumstances. And probably the more common thing is just looking overdone or unnatural or having the filler migrate, which we constantly see called out in, OK Magazine or whatever. When people look a little wild.

Bri (29:28):
Kathy, sorry. I'm done. I'm sorry Kathy, I'm not being very nice to you today.

Dr. Gallus (29:32):
But yeah, don't overdo it. So I feel like one of the things that we used to do kind of a lot or trended really was the tear trough filler. So along this of your eye and then it became less and less popular because it just looks unnatural and lips controversial. More is not always better, Bri, but everybody has their aesthetic. It has to match what your goal is, what your aesthetic is. And then I would also say that filler is not necessarily preventative. It's restoring volume loss or augmenting some feature you really like, but it's not preventing anything. Those things are like lasers and peels and skincare. So I think if you want preventative, I think most bang for your buck is laser. Would you agree?

Bri (30:21):
Yeah, I agree.

Dr. Gallus (30:23):
Because there you're stimulating the skin to heal itself and stimulating collagen, elastin. And one of the bigger components of aging skin is a loss of collagen and elastin. You stop making as much of it after you hit 35. So without stimulating your skin to create collagen, elastin, your skin's going to get thinner and more wrinkly and crepey and all the things we all hate. And by the time it's gotten to that past point, it's really hard to restimulate it to do anything.

Bri (30:53):
Right. So if you're just starting out, would you suggest somebody maybe start with, and you're younger microneedling, what would be the first thing you would start with?

Dr. Gallus (31:04):
I think it's a good baby step to do either a peel or microneedling. Both of those are increasing your skin turnover and over and stimulating collagen and elastin. And I think that's a good win-win. And then we like microneedling with PRP, it gives you a really nice glow. You can do microneedling and add skin brightening to reduce any pigmentation that you might have already picked up. Things like IPL are helpful, get erase the sins of the summer. So it takes away the surface pigmentation that you might have.

Bri (31:41):
Not if you're wearing sunscreen.

Dr. Gallus (31:44):
I know, but even so it's still like it happens or it's accumulated over your lifetime. So all of those things factor in. So IPL can be great for that, but I do like radiofrequency microneedling. That's probably not what I would start with in my twenties, but it's great. Maybe thirties, forties. And that's adding energy at the tip of the needle. So it's tightening the skin a little bit there as well. If you don't need volume, a good alternative is Sculptra. It adds, increases collagen, elastin stimulates the skin to get a little firmer without adding volume or too much volume in an unnatural way. So those are all options.

Bri (32:25):
We love that. And then as you get older, you can migrate depending what your concerns on to IPL, CO2.

Dr. Gallus (32:35):
Yeah. So CO2 is also a great option, but most young people aren't. It's a week of downtime. I don't know that you would need to do that in your twenties. You really have to have a lot of disposable income, but thirties, forties, definitely.

Bri (32:49):
Or work at a plastic surgeons.

Dr. Gallus (32:51):
Yeah, but

Bri (32:54):
I literally can't ever leave because of the amount of work being done to my face here and maintenance. I'm going to be here when I'm 80.

Dr. Gallus (33:03):
I mean, if you're scared about stuff that might be a little bit more invasive, then I would and or you have ethnic skin, then you want to start with lesser intense things. We have a BioRePeel, which is a light peel that you can do. It's safe and also so good, so nice. But a lot of those things. So my rule of thumb is if the downtime, the recovery time is minimal or small, then usually you need multiple repeated treatments over time. If the recovery is long like a week or has a bit of downtime while your face has to resurface, then you don't need to do it as often. So if you're doing a CO2 resurfacing and we blast your face off, you shouldn't need to do that again for two or three years at least, depending on what else you're doing. But if you're going to do microneedling without energy, then you probably should do one a quarter if you can, because otherwise just doing one is nice. But then, so I definitely think you should have a long-term commitment to skincare and maintenance treatments. And then remember that the earlier you start surgery doesn't mean that you won't need to do any of these things for maintenance. There's no getting out of it.

Bri (34:28):
Yeah, there's not. You're still have to,

Dr. Gallus (34:29):
Unless you want to move to the moon, you need a lot less gravity.

Bri (34:33):
Yeah. Still going to have to do it after. But also your nutrition plays a huge role. Make sure you're drinking water, get your vitamins, get your grains, get your collagen. It's all important.

Dr. Gallus (34:48):
Yes. I do think it's a little bit, we're starting to back up and take a little bit more of a holistic approach and not just doing the one thing, isn't it? Just Botox is not the answer. It's a kind of multidisciplinary, holistic way of taking care of yourself and it's fine. You can't get overwhelmed with that. You can have a glass of wine and it's not going to kill you. You're not going to look like s--- the next day.

Bri (35:14):
Yeah. You're not going to look like Martha at 84 from just drinking greens and horseback riding.

Dr. Gallus (35:20):
No, there's more to it's important, but if you're also smoking and drinking every night, you're going to age faster too. So again, you have to balance it with lifestyle and

Bri (35:34):
Stop smoking. All these absolutely gorgeous young girls come in here and they smoke and I'm like, just stop it. Stop.

Dr. Gallus (35:44):
Yeah. The vape is not it. Okay, Bri, you're on a budget. What would you invest in then?

Bri (35:51):
Skincare.

Dr. Gallus (35:52):
Skincare. And then second would be Botox.

Bri (35:58):
Oh f---. I don't know. I really love my Botox.

Dr. Gallus (36:03):
Skincare first. Otherwise, everything else is

Bri (36:04):
Skincare with your sunscreen and then Botox and then if you're young, so you're in your twenties. And then chemical peels. I did those super heavy when I was trying to get my skin back in shape. My skin was a hot mess. I know I've talked about this before. And Ashley would just peel the crap out of my face. And I think that helped so much between that and the skincare, it's, I eventually want to start getting back into retinol. I stopped doing it. Or what do we use tretinoin? So that I need to start getting back into, I did not do it during the summer. I was outside a lot. What age would you suggest people start adding a retinol or vitamin C to their I can't do vitamin C. It makes me break out so bad.

Dr. Gallus (36:59):
I would say if you can tolerate it 30, A lot of people are already on a Retin A in their twenties anyway, if you have acne. So it doesn't hurt. But yeah, some of the best skin I've seen are ladies who have been using it since their thirties or forties and are now like 60 or 70. And you're like, huh. Okay. So I'll start back today. I mean, most of the skincare products we use have some retinol in it. And it doesn't have to be retinoic acid every day. It can be once a week, twice a week, something along that line. And then a lot of the products, like the AnteAGE stuff, the accelerator has a retinol adjacent product in it. So you don't necessarily need to have your face slough off with Retin A, but it is nice to throw in there for sure.

Bri (37:50):
Yeah,

Dr. Gallus (37:51):
I know. I used to do it every August. I would take a tube of Altreno or Refissa or whatever the retinoic acid du jour is in our office right now. It's Altreno. And then August, September use it until it was done. And then so every year do that. So that way you get, and then your other medical grade skincare products have retinol derivatives or retinol adjacent stuff, plant-based stuff.

Bri (38:17):
That helps. I went up to my daughter's room and the other day, and she had three things with retinol. I was like, but you're 11. I'm taking all of these.

Dr. Gallus (38:25):
That's too young. You cannot use these. Did she steal it from you? Or

Bri (38:30):
I don't know. They must have come in a set or something. And I was like, you don't use these, right? Of course she does. So I was like, nope.

Dr. Gallus (38:41):
No, that's crazy. It's not going to do any, it's not helping. Their skin's already in great shape. Yeah, they're making collagen, elastin. They're doing, again, they just need to be washing their face and using sunscreen essentially. Unless you have acne and then you can treat that, but put your little star patch on and move along.

Bri (39:02):
Yeah. Oh yeah. She won't do that either, which I think is so funny. She's like,

Dr. Gallus (39:06):
Oh, really?

Bri (39:07):
They cause cancer.

Dr. Gallus (39:08):
Oh God, no.

Bri (39:09):
Yeah. So she actually threw out all my pimple patches in my room too, and I was like, that was rude.

Dr. Gallus (39:15):
I love those things. I don't use 'em, but I think it's cute when the kids have 'em on.

Bri (39:19):
I love them. They're adorable.

Dr. Gallus (39:21):
Alright, so that is our quick and dirty spiel on preventative treatments. I think the motto is to start early and wear sunscreen. Amen. Thanks for joining us. If you have questions, need info about scheduling, financing, click the show notes for links. Give us a call or drop us a like, like and subscribe.

Bri (39:44):
Like and subscribe. Or come in and get a peel and a laser.

Dr. Gallus (39:49):
Love that. So we're going to scrub in and scrub out. If you're listening today and have questions, need info about scheduling, financing, reviews, or photos, check out the show notes for links. Restore SD Plastic Surgery is located in La Jolla, California. Learn more about us. Go to restoresdplasticsurgery.com or follow us on Instagram @restoreSDplasticsurgery. If you enjoyed this episode, please share it and subscribe to All the B's on YouTube, Apple Podcasts, Spotify, or wherever you like to listen to podcasts.