Better Skin With Blood? PRP vs. Exosomes Explained

Dr. G (00:02):
You are listening to another episode of All the B's with me, Dr. G and my scrub tech Bri. Hey, I am Dr. Kat Gallus and you're listening to All the B's with myself and Brianna. Hey, Bri.

Bri (00:22):
Good morning. Happy hump day.

Dr. G (00:25):
Yeah, I don't know why we do this to ourselves on a Wednesday, but yeah, today we're going to try to have an intelligent conversation about exosomes and PRP.

Bri (00:35):
Key word intelligent.

Dr. G (00:39):
Yeah, I don't know how we're going to, it's hard. I barely understand exosomes and PRP, and then to take that information and translate it so that the average person can understand it. Remove all the medical speak is a little challenging, but I think I've got some ideas about how we're going to cover it.

Bri (01:01):
She started talking about it yesterday in the OR and I was like, you really need to dumb it down a little because I don't understand that, so.

Dr. G (01:08):
I know. And then I used some stupid word, which I forgotten now to talk about it.

Bri (01:14):
Adding it to my armamentarium.

Dr. G (01:17):
What was the word? It was another A,

Bri (01:20):
The word was,

Dr. G (01:20):
I was another A word I feel like. No?

Bri (01:24):
It was hard.

Dr. G (01:27):
Oh, arduous.

Bri (01:28):
Arduous. And I was like, can't we just say hard?

Dr. G (01:32):
I forget why I was even using the word arduous. Okay, well that's enough.

Bri (01:36):
This conversation is arduous.

Dr. G (01:39):
Slay. Okay, so let's hit our celebrity news because Kylie Jenner had been making the rounds on social media. Everybody's like no longer gate keeping their plastic surgery and telling us what their boobs look like or what implants they have. And then somebody captured her scars, her incisions so great.

Bri (02:03):
Just looks like she had a mastopexy.

Dr. G (02:05):
I know people are zoomed in and I'm like, yeah, that's an incision. I mean, it's not Doja Cat level good, but it's probably just still healing. I don't know.

Bri (02:15):
And everyone's scars differently and it's kind of hard to judge that.

Dr. G (02:21):
Right. As we've been accused of rage baiting people and women on women hate or whatever. I will just say, I think she looks good and the incision's showing. So kick rocks. It's fine.

Bri (02:39):
Yeah. All the pictures of her that I've seen though, it doesn't look like she has that very lateral incision. It looks like she just has all her bikini pics, you don't see that incision at all?

Dr. G (02:50):
Well, they probably Photoshop 'em out.

Bri (02:53):
Yeah. So then do you think she had a lift?

Dr. G (02:57):
Hell yeah. I think she did. I think she did. And she had implants put in and she'll probably need another one. The implants are pretty large, but they're usually really good about Photoshopping stuff, so everyone thinks, but they're not. So I mean, it would be better if you could keep it real and let us see your incisions, like Doja Cat, but it's fine.

Bri (03:23):
Yeah, exactly. Be fully transparent. We didn't see that one.

Dr. G (03:28):
No.

Bri (03:29):
There's a lot of things you can do for incisions, like lasers after it, scar creams, scar tape.

Dr. G (03:34):
People were coming at her, can't you find a better fitting bikini? And I was like, geez, calm down.

Bri (03:43):
It's always lose lose no matter what.

Dr. G (03:47):
I mean, you struggle to find a bikini that holds everything in and doesn't.

Bri (03:52):
I do. So we had our annual Christmas in July party on Saturday, and the struggle I always find is finding a bikini that covers everything and my scars and doesn't free the nipple mid pool sash. So yeah, it's hard. I want to wear a tiny pink bikini, but I also have to be cognizant of my scars. Sun's out, tits out.

Dr. G (04:23):
I think everybody looks so cute in their stuff at our party. So then let's move on. So yeah, she has scars. Everyone needs to get over it. Moving on. This actually was horrifying. Somebody went on Reddit to talk about PDO threads in their nose, and I was like,

Bri (04:45):
Oh no.

Dr. G (04:46):
Oh, I have questions. Why, why?

Bri (04:50):
Okay, so is that just the thread and it just bunched up or what happened?

Dr. G (04:55):
Yeah, I mean, who is putting threads in the nose and why are we doing that? I just think, no. So PDO threads are just these sutures with little spikes or cones on them that you stick under the skin and then pull back and it locks in. But it's usually used for the neck and the face, lower face. People have tried them in the knees and the arms. We had a patient that had 'em put in her arms. Remember? Don't recommend. One star. So when they go in and then don't dissolve, then they create a problem. Also, it can create bunching. If you're putting them too superficial, which honestly in the nose you have no space. When I saw the title of the article, I was like, oh, botched nose after popular surgery treatment. I was like, oh, she had a liquid rhinoplasty and then had an issue and I was like, oh, nope. That wasn't even it. Somebody put threads in there.

Bri (06:07):
How do you get those out? Because barbed, so you can't just go pull it out?

Dr. G (06:11):
No. So either you have to wait for it to dissolve and that particular suture is going to take a while and it's inciting collagen, so it's creating scar tissue. And as you know in the patient that had it done to her arms, they were really superficial. And although they should dissolve and they usually do when you don't want them to like, oh, they're holding up my neck. And then they dissolved too fast. I mean, they're commonly used to give that fox eye look. Right. You put 'em in the lateral brow, you pull everything up, but then it lasts like six months. So in these cases, I guarantee that girl's going to have that problem longer. And the one that had 'em in her arms, they've been there for years.

Bri (06:52):
Years. I think they last two years or something.

Dr. G (06:56):
And hers created a foreign body response. And so there was scar tissue there because you remember I was like, maybe I'll just be able to make tiny incisions and pull 'em out. Nope, we put fat over it. There's really nothing to do. She's kind of stuck with them.

Bri (07:13):
Yeah, they sound good in theory.

Dr. G (07:18):
Well, the thing is, they sound good in theory every 15 years. When I was just in training at 2004 to 2006, thread lift was just becoming a thing. And they were prolene sutures, so permanent blue sutures used and they were cases, if you put 'em improperly, again, you can't go back and then get 'em out. You make a tiny little incision, insert it, and then yank. That's it. And if it doesn't go well, now you have this permanent suture and then people are getting,

Bri (07:53):
Prolene is not barbed.

Dr. G (07:55):
It was barbed for the

Bri (07:57):
Oh really?

Dr. G (07:58):
thread portion of it. Not like you're just typical prolene, but the threads were made of prolene, so, so they didn't dissolve. People got lasered. It melted the prolene. It was just a hot mess. So they pulled 'em off the market and then that was that. And then maybe 10 years ago they're like, Hey, we have these things called thread lifts. And I was like, no, get out. And they're like, no, no, no, these are dissolvable. I was like, okay, no, still no, still a no for me. Sorry.

Bri (08:30):
We've done, I don't know if it was with you or Dr. Chao, a revision facelift, and there was prolene coming out by the tragus and it was probably from 15 years ago, and this whole time she's had it just chilling there. And I was like, that's crazy. They just stay.

Dr. G (08:53):
Yeah, there's nowhere for it to go, to be honest. I mean, if you're going to get thread lifts, I would say stay in the indicated areas, which is lower face, possibly neck, upper brow, go to somebody who has a ton of experience doing it.

Bri (09:11):
Right. She looks like she's had some in her lower face by the pull on the corners of her lips.

Dr. G (09:16):
Yeah, it could just be the angle, but yeah. And then make sure you're going to an accredited facility. So they're actually using, I mean, I feel like this is another area where you could use, the threads are fairly expensive, so you don't want to compromise on that. I feel like there was another recent story of people getting injected in someone's garage or some nonsense with fake Botox. I was like, what the hell? Just go somewhere licensed and certified. So you know what you're getting.

Bri (09:50):
I'm all for shoving shit in my face, but I think that's where I draw the line.

Dr. G (09:56):
A hundred percent. Yeah. I'd like to know what is actually going, it needs to be not a Walmart version of whatever. .

Bri (10:06):
Right. You don't know what you, I mean, you don't know what could be in that.

Dr. G (10:10):
People are getting actual botulism from this nonsense. It's crazy. Anyway, it's good that this girl put it out there. Sad conclusion. 5 4 8 1.

Bri (10:25):
Oh,

Dr. G (10:26):
Sorry. Okay. Yeah. And there's no dissolving it like you can with nose filler with putting filler in there. It's just a bummer.

Bri (10:36):
Yikes. Zero stars. Zero stars.

Dr. G (10:38):
Zero stars. Okay. And then I thought we quickly cover, I don't know why Pam Anderson's always making the rounds about her not wearing makeup, but she must've gone on a podcast to talk about it.

Bri (10:49):
She looks like Uma Thurman.

Dr. G (10:53):
It's the haircut.

Bri (10:54):
Okay, okay. I mean, she has great skin, but she does definitely look so different.

Dr. G (11:02):
I think it's because she's blonde and so if she doesn't put anything on, then it's definitely a different look when you're not wearing red lipstick and you have mascara on and your brows aren't done. It's more of that than anything else. And she did undo some of the filler it looks like, but I don't know. She explains horrified reaction. I'm not sure people are horrified. And also in some of the clips of her, she is wearing makeup. She's wearing the no makeup makeup because I'm like, girl, I can see her eyelashes, which are clearly blonde. So that means you have mascara on, which is fine. Less makeup is fine. You do have some makeup. And I think she's certainly not saying that she doesn't wear skincare or sunscreen.

Bri (11:56):
I feel like it's just a different, I mean, it comes with aging. She looks fabulous there. I mean she looks fabulous in both, but I think it is also haircut.

Dr. G (12:06):
Yeah, she has a no makeup makeup look there, right?

Bri (12:09):
Yeah. Her lips look at least tinted.

Dr. G (12:12):
Right. And her cheeks look flushed. She has mascara on.

Bri (12:17):
Yeah, the no makeup makeup look is in. You're telling me how your daughter Juju, she's sitting there spending all this time trying to do the no makeup makeup look.

Dr. G (12:28):
Yeah, all my kids are

Bri (12:30):
Same with my daughter.

Dr. G (12:31):
Yeah, they look good.

Bri (12:33):
I'm going to spend an hour trying to not look like I have makeup on.

Dr. G (12:37):
It's fair.

Bri (12:38):
Okay, sweetie.

Dr. G (12:39):
Yeah. So

Bri (12:41):
If I could pull it off, I would.

Dr. G (12:42):
I just think it's harder for blonde people. You feel less vibrant or something. I don't know.

Bri (12:49):
My eyebrows are so blonde, it doesn't look like I have eyebrows.

Dr. G (12:54):
Which is what Pam An looks like, except in some of these no makeup looks. You can see her eyebrows. So they're either been tinted or whatever. Anyway, she talked about it on a podcast with Elizabeth Day, how to fail that she had to deal with people being horrified. I mean, it's like,

Bri (13:14):
I dunno if horrified would be the word.

Dr. G (13:17):
I mean, I don't know how much time you were spending putting on makeup, honestly. You had a glam squad that followed you around. I would do that every day if I

Bri (13:29):
Right. I was just telling Dr. Chao, I think we need a beauty room.

Dr. G (13:34):
It wasn't about being pretty, it was about being brave. Okay. I mean, get it. It was part of our identity to be glammed out.

Bri (13:44):
But you can't say who's looking at me at Paris Fashion Week. Of course everyone is. Hence the point of going to Paris Fashion week.

Dr. G (13:52):
And she's worried about wearing no makeup when most people just have eight filters on. Anyway, so whatever.

Bri (14:01):
I accidentally posted a reel on Saturday at our Christmas in July without putting a filter on it. And I was like, damn. I was like, Bella, how do we go back and put a filter on it?

Dr. G (14:14):
Well, Bella thinks that you shouldn't have put filters on it. So I don't know. We're just in a

Bri (14:21):
Naturally beautiful phase. That's why I have to have exosomes and PRP. That's right. So the no filter to take away the filter.

Dr. G (14:33):
Okay. And then what everyone's been talking about, which is Love Island, which is finally wrapped up, right?

Bri (14:40):
Yeah. Wow.

Dr. G (14:42):
Wasn't that the reel, that was the reel that you were filming,

Bri (14:45):
Right? I was filming the mama, mamacita. Yeah. I had to stop watching that show. It was a little much for me. There was so much going on, but a couple people got canceled, not canceled, had to leave the villa for some racial comments. And then Amaya, who nobody thought would win won. And I say nobody as in me. I dunno who else thinks that, but it was like, dang.

Dr. G (15:17):
Yeah. And I think they didn't make the racial racist comments on the show, which would be

Bri (15:25):
No, they were from,

Dr. G (15:28):
Yeah, I feel like they must leave people on the, they have to vet these people and so they see that stuff and then they let 'em go on the show and then they wait for other people to be like, wait, have you seen what so-and-so said?

Bri (15:44):
You know, everyone's going to be digging up their social media once they're on a show, and then you get a TikTok from two years ago when you're referring to your eyes as Asian, and then you make people upset.

Dr. G (16:00):
And then you get yanked and then nobody knows what's going on on Love Island. They're just told you have to leave. Someone is leaving due to a personal situation. Okay. Yeah. I mean the context of her slur was pretty bad, which makes me think they had to know that going in when they put her on the show, no way they wouldn't know. It was just there to create production drama.

Bri (16:28):
Yeah. I mean, there are some detectives out there that are going to find everything. I doubt that they looked at that video, opened it up, and it was like, oh, it's about Botox or whatever it was about that. They kept watching it and was like, Hmm, who knew? I'm sure they saw it in pass. Nothing bad on that.

Dr. G (16:46):
Maybe. Maybe. I don't know.

Bri (16:49):
My personal thoughts,

Dr. G (16:51):
I feel like I smell a setup, but it's fine. It sucks for whoever it was.

Bri (16:56):
I thought she was going to win.

Dr. G (16:57):
She was paired up with

Bri (16:58):
Yeah, Nick. They were like the match from, yeah, I don't know. I don't know.

Dr. G (17:06):
They were, I don't know. Anyway, they got matched up and then bye, bye Sierra.

Bri (17:11):
That's who I thought was going to win. But

Dr. G (17:15):
I wonder what the next big show all our Labiaplasty patients will be. Listen, watching when they recover. This has gotten very many ladies through the three day recovery period.

Bri (17:28):
Pretty much like everyone, we asked what show they were going to watch while they were doing nothing. They said, Love Island. And that's what sparked me to watch, because I was like, what am I really missing?

Dr. G (17:38):
Nothing. Nothing. But if you're stuck recovering from a procedure, it's probably not awful. You could doze off and not really miss anything.

Bri (17:48):
I think that's what I did.

Dr. G (17:51):
I basically did the TikTok recap for all of that and saw the mockups, which was just as good, honestly. Yeah. Alright, well moving on. I do have comments about Jennifer Aniston dating a hypnotist, but that's really,

Bri (18:08):
She's what? That's who he is.

Dr. G (18:09):
Yeah. I'm not even,

Bri (18:11):
He hypnotized her into dating him.

Dr. G (18:15):
It's so random. I can't, but it's not on our list of things to talk about. It's not plastic surgery related. It's just so random.

Bri (18:23):
That's crazy though. Thank you for a hypnotist? No one's commenting on this.

Dr. G (18:30):
Oh, people are commenting.

Bri (18:31):
She is just hypnotist. Jim Curtis.

Dr. G (18:36):
Girl. I mean, you can date whoever you want.

Bri (18:39):
She needs to make sure she's un hypnotized or something. Because out of all the people, she could date anyone.

Dr. G (18:49):
I mean, he's cute. Age appropriate.

Bri (18:52):
Yes, age appropriate. Cute. But he such his turn to love

Dr. G (18:59):
Random

Bri (19:00):
Can't change my mind.

Dr. G (19:02):
I don't know that I would want to be known as a hypnotist. It gives the mentalist, do you remember that show?

Bri (19:07):
Yeah. Two stars.

Dr. G (19:11):
Okay, moving on. Okay, so plastic surgery adjacent is Lizzo revealing the truth about her weight loss, which she really, I mean, so she lost a ton of weight and then she's annoyed because people are like ozempic. And now she's like, wait, no, I busted my tail getting to this point. And it's not just Ozempic. It's not Ozempic at all. And then she's like, of course no shade to people who might be on Ozempic. It's like you can't win.

Bri (19:45):
No, you lose weight and you're automatically on Ozempic. And then if you say you're not, you're shaming people that are on it. But she honestly, with the way she had any surgery, she doesn't look like she has a ton of loose skin. It looks like it's appropriately shrunk as she lost weight kind of.

Dr. G (20:03):
Yeah. Well if she did it by training and diet changes, blah, blah, blah. She quit drinking for an extended period of time, then yeah, I think you won't completely deflate. You'll have some loose skin, but it's not as bad as it would be if you rapidly lost it. Yeah, she looks good.

Bri (20:27):
Yeah. However you lost it. Good for you. The health benefits,

Dr. G (20:33):
Right?

Bri (20:35):
Yeah,

Dr. G (20:35):
I think it's great.

Bri (20:36):
I mean, I think people are shaming people so much for losing weight, but it's not just about losing weight. Think about all the things that come with losing that much body fat.

Dr. G (20:48):
Yeah, even your internal organs benefit, everything's better. Her blood pressure's probably down.

Bri (20:56):
Cholesterol cholesterol's probably down all the things. So you can be more active with your children, you can be more active outside. It's probably easier to run, easier on your joints. Let people live, Ozempic or no Ozempic.

Dr. G (21:12):
Right? I think she's just healthier, so that's good. Yeah. And if she gets to the point where she wants that loose skin taken off, see a plastic surgeon.

Bri (21:21):
Yeah. Holler at your girl.

Dr. G (21:26):
Alright, so let's talk about our topic of the day, which is PRP and exosomes.

Bri (21:37):
I'm a huge fan of PRP, huge fan. I just did it like a week ago.

Dr. G (21:43):
Yes. I need to get on that table. The last time I did it, we injected it under my eyes, which was kind of, we might have overdone it, but it turned out it did fine. So PRP is a treatment celebrities swear by, sure. Of course the Kardashians do it because they have disposable time and money. So what is it? It's platelet rich plasma. It's your own blood. You spin it down. So we draw a tube of blood, we put it in the centrifuge, it gets spun down and the platelet part then sits there on top because the red blood cells and all the other garbage goes to the bottom. And then we pull off the plasma component and it's supposed to have things like growth factors essentially in there that help your skin turnover and rejuvenate.

Bri (22:46):
We do have a whole little video on our Instagram that we made about the whole process for at least doing PRP with microneedling. And it shows the process. It shows our nurse Azella, she's microneedling my face with my PRP and I mean, it makes your skin look so good.

Dr. G (23:07):
Yeah, it's so glowy.

Bri (23:08):
So glowy. It helped with, I had all these little acne scars and I think the combination of microneedling and PRP kind of helped, what would the word be? It just helped make my scars look less deep.

Dr. G (23:24):
Yes, it did. Well because it's stimulating collagen and elastin and getting your tissue to regenerate, and then it does kind of create a little bit of an inflammatory process, which you need to stimulate cell turnover. But that combined with the microneedling also stimulates collagen and elastin. So the microneedling is creating little micro injuries to try and get your skin to heal. And then the PRP is coming in there to really give the extra boost assist. So I think that it's a really nice treatment. It's not an at-home treatment, obviously, you need to be able to draw the blood and spin it down. And we use special tubes that have special reagents in them so that we get the best plasma from it. But they are great for microneedling, for skin. You can inject under the skin, but I feel like microneedling versus injection are both equivalent. That's been studied. And then the other area that it's really has studies to back it up are in hair restoration. So you can inject it in the scalp for hair rejuvenation. And we have a patient we're doing that with now you have to repeat it every four to six weeks and it should help with thinning hair, which she has. What did she say? She has a comb, No, it was the other nurse that has to

Bri (25:00):
Comb over.

Dr. G (25:03):
But yeah, sometimes with menopause or just some people are prone, I think in Stella's case it was stress related at a point where she had hair falling out from alopecia and then you can try to stimulate that hair to regrow if it's not completely gone with PRP injections. So it's really nice. It all involves using your own blood. So that's where it gets a little dicey. If your blood sucks, then what kind of growth factors are we getting? So I wouldn't do it for someone who's 80. Right?

Bri (25:39):
And they say to really keep your nutrition in check prior to getting it done. That way you're getting the best of the best.

Dr. G (25:47):
You don't want to come in after a bender and do PRP.

Bri (25:51):
You need to be hydrated. We got to have all the good stuff in there.

Dr. G (25:55):
Right. So on the one hand, you're using your own blood, so it's very safe. There's no chance that you'll have a reaction. The only danger of doing PRP, and this ties back to what we were talking about before, is going to somewhere that's not certified. So was that I did that one place in Arizona that was reusing needles and whatnot and had an HIV outbreak. Just disaster.

Bri (26:25):
I went to Mexico and did it. I did the PRP with microneedling and a, I'm pretty sure I don't know what they did to me, but even drawing the blood, I mean, I'm not going to go there, girl, but they injected it all over my face and they just stabbed me with little needles all over my face. And I wasn't numb. I don't think they were even paying attention to any sort of anatomy, nerves, anything. I don't know how superficial that stuff is, but most painful thing in my life and I have done so much, it was terrible. I hated every second of it.

Dr. G (27:02):
And you don't know, are they using clean needles?

Bri (27:06):
No

Dr. G (27:06):
Are they changing out the cartridges? Is it spin down?

Bri (27:10):
I don't even think they were aestheticians. I don't even know what they were. I feel like oh man.

Dr. G (27:15):
So you can still get that same crappy strip mall effect in the states if you're not paying attention. In California, it's a little harder to do because you have to be an RN or a higher licensed to administer anything that involves a needle. But like I said, Arizona, there was a case where they were reusing stuff and had a patient with HIV that they weren't aware of and then managed to spread that around. I would say Hep C is more likely to get spread if you're not, I don't know why we're reusing needles. Period.

Bri (27:56):
They're like 10 cents.

Dr. G (27:57):
I know stupid. So anyway, but it's considered experimental because there aren't great studies for it. All the best studies show are with hair restoration. It's really hard to put it on someone's face and then say, look, they look better. I mean it's a subjective situation. And then also the variability in your own plasma, right? So what you're using your own stuff. So if you're maybe sick or not super healthy or a little bit older, then are we going to get the same results as a 25-year-old? But it is a great treatment for most patients, like most of us in the 20 to, I don't know. I've done it and I'm 50 plus and it does work on my skin, so it's nice. But let's say you don't want to donate your own blood or you have a limited amount too. So for scalp, we'll usually do one or two vials and inject that.

(29:08):
But let's say you want to to do your face, neck and chest with microneedling and maybe inject it under the eye. All of those areas, you might need more blood than you want to donate at one time. So you could then switch to exosomes. So I'd say for PRP, we like it for microneedling, for the face, injecting it under the eyes is nice. It's not a volumizer, but it's definitely helps thicken and enhance the skin. So I've done that. I injected it. You just have puffy under eyes for a couple of days and then it gets better. The microneedling, you get instant results, right? You look great that evening. Sometimes people can get a little bit red. It's good for calming inflammation and all those things. So two thumbs up in our book. PRP.

Bri (29:57):
Yeah, 10 out of 10. So when would you suggest, can exosomes and PRP be used together or is it two separate treatments or topical?

Dr. G (30:11):
They can, but I don't know why you would bother. I think we did it to me just for fun. But exosomes are expensive and you're trying to accomplish the same thing essentially with that. So usually you can choose one. So for older patients I would say use exosomes because those are derived from different places. That's where it gets starts to get tricky when you try to explain what exosomes are.

Bri (30:37):
That was my next question. Please explain.

Dr. G (30:43):
So we talked about the PRP, which is the platelets get separated and they have growth factors. And so exosomes are little, almost like, I was trying to think of a way to describe them, cuz they're not anything. They're little packages. So I'm like the Amazon of growth factors.

Bri (31:10):
I love that.

Dr. G (31:11):
They're like the brown boxes that show up on your door in you're life.

Bri (31:16):
Every day.

Dr. G (31:18):
And they come from different warehouses and they bring different things. So it's basically that brown box. So they're packaging basically. So they're little things that come from within the cell, but they're essentially the packaging. And then you can package different things in the little exosome and then you throw it on your skin and it releases the package. So there's a few different places you can get exosomes from. Umbilical cord blood is probably one of the most common ones. Bone marrow is another. It's from different stem cells. So once you start saying stem cells then everyone gets excited, but you're not putting stem cells on your face, you're getting exosomes from these stem cells and then using them to transport different things that you need into your face or wherever you're putting it to kind of rejuvenate. So fibroblasts are another source. There's so many little places you can get, oh, I almost forgot, adipose derived stem cells is another source of exosomes

Bri (32:31):
Who is donating this? Because all this bone marrow donation, I mean how painful.

Dr. G (32:37):
I would say bone marrow is going to be a really great source of exosomes, also an expensive source. And as you know, AnteAGE the growth factor stuff we use, our skincare, we get our exosomes from them, and their exosome solution is sourced from that 25-year-old healthy girly who donates her bone marrow.

Bri (33:04):
They have a very stringent, I don't know if that was the right word. They have a stringent criteria. When the rep came into our office, we were like, where do they get it from? It was like a 19 to 24-year-old, athletic, don't drink. I was like, where are you finding these people?

Dr. G (33:23):
Because yeah, where are these three girls?

Bri (33:25):
Yeah, it was so strict. I was like, huh, interesting. I know what I was doing at 19. I was already on my first child somewhere. You know what I mean? Yeah.

Dr. G (33:37):
You were not donating your bone marrow.

Bri (33:39):
Not donating my bone marrow.

Dr. G (33:42):
I will have to agree. I was also not donating my bone marrow. When you're using exosomes, they are supposed to, they're sort of, I'm trying to, so since they're just the packaging, they're created to deliver different things and the idea is to promote tissue regeneration and anti-inflammation. So we use it for healing to promote healing and kind of skin turnover after laser or microneedling. But the other common use is to inject it into tendons like tennis elbow or knee pain, ligament tears. Ortho is the other category, arthritis. Ortho is the other category of surgeons who like to use both PRP and exosomes anyway, so going back to exosomes, they're carrying a bunch of little stuff that we need that maybe your cells aren't making so that you can increase your skin turnover and make yourself look younger.

Bri (34:51):
Basically the stem cell is the Amazon warehouse and inside it are the exosomes, which are all the little packages which you get to pick to be delivered via the prime van to the needed areas of things you need addressed.

Dr. G (35:10):
Yes.

Bri (35:10):
Slay.

Dr. G (35:11):
In this case, the exosomes are the packages and the prime van is going to be your microneedling.

Bri (35:19):
Yes. Wow.

Dr. G (35:20):
And the warehouse is somebody's bone marrow.

Bri (35:23):
Say no more.

Dr. G (35:23):
There. That's it. That's all you need to know. They just need to be refrigerated.

Bri (35:32):
Yeah. Make sure they come on ice.

Dr. G (35:35):
Yes. They're sensitive generally speaking. So I feel like you can use this, like I said, if you don't want to use your own blood or if you're older, and maybe that's not a great idea. So I think they're equivalent. They're expensive because you can imagine making the little exosomes, it requires technology. You need stem cells to culture. It's a complicated process to create them. Can you get 'em from platelets? You can. The reason I bring up platelets is because there's this skincare line called Plated that derives their exosomes from platelets, which is not the most common place that you get exosomes from, I will have to say. But in their case, they're acknowledging that the platelet exosomes are stable in their skin cream and at room temperature and on the shelf, which is a lot because generally speaking, it has to come refrigerated. It needs to be reconstituted and then used immediately, otherwise it doesn't work. Kind of like platelets when we do PRP, if you don't draw that stuff up and throw it on immediately it clots off and then you're done. Which we've,

Bri (36:58):
Also tried before.

Dr. G (36:59):
In my case, Yeah. I usually try to do the procedure in between different other things like seeing patients and while I'm running around my own blood is clotting.

Bri (37:09):
It was so thick it couldn't even get through the needle.

Dr. G (37:12):
Yeah. Major bummer. Anyway, so Plated uses exosomes, but they have some proprietary technology that allows it to be shelf stable. I mean, we've all tried it. I thought it was fine. People rave about it. And I feel like one of the articles that we pulled for this was about plated maybe. I can't remember. I think it was maybe, oh yeah, it was Megan Fox finally lets us in on our skincare secrets. And she uses Plated.

Bri (37:45):
Oh she uses Plated?

Dr. G (37:47):
Sure. I mean, I feel like our AnteAGE now added biosomes to it. They're not willing to call it exosomes. They have growth factors that they get from the bone marrow and then they also add in a biosome to that to make it, I feel like, I don't know, there was nothing broken with the AnteAGE and I trust their technology and it's a little bit more transparent than the Plated skincare science. So we've chosen to stick with AnteAGEMD, but

Bri (38:17):
I really like AnteAGE.

Dr. G (38:20):
Yeah, I mean it works. So people do love the Plated, but it's hella expensive. And I don't know that they have, where are the papers? And then they try to tell you to put it on everything. It's a nice serum, but I didn't notice any difference.

Bri (38:38):
Me neither.

Dr. G (38:40):
Not gatekeeping, but apparently Megan Fox likes it, but she drinks her own blood, so I don't know what

Bri (38:46):
That may also be it. She just drinks her own platelets.

Dr. G (38:52):
I don't recommend doing that, just to be clear. So we do not treat joints with PRP, but we do apply it to the skin and the same with the exosomes. And I would say the most common area we use the exosomes are you can do it after microneedling, but it's an added expense, probably a little bit more expensive than using your own blood. But after CO2 laser, it's fantastic.

(39:16):
And it's been shown to increase your healing time, which we all know after major laser resurfacing, you kind of look like a burn victim for a week. And if you can cut that time down to seven days or so, from seven to five or five to three, then it's worth it. And you're also getting the benefit of both the laser and the microneedling are creating channels in the skin that are allowing those exosomes to get in deeper. So that's the other thing. I mean skincare is skincare, but it's only going to penetrate as deep as your epidermis. And it has a very hard time going any deeper than that unless you are creating channels for it or doing something to skin. If you're not exfoliating on the regular, then all that stuff's just sitting on top of your skin. So making sure that you have a good skincare regimen so that these products can penetrate is important. Otherwise, that Amazon package is just sitting outside your door doing nothing.

Bri (40:15):
Or at the wrong door.

Dr. G (40:19):
You got to bring it in. Bring it in. So, all right. Is it a permanent treatment? Absolutely not. You got to keep doing it.

Bri (40:32):
Do you think people need to start, so you said exosomes are, or no, platelets are in Plated, but is this something you need to have in daily skincare?

Dr. G (40:43):
I think it can't hurt. I think having some sort of growth factor is, we all know that retinol and antioxidants are great for your skin, sunscreen, obviously. I think if you want to go next level, you need to use some sort of growth factor. And that can be exosome, it can be growth factors like in AnteAGE, ideally something reputable. So I would not go to Sephora for some growth factor nonsense. God knows what you're getting. But we know AnteAGE is sourced. They have the papers, they're using the bone marrow derived growth factors. They're adding biosomes. Plated also has science behind their exosome delivery system. They've invested time and energy and money into creating this. And I feel like that's next generation skincare. Or you can dial it back and do antioxidants like vitamin C, still a win, and retinol, which I think you should always be using retinol or Retin A or some derivative or some plant-based version of it to create skin turnover because that allows your other skincare products to do their bestest. You need to not have a bunch of dead skin sitting on your face. But all of this is a process. Remember, your skin's constantly turning over and you need to, be applying something on the regular. It takes time to see results. If you're doing it topically and it needs to be done continuously, that's the breaks. You're always aging and you're always stepping outside and there's sun and pollutants and all the things. It's like getting your teeth cleaned twice a year and not brushing your teeth every day. That would be pointless.

Bri (42:29):
Yeah, it's like if you have a facelift though, you still need to have proper skincare. It can only do so much.

Dr. G (42:38):
Right. We're only lifting the skin. We're not treating the skin unless we're also doing it with a laser at the same time. And so you got to treat that outer skin as well. So I think it's important. And it's an investment in your skin.

Bri (42:52):
So can this replace getting Botox and filler done or is this more of an add-on?

Dr. G (42:58):
I feel like all of this stuff is synergistic. So I think adding this to your armamentarium, just kidding. Adding this to your toolbox is a good idea depending on what your tools are. So Botox and fillers aren't going to change the texture tone of your skin. It's not going to address, it does help with fine lines, but it doesn't address pigmentation. And I think, or if you have rosacea or areas of redness or inflammation, Botox and fillers don't help with any of that. So I think it's sort of addressing some other areas that are part of skin rejuvenation that are complimentary.

Bri (43:36):
And when people get these treatments done, do they usually see results immediately or is it?

Dr. G (43:42):
Yeah. I mean, I think from doing PRP and I do as well, PRP or exosomes topically applied for your skin, really does give you such a nice healthy glow. And if you do a series of 'em, you can count on seeing improved skin quality with the hair restoration. That does take a series of treatments. So you're not going to have wake up tomorrow with a full head of hair. That takes some time.

Bri (44:06):
Not a hair transplant.

Dr. G (44:08):
No. Even that takes time. Yeah. So like I said, I think this is the future of skincare is figuring out how to get these exosomes growth factors and PRP into topical skincare, knowing that it's probably best delivered via injection, microneedling or laser, but topical wouldn't hurt. You just need to know the delivery system has to be effective.

Bri (44:34):
Yeah, we love huge fan.

Dr. G (44:38):
Yeah, we do like it. So two thumbs up for PRP.

Bri (44:43):
Two thumbs up. And if you're not sure what to do, you can always come into the office and you can get a little skincare plan set up for you.

Dr. G (44:53):
Yes. We can give you all the options. I like to give people the most basic, these are the bare bones of what you should be doing. And then go up from there. Because a lot of times people ask us what we do for our skin, and I'm like, you got a minute. But yeah, it definitely, we can give you a least complicated to most complicated options. And just doing something I think is a first start. People get overwhelmed. And also we don't, my other not favorite thing to do is start somebody on 80 products at once. So we do like to start slow because you want to make sure each product is doing something that you're not having some sort of reaction to it. People have sensitive skin and that you're adding slowly so that it's a regimen that you can keep up with.

Bri (45:42):
And maintain. I know my sister finally started using Retinol and she's like, I'm just going to lather it on my face every single night. And she burned the crap out of her skin and then just broke out really bad. And then on the opposite end, my sister finally at 32 has switched over from the St. Ive's oatmeal scrub to proper, skin care. I'm like, we're a big girl now, so we can start adding things into our repertoire.

Dr. G (46:13):
Yeah. Yes. And my other pet peeve is if you're not using sunscreen, then don't bother.

Bri (46:19):
Yeah. You need sunscreen.

Dr. G (46:22):
Yeah. Otherwise it's getting undone the second you walk out the door.

Bri (46:26):
Yeah, every day.

Dr. G (46:28):
Every day. Alright. So yeah, as Bri pointed out, if you're listening and you have questions or you want more information about skincare, reach out. Leave us a comment. Don't hate on us, we're just girls trying to do ourselves.

Bri (46:43):
We're just girls.

Dr. G (46:43):
And we look forward to hearing from you. So I think we're going to scrub in

Bri (46:51):
And scrub out.

Dr. G (47:00):
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. To 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.