Botox Explained: Myths, Benefits & Everything You Need to Know

Botox is one of the most popular cosmetic treatments in the world—but it's also one of the most misunderstood.

In this episode of More U, Dom and Dr. Ben break down everything you need to know about Botox, from how it works and when to start, to the biggest myths, misconceptions, and mistakes people make.

Whether you're considering your first treatment or simply want to understand the science behind Botox, this conversation provides practical, evidence-based insights from experienced professionals.

In this episode:

•  How Botox actually works 
•  Common myths and misconceptions 
•  When is the right time to start Botox? 
•  Preventative Botox: fact or fiction? 
•  Safety, risks, and side effects 
•  Does Botox look natural? 
•  The biggest mistakes patients make 
•  What to expect before and after treatment 

If you've ever wondered whether Botox is right for you, this episode is a great place to start.

🎧 Subscribe to More U Podcast for conversations about aesthetics, health, performance, and personal growth.

⏱ CHAPTERS

00:00 – Episode Trailer
 00:36 – Welcome to More U
 02:05 – Why Botox Is So Misunderstood
 05:20 – How Botox Actually Works
 09:10 – The Biggest Botox Myths
 13:30 – When Should You Start Botox?
 17:15 – Preventative Botox: Does It Work?
 21:40 – Natural Results vs. Frozen Faces
 26:20 – Common Botox Mistakes
 30:50 – Botox Safety & Side Effects
 35:10 – Questions Every Patient Should Ask
 39:30 – The Future of Botox & Aesthetic Medicine
 44:00 – Final Thoughts & Takeaways

📲 SOCIAL MEDIA

Podcast: @more_u_official

Hosts: @dominicmazzone1
@manyfacesofchicago

#MoreUPodcast
 #Botox
 #AestheticMedicine
 #PlasticSurgery
 #AntiAging

Transcript

SPEAKER_00 0:00

Tox is actually down. Juvederm is their filler sales. Those are down like 23%. You know, these are not great results.

SPEAKER_01 0:08

If you're in LA, uh you go around the corner, there literally is a med spa injector clinic every freaking hundred yards. The next 18 to 24 months is gonna see a lot more toxin hit the market. There's some clinics that survive by the syringe, so they just keep encouraging people to do more and more and more. And it's like, I mean, step back, look at the patient.

SPEAKER_00 0:35

Today, want to kick off, want to talk about something. There is this crazy article that came out in Bloomberg, and it was titled The Fight to Save the $2.7 billion Botox Empire. So basically, what's going on in the world of Botox? This is just really interesting, is that Botox is actually down. Allergan is the maker of Botox. Allergan that's a public company, so they report their numbers. We get to see what's going on. You know, their Botox sales have not been great. Juvederm is their filler sales, those are down like 23%. You know, these are not great results. And there's a few things that are driving this. We're gonna just talk about it. Hold on.

SPEAKER_01 1:15

Let me I'm gonna chime in because there's a couple important points. So for the general listener who's not in the aesthetic world, you know, Botox, Abby, I you might argue with this down, but many would call them the Coca-Cola of the aesthetic world. They're Kleenex. And then there's Pepsi and Mountain Dew and Sprite and all the other competitors. But they really were, I don't know if they were the first, but they really were the first to dominate.

SPEAKER_00 1:36

Yeah, and in fact, I I use the word Kleenex because Kleenex way back in the day was fighting companies not to say Kleenex. They were fighting just people saying Kleenex because they're like, no, no, no, only we are Kleenex. But everybody started thinking every tissue is Kleenex. Well, this is kind of happens with Botox. There is a lot of competitors to Botox. They're out there.

SPEAKER_01 1:58

Ziemen, Disport, MayaBlock, Daxi, Juveau, Juveau, exactly. Yeah. So there's a lot of out there.

SPEAKER_00 2:04

So there's there's other opportunities out there for both physicians to utilize these products and also for the patients to actually get these. And what's been happening out in the world is you know Botox dominated. Botox, what do you think, Ben? 95% of all toxin usage was probably Botox.

SPEAKER_01 2:28

Yeah, I mean, definitely over. I mean, if you go five years ago, 100%, I would say, you know, almost, you know, if anybody, other than the um therapeutic forms like myoblock, for instance, uh, was, you know, we would use in the hospitals from time to time. But yeah.

SPEAKER_00 2:42

Yeah. So so what basically happened is all of a sudden they started getting competition. And what happened is is Botox was saying, hey, look, hold on a second, we're the best. And these other toxins were coming up going, well, what we have is the same as what you have. And that created companies that really grew in size, like Galderma. Um, for all of you out there that know fillers, uh, Galderma is the least.

SPEAKER_01 3:12

I mean, I like Pepsi, but I like I like Pepsi a lot, but Galderma, many would argue they're the Pepsi, although I would say they're approaching the the Coke state. I would say so, right?

SPEAKER_00 3:21

Yeah, well, I I think so. I mean, there look, we're we're seeing overall out there a lot of disport usage. We have a lot of patients out there in the world that don't care like what they're what they're getting in their face. There's some folks that still ask for Botox. There's some people that still want Botox. But what what's interesting is that this very much looks like long distance service. Way back when your phone company was telling you, hey, we have the best long distance service around. And all of a sudden these other companies said, Hey, well, we actually offer you long distance service. And you know what ended up happening was there really wasn't a difference between the long distance services. There was no difference between long distance services. This is kind of what's happening with Botox. There's starting to be less and less of a discrepancy between the toxins, and there's more going on. And what's happened with Botox is this is a little interesting tidbit about Botox, is that Botox is not wanted to lower their price. And the reason I want to lower their price is that they have a therapeutic indication on Botox. And that therapeutic indication has quite a high price point. Well, what you can't do is take the therapeutic price and a cosmetic price and have those things be different. They do it through discounting and some other things that they try to do, but it's just it's it's a it's an issue for them. So where it sits right now is they are now up against a very tough situation where they have lots and lots and lots of competition that's currently in the market. And here's the crazy thing the next 18 to 24 months is gonna see a lot more toxin hit the market and a lot more filler hit the market. Interesting enough, Juveau, which is Evelis, is the is the company. Juveau's toxin sales haven't looked great either, which could indicate, obviously, that the overall market is down a bit. And that's just been a conversation that's out there that the overall market is a bit down. We're definitely seeing that from just all the different toxins that are reporting. I think also Allergan in particular has had some interesting missteps. They had a loyalty program, they made changes to that. That was a bit of a disaster. They've changed management numerous times.

SPEAKER_01 5:48

Dom, I'm starting to get worried that your car is gonna blow up or something. These are powerful people.

SPEAKER_00 5:52

Hey, listen, I was just about to say that I think the current management at Allergan I actually really like. I think they're um I think they understand what the issues are, and I think they really want to do something about it. I think past management, for all intents and purposes, I thought did a really bad job. I I think they did not do a good job.

SPEAKER_01 6:12

And so, you know, in their defense for the general person, that that that therapeutic indication in the insurance, it's one of the really messed up parts about the U.S. healthcare system. So they can overbill insurance, then they underbill if you're cash paying. So it their hands are probably truly tied to a certain degree, right? Yeah.

SPEAKER_00 6:30

Oh, I think they're in a tough spot on that. I I think so, I think that's true. I think the problem is they've just been adding a little bit of insult to injury. And just listen, this is gonna be my business stuff coming out. So for all you business wonks out there, you know, any business has to be really careful thinking that what you have is more valuable than what the market perceives its value actually is. Um, you're saying, hey, what I have is incredible, it's fantastic. That's fine. But if the market doesn't think that is the case, the market is going to put its own perception on that, and that is gonna change the value in which your product or service or whatever it is, its total value actually is.

SPEAKER_01 7:15

I think that's you know, the key, the key to that, you can get away with that when there's not nine direct competitors, but when the competitors start to prove themselves and say, hey, look at I also work really well, I also make people look nice. I also, you know, but we can co-brand, we can co-market, we can, you know, yeah. In part, I know uh like you alluded to, some of them don't have the therapeutic application, so they have more freedom.

SPEAKER_00 7:39

Yeah, you know what I mean? Yeah, it's a big thing. I think that's I think that's true. I I think a couple more things I just want to hit in this is that, you know, in the article, they were saying, um, yeah, people are coming in asking for Xeomen, which by the way, I I think out of all of the toxins, I usually see Xeomen use the least when we look at our clinics. It doesn't mean it's a bad product or anything like that. It's just that it's kind of used the least. I mean, I think rarely people come in and ask for a specific toxin. I don't know what your experience has been with that, then is that.

SPEAKER_01 8:12

Yeah, unless there's some sort of special or something like that. I forget who it was. Xeamin had somebody famous in some Super Bowl commercials or something. So there was a time, yeah, but when, you know, that's what it takes, you know. But yeah, rarely, you're right, they say I want neurotoxin, or to the Kleenex comment, they say I want Botox. Botox.

SPEAKER_00 8:31

Yeah, exactly. Do you think it's now, I think it's, and I think this is interesting. Like, I think it's now like in vogue to say that you don't have filarin toxin when you actually do have filler and toxin. Like, if is the stigma, I think it's possible that the stigma had came come completely down. And I would say around 2022 is probably the lowest it ever was. And then I feel like the stigma's kind of just creeped back up a little bit. Yeah.

SPEAKER_01 9:00

You know, it it really oscillates. I'm sure it's almost sinusoidal, where in in unfortunately, I think it's very celebrity driven. You know, a lot of them are really getting it out there that they do this stuff, and then people are like, oh my God, I'm not like them. I do it myself, or I do it differently, you know. So you see it in waves. I there's still that group of people who say, screw it, I don't care, I want to look good. And then there's the people who say, uh, no, I don't do that. I'm very clean and green and organic, you know. So um it's it's an evolving thing right now. But I still think there's a good number of people who are open about it, you know?

SPEAKER_00 9:35

Yeah, I I I think there is too. I just think that it's almost like, well, I'm I'm gonna I'm I I just feel like that it used to be the case that, you know, people are like, yeah, sure, I get I get toxin filler. What's the big deal? And I feel like it's now it's like, no, you know, you're not you're not supposed to do that. I just feel like the stake was down. So I think what's happening is is people are hiding it more than anything else, hence why you really need a fantastic injector to make sure that you actually get a great experience. Speaking of bad injectors, I want to just move us along. I want to talk about injector Barbie. This is the craziest story. Okay, so this is in uh Van just in in Vancouver. Injector Barbie, they were these two sisters. I'm gonna just start this off being very clear. They were not licensed. Okay.

SPEAKER_01 10:23

I don't think I think one of them was like a supermodel or something.

SPEAKER_00 10:26

Yeah, like I I they they were not healthcare providers at all. They decided, they maybe watched a YouTube video and felt like, uh, sure, filler, I can eject that. They were advertising basically butt lifts with filler, right? So check this out, Ben. They're doing that. They would say, okay, great, we're gonna give you a butt lift. We're gonna use filler. They were charging huge dollars for this, okay? And then what they would tell you, by the way, folks, this is your first guess that something's wrong. They would tell the patient, go to your doctor and tell them you have a toothache so you can get some antibiotics before we do it. What? I mean, talk about a red flag, okay? Okay, well, right out of the gate. So then they should the woman shows up, she gets her butt injected with a bunch of filler. It gets infected, right? God knows what else. This is my and I'm sorry, folks, I'm laughing because it's so ludicrous. She calls injector Barbie, she says, Hey, look, I'm having a serious problem like at the injection site. I'm having like fluid come out, everything like that. I'm starting to, I have bleeding there. Injector Barbie sends super glue to her via Uber Eats to close up her wound. Is this is this is this Rambo? Like, tell me, like, Ben, have you ever used um super glue? I never have.

SPEAKER_01 12:04

To be honest, Dermabond, which we do use, is a very similar uh uh chemical makeup as super glue. So, you know, I remember my grandfather used to use super glue on his wounds when he had them. Uh, you know, he he was in World War II. So uh, you know, I listen, this brings up, it's this is like the tip of the iceberg. You know, I like I said, Dom sent me like a I don't know, 15-page article. So I quickly logged it into Grok and said, Can you sum this up for me in four sentences, please? And so it did. Uh so that's what I know about the article. Uh, but it the you know, it also said, Would you like to know about more of these scenarios? Would you like to, and surprisingly, Dom, a lot of them were in Canada.

SPEAKER_00 12:41

Like if I can't, actually, because we're locked up pretty tight here.

SPEAKER_01 12:45

Yeah, I I thought so, right? I and maybe it was just because that this particular one was in Canada, right? So maybe it was just extrapolating them there. Miami, there's been a handful of these. You know, if you go, if you're in LA or you go around the corner, there literally is a med spa injector clinic every freaking hundred yards. I forget what it was, but I think there's like more clinics that do injections than than than uh Starbucks or something right now in the US. Like something, some crazy outstanding number where, you know, people when money is involved, people do crazy shit. I think it really is.

SPEAKER_00 13:16

Well, I think the thing is though, is that what that really speaks to is you have to find you have to do your homework. When you're looking for an injector, you have to do your homework. There's plenty of very qualified people out there to do these things. But if you're just not doing your homework, you're not even asking, hold on a second, are you a healthcare provider at all?

SPEAKER_01 13:40

Like, I I would be interested in your input of this down. I was thinking, you know, because some people would argue that Botox, for instance, or Allegrin or Abbey or whoever the hell you want to say, call them, is part of the problem. Like they really did push it. They do a lot of trainings. I mean, and I'm sure they have some sort of certification things you have to submit before, but they also trained a lot of people who don't have a background in aesthetics. You know, there's like the core ones, there's the the facial plastic surgeons, the dermatologists and the plastic surgeons, then there's the nurse practitioners, then there's an N PA, then you go down to an RN level. Then in some states, countries, uh uh, territories, whatever, you can be an aesthetician. You can be a, I mean, so they I would say similar when just when when something becomes so capitalistic and money driven, the the lines get blurred more easily because it's beneficial to companies like that to just get a shit ton of people, they think it's beneficial to get a shit ton of people injecting, but then you get some bad experiences and they actually hurt the industry as a whole. So it's it's very similar. You know, when I was in med school, it was the pain scale. Nobody could be in pain, you couldn't do pain. We found out that was essentially driven by the narcotic industry that had become so uh money driven that they made it. I mean, I used to give people 150 pill pain pills when I was in uh med school and residency because we were told they can't be in pain. We're like, oh, they'll just throw them away. But you know, and then now I can't even get somebody narcotics without like donating blood first, you know. So there's like those pendulums, right? And I feel like the aesthetic world is swinging a little bit back to um the the more qualified people are trying to um you know take it over and kind of direct the decisions.

SPEAKER_00 15:19

Well, I think you kind of clean it up a little bit, right? Because, you know, I think people need to really pay attention to the who is gonna be sticking a needle in their face. Also, like also that includes your butt folks, too. Yeah, like I mean, you you have to be because you can listen, there's techniques to use filler to augment the buttocks.

SPEAKER_01 15:41

I mean, I I don't do that, but you know, my but you need someone qualified, don't you? Yeah, no, 100%. You actually that's probably one of the most dangerous places to put filler because the vessels are huge, and you know, you can cause an embolism uh similar to like the BBL, the Brazilian butt left style. I mean, you could cause some, you know, definitely life-threatening uh problems.

SPEAKER_00 16:00

Issues, yeah. And and so I think I think that really speaks to just a couple things is look like people like really need to be paying attention to who is actually doing these things.

SPEAKER_01 16:11

I think you mentioned Canada being lockdown, the UK, uh Australia. I mean, there's been some serious uh uh crackdowns like recently, right? Yeah.

SPEAKER_00 16:22

Uh well, yeah. But the thing is that the UK was the absolute wild west. And so they really had a swinging heart. But I can tell you something just interesting about Canada. There isn't a province in Canada that allows anyone other than a doctor to be the medical director of a clinic. So that's an important piece. What a lot of people don't realize is that these clinics they're walking into that have a medical director, there's many times that the medical directors never even step foot inside the clinic. That's like a thing. So you're saying, well, actually, I'm going in a place, there's nurses, I see a guy or girl on the site that's the medical director. Ask the question, is the medical director here? Do they are they on site? Because most times they've never even walked into a clinic. And that's not that's not really the best setup for that. And I guess the question is is is what I said also, Ben, which is, and you kind of answered it, is like a Brazilian butt lift with filler, like how difficult is this? I would say it's probably like on a scale of one to ten. Are we talking like seven, eight?

SPEAKER_01 17:29

Um, I mean, you know, if you know what you're doing, if that's your anatomy, if you're a surgeon and you know it, I don't think it's not necessarily difficult. The but dangerous-wise, it's definitely into the nine, 10. You know what I mean? So in in it, you're talking millimeters of change where you can get yourself into trouble. So, you know, at this point, I wouldn't nothing I do is difficult, right? But it's because of my background, it's because of what I know. I mean, you have your protocols, you you do it safely. But it's just without that insight, it could be quite dangerous, a lot of this stuff, you know.

SPEAKER_00 18:02

So that makes a ton of sense. It's it's never difficult for the person who knows what they're doing. That's bottom line.

SPEAKER_01 18:09

That's really it, yeah.

SPEAKER_00 18:10

Right? For the person who knows what they're doing, it's not difficult. But for someone that has no training, doesn't know anatomy, all those kind of things. I mean, that's crazy. And and you tell me, sorry, Ben, let me ask the question maybe a little bit of a different way. Um I'm a nurse, I'm a PA, I'm a doctor, I took a weekend course on Botox and filler. Um, should I be injecting fillers for a Brazilian butt lift a month later?

SPEAKER_01 18:41

Like In my opinion, in my opinion, no. And and this is where I would argue that the some of the companies they do do those. And even, you know, I have friends that are ER physicians and they're like, I think I'm gonna start doing Botox. And I'm like, listen, I mean, it's not Botox is fun, it's good, but you know, you can really cause some damage with Botox if you do it improperly. You can definitely piss somebody off for a good three to six months if you do it improperly. So, you know, and these are people paying cash for finesse things, you know, sub-millimeter. A millimeter, you know, five pieces of paper put together, that thickness, you're gonna you you can really make somebody look worse than better. So um now, for me, it's easy. I've done it thousands of times, so it's it's not hard for me. Um, but it the the you're talking millimeter uh changes. So yeah, I don't know if I'm explaining that properly or not, but yeah, no, you're explaining it.

SPEAKER_00 19:33

I think you're doing a good job. I I think the people don't understand that when you talk to people who really, really know how to inject, let's just take let's just take toxin for a second. Things like spread, things like depth of the needle, these kind of things, I they don't understand how absolutely intricate it is to get the right outcome.

SPEAKER_01 19:59

Yeah, and the dilution and the the size of the needle. I mean, there's so many variables that the smallest change can make a significant difference. Um yeah, it's one of those things, and and I I alluded to it earlier. Unfortunately, these kind of, which is the few still bad actors are kind of giving us all a little bit of a bad rap as an industry. I mean, we make I I always say everybody's like, I don't want to look stupid. I see so many people with filler, they look stupid. I was like, Do you know how many hot people you see with filler? You just don't know they have it. So it's just it's 10 to one. Of course, the stupid ones, you know, go blow up on Instagram because they look ridiculous. But, you know, one of the big issues with the with that with the uh non-surgical filler injector world is you pay, I tell every patient this, you pay me per syringe. I don't really make that much money on filler. I do most of my stuff on surgery, but I love fillers. I think they do great. But if I do one syringe, I get a thousand dollars. If I do two, I get two thousand dollars. If I do three, I get three thousand dollars. So there's some clinics that survive by the syringe, so they just keep encouraging people to do more and more and more. And it's like, I mean, step back, look at the patient, look at the aesthetics as a whole, do some cephalometrics, go through it. I mean, if you if you if you really listen to the Doris Day episode that we just did, you can see in somebody's mind who like really cares about the patient as a whole, their aesthetic, their mental health, and those are the people you want to go see that that can take this is really almost obsess about it to an unhealthy degree.

SPEAKER_00 21:28

Sorry, that's a really good point. I don't want to lose what you just said, which is this combination of uh obsessiveness on result and technique and those things combined with experience and knowledge is is what you're actually looking for. And Ben, you just said something else is that you know, the thing in the industry a lot of people don't talk about is that usually the best outcomes that you see out there are ones that you actually don't know are outcomes, that you don't actually Actually, I know that someone had filler, that someone had Botox. It's so natural, looks so beautiful, looks just so so great that people look at that and go, God, that person just looks great. But they don't look at them and say, Oh, they got Botox and filler. Yeah, that's the difference. Yeah. And sorry, I'm just gonna get it personal and she might kill me. But so I was in Chicago last week and um my wife saw Dr. Eliza last week while she was in there. Dr. Eliza Parker at Cadella in Chicago, she's amazing. My wife went in there and then I I saw I saw Eliza and she's like, okay, don't be mad. I actually put a little bit of filler in your wife's lips. And I look at my wife, my wife was elated. Like, she was so happy. And guess what? I didn't notice. I couldn't tell. I thought she looked beautiful, but I she's my wife, and I always think she looks beautiful, but she looked great. But first of all, my wife was totally elated. I didn't even it didn't know. It's like she didn't have dark lips, she didn't have any of those kind of things, and it's like those are great results. Like those are great results. Anyway, then I want to talk about this, man, because this is just out of control. This is out of control, man. This facelift craze. I want to talk about this facelift craze. I want to talk about how people are just going bonkers on facelifts. And I and I have no problem with anybody getting anything they want. I think it's great. I more want to talk to you because you are the man you know. I want to understand about the necessity. They're blowing right past. Hey, let me just get a little bit of filler and I need a facelift. And I feel like it's getting younger and younger, and I just want to get your general thoughts on that.

SPEAKER_01 23:47

I mean, it's a it's a loaded question. The facelift is hot right now. It's good for all the plastic surgeons in the world, including me. So I'll take it when they come. You know, I normally tell patients there's something I'm very good at, and I'm good at a lot of things. I do a lot of non-surgical, I do a lot of filler, Botox, lasers, neurotoxin lasers. I do a lot of surgery, obviously. And the I think the beautiful part about that is I'm happy to discuss all of those options to each person. Some people just want a little tweak, they want to be able to go to dinner and hide it from their husband. Some people want a total, you know, makeover and are can give me a month downtime with $30,000. So there's that range and many levels. There's so much fear-mongering on both sides, to be honest. The the surgeons that don't do filler, oh, don't do filler and botox and threads, it's gonna make you look, it's gonna make my facelift harder. That's not true. I'll get into that. And then there's the uh um the non-surgical people, oh, don't do a facelift, you're gonna look overpulled and dumb. Also not true. Um, I could see how both of those how you could come up with that argument with both of those, because they can both uh be true to a certain extent, but the by the you know, by and large, they're not. Um so let me address the facelift one first. I it is extremely rare to do a facelift in somebody who doesn't have filler, neurotoxin, uh lasers, even threads, whatever, done over the multiple years before. Because of course, as Dom said, you want to look good, you want to feel good, you're trying to delay this facelift. You know, they can range from $10,000 to, you know, $500,000. Honestly, I know it's crazy. That can be the $500,000. There's a few jokers charging. Good for them. Um, so they can range in price, obviously, from that. The downtime is I normally tell people you're gonna look like an idiot for three weeks. So, I mean, this is a serious commitment. And I don't do a facelift, neck lift on anybody until they're begging me for it because it's a lot to go through and you gotta want it. So that alone is a reason that you would hope to defer it. And you can really defer these quite a bit with the right um non-surgical treatments, with hyperbaric, with with a little bit of filler, keeping the skin tightening, obviously good sunscreen skincare. So um, yeah, it really comes down to fear mongering. Again, all of this driven by money and and pride, essentially, um, and in the in these two sides pushing so hard against each other that they they're only using extreme examples to to make their point. I think that's where it comes from. Yeah.

SPEAKER_00 26:19

So is there is there and and I know probably everybody's different, but let me give you an example, okay? You're 35, 36, 37 years old, and you're like, I kind of don't like this on my face and this in my face. It seems like there's a jump to a facelift instead of, hey, we can actually knock that out with a little bit of toxin and a little bit of filler, and we should try to do that as long as we can until it's time for a facelift. Is that is that kind of there? I like I I don't know.

SPEAKER_01 26:50

Yeah, I mean, again, it's a personal decision. I have the only time I've done facelifts in 30-year-olds, I've you know, nowadays we're seeing people who have lost 100 pounds, two, you know, 150 pounds. And these people, for better, or unfortunately, I haven't figured out a good way to say it, but they've like damaged their skin to the point where nothing's gonna make it better. We got to remove some of it. So, barring that, a facelift in a 30-year-old, um, you're trying to tighten something that's not loose. And what happens, I mean, this is just physics, anatomy, physiology. When you try to tighten something that's not loose, the scar is gonna widen a little bit, they're gonna get a pulled sensation. So you it's just gotta be really selective. And yeah, in my mind, I really yeah. So it's I've never heard that.

SPEAKER_00 27:35

Say that again. You you're trying to tighten something that's not loose.

SPEAKER_01 27:41

Yeah, it's it's it's you know, you can't just cut skin out if there's not excess skin, right? You're gonna it's at the expense of something, it's just how the body works, it's how anatomy works, it's how physics works, it's just it's simple. You can and then you're gonna end up with a scar. And the other thing I tell people a facelift lasts 10 years in the best of in the best of hands, these hands, maybe 15 if you really you know get lucky and take care of yourself. So you're 30, you're hopefully gonna need seven facelifts. And they don't get easier. Uh I've only I did one woman, I did, I was her fourth facelift. She was 83, so I didn't do her prior three. And it was a bitch. It was hard. It does, you know, it does not get easier. The layers are a little bit uh complicated. So yeah, it's just it comes down to if you do it when you're 30, you're not gonna be making much change because you can't remove that much skin, you can't move much tissue, you're going through this thing, you're gonna look all beat up, and and then you're gonna do it again when you're 40, and then when again when you're 50, and then again when you're 60. You know, they say the person that's gonna live to be 150 is alive today, Dom.

SPEAKER_00 28:44

Yeah, I know, right?

SPEAKER_01 28:46

I've heard that's what they say. Yeah, it's incredible. So imagine, you know, and not it it that all of that aside, you can get a really nice outcome with well done non-surgical or little tweakments, fat sculpting, even you know what, filler, do a little fat transfer. I mean, we have so many options other than going really deep down into the face and trying to manipulate things that I just that's this is how I guide patients. And still, I'll have a few that will talk me into it, and I'm just very transparent. Okay, you're gonna have a scar. Okay, this is the change you're gonna get. Okay, this, you know, it's like, I mean, if it's if it's fully consented and everybody understands and you know what you're getting and they consider the other options, you know, though this is how this world works.

SPEAKER_00 29:27

So is I mean, is that kind of like a thing where people are kind of waiting and waiting and waiting to kind of like if you're trying, if you're able to push the facelift off later, everybody says I don't want to wait too long.

SPEAKER_01 29:42

Yeah, the the other the counter would be I don't want to wait too long, I'd rather just have it done. But you know, it's not one thing you just want to have done. I mean, you know, you're this is a big serious uh commitment. We're gonna do some, you know, a lot of work, we'll do it well, but you gotta want it, you gotta need it, uh, you know, quote unquote need it. Your your tissues have to be able to tolerate it, you know. Um, and then there's just some other options out there to give people a really nice outcome. Hopefully, and I my answer is normally, you know, hopefully I can defer you, just keep kicking the can down the road, and you never end up with a face left. Right. If you want to face it when you're 30, you're probably gonna end up one. So, you know, you're you're self-conscious enough that you're you're you're gonna be paying attention to that. But the further you can push it down and still be happy. I'm not, I'm not, I'm not saying I want you to just deal with what you got. I'm saying, you know, make it better by ways that work and are safe and are effective and make sense, you know, physiologically. If we know how the face ages, the skin loses elasticity, the bone uh uh remodels itself and gets a little thinner, the muscles flatten and thin, this the deep fat pads pseudo-herniate, the superficial fat pads shrink. I mean, we know all of this. So, you know, a face if is not countering all of those. Um uh well, and you if they're not, if they're not, if they haven't happened to a significant enough agree, uh uh degree, then then it's crazy to do a face off. So I was just on like the news, uh they did a clip on me with this, you know, I was like, it's crazy to do a face off in the large majority of 30-year-olds. It's just the reality. And the number of like pulled tight things I feel and revisions I've had to do. This isn't a disc to Turkey or Mexico or Russia or Venezuela or wherever the hell these people went, but there's a lot of those places that are doing this in these young people, and it's hard to reverse, you know. So that would just be my other um caveat.

SPEAKER_00 31:34

Is it um I guess the other thing to Ben, can we just dispel dispel a myth? I I ask you this sometimes when we're together, and I want to do it on the pod here too. Like what this deep plane facelift. Is this one of these is it is that something that's actually different, or is it the same thing just renamed?

SPEAKER_01 31:55

I would say it is actually something different. Well, no, it shouldn't say it's something different. We've been doing, we as a as a uh um field have been doing deep planes for a very long time. So it's definitely become repopularized. There's the deep plane, there's the superficial, there's a SMAS, superficial musculoepineurotic. Um, there's there for a while there was some sort of a daylight lift or lunchtime lift or something. So the deep plane, they really are getting deeper. I mean, it makes sense, they're getting deeper into the face, onto the musculature, even onto the bones, uh, periocular area in certain areas. Um, and it has a role, honestly. There's in sometimes if if you're if you are heavyset or you were heavy set and you're 65 years old and you got this thick skin and your cheeks are really down, sometimes you do got to reposition the entire cheek. So I think in those cases, I think it could be really well uh tolerated. In a 30-year-old, it just doesn't make any sense. I mean, it just did my I I did this post and it got people people got really mad at me because I was trying to kind of count. I'm kind of the anti-deep plane guy, to be honest, for what it's worth, so you can check out my stuff. I did a post on Margot Robbie. Margot Robbie, she's like 38, 40, something like that. And she's beautiful. She's got really good structure. Many people, the reason I bring her up is because people show me her jawline and say, I want to look like her. And my point is, okay, Margot Robbie still has her submendibular gland. She has her entire digastric muscle. These are things they remove in a deep plane. Her cheekbones are where her uh uh musculature is where it would be for a 38-year-old. So the point is, what makes her look so good, she's got structure in the right spots, she's taking good care of her skin. You know, it's it's not that they removed these anatomical structures, she's just got the certain things that you could tweak or compare your own anatomy to. But so I don't know if that's making sense, but it it's it's it's I'm trying to exemplify that. Look, this person, you're showing me her, and you're asking me to remove stuff out of you to get you to look like her. When if you do her cephalometrics in yours, it's not that she has less than you. It can be as simple as a little filler deep down in the bone. Maybe a little chin implant, maybe it is a little fat sculpting, maybe it is skin tightening, but you know, it's you really gotta look at yourself, what you want, what you're after, your anatomy, your goals, your physics. It's it's such a complicated scenario that uh I got a hard job, man. Ben, Ben, you're out there working, man. I'm working, man. I'm like, man, you're like on the job. I told I told you this before. My old man, I used to roof houses with my old man, and he would look at me, he'd be like, You're doing this, so when you're older, you don't have to use your back, you can use your brain. And I I'll call him every now and then be like, dude, I'm still using my back, my neck hurts my back, I'm like slugging it around.

SPEAKER_00 34:33

Stay in it all day.

SPEAKER_01 34:35

Yeah, it's like fucking eh.

SPEAKER_00 34:36

Um, Ben, that was um that was awesome. I think there's more to talk about that. And actually, we have to um take one episode at some time, and I just want to completely deconstruct like the jaw fascination because I know that you are the absolute leader.

SPEAKER_01 34:52

You know what? Let me I'll dive into it real quick. You know, everybody likes a nice jawline: old, young, gay, straight, black, white, Hispanic, man, woman, trans, whatever. Now we can feminize it, we can masculinize it, we can soften it, we can sharpen it, we can be harsh. So it's just one of those things that's so uh interesting. And I mean, I can nerd out about it all day, but uh it's funny because uh I had a colleague ask me, he's like, dude, all you do is jolly. What the hell? Like, don't you get bored with it? And I was like, you know what? The more you do, the more complicated it gets.

SPEAKER_00 35:22

It's a little bit bizarre in that way when it comes to surgery, but yeah, so well, it's uh I mean I think that's a whole thing too, is that you've done so many of these and you're so damn good at it that you're seeing things that other people just wouldn't normally see, and that's why it's getting difficult because you you're yeah, probably you're you're at a point, you're at a level of perfection that is like the point zero zero zero zero zero one percent, right?

SPEAKER_01 35:46

Yeah, there's nobody you can't do more of these app right every day. There I mean it's physically impossible to do more of these than me.

SPEAKER_00 35:51

Ben, that was fun. Uh, as always, I love hanging out with you, but I thought I thought that was really great and helpful for all of the folks out there.

SPEAKER_01 35:58

It's interesting. If you if you have heard of any of this or you know, or there's something specific you would like us to address, put it in the comments.

SPEAKER_00 36:04

Everybody out there, our next episode, we got some hitters that are coming on. It's gonna be a lot of fun, so make sure you stay tuned.