Cosmetic Doctor reveals ALL her Secrets [SUJY #003]

In this vlog interview, I walk through Vancouver, BC with Dr. Jiyeh Joo, an aesthetic and cosmetic physician from Toronto, Canada, and ask her everything you’ve probably wondered about skincare, anti-aging, and the truth behind beauty trends.

We break down what actually works (and what’s a waste of money), from daily skincare routines to procedures like Botox — and even where the line is between self-improvement and going too far.

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Chapters:
00:42 Introduction
03:00 Eczema
07:38 Basic Skin Care Routines
09:12 What is K-Beauty?
10:24 Skin Types based on oil production
11:51 Skin differences between ethnicities
12:42 Skin types based on melanin production (Fitzpatrick classification)
15:32 Men vs Women – Skin care routines
16:04 Where you should save and spend your money – Skin care products
19:30 Night-time cleansing hacks
20:39 BOTOX – everything you need to know about it
24:39 Melasma – what is it and how do we treat it?
26:01 Aging – How does our skin change and how can we slow down this process?
28:00 Current skin care trends – Trash or Truth?
28:13 Looksmaxxing
29:19 Red-light therapy
30:41 CO2 Lasers
31:10 Sunscreen – the cheapest and most effective product for skin care
32:15 Cosmetic ethics – Where is the line between optimization and body dysmorphia?
36:29 Emergency vs Cosmetic medicine
38:00 How to know if a cosmetic doctor is good or bad at their craft?

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Dr. Jiyeh Joo is a Toronto-based aesthetic physician specializing in K-beauty and cosmetic dermatology. She shares evidence-based skincare advice, anti-aging strategies, and insights on treatments like Botox and fillers—helping you achieve healthy, natural-looking skin with confidence.
Instagram: @withdr.jiyeh @rejooclinic 
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Post-production: Ben Jones

Transcript

SPEAKER_00 0:00

Is there like a sniff test to determine who is a good aesthetic medical doctor versus who is a bad one? Hey what's up? I'm in downtown Vancouver and I'm meeting up with Dr. Gia, who is a famous cosmetic and aesthetic medicine doctor who's visiting from Toronto. And I asked you guys over Instagram to give me any questions regarding skincare or cosmetic medicine. And I'm gonna be hanging out with her for the day. I'm gonna go over all the questions that you gave her. Uh so let's go meet her. So we have uh Jie Ju. Hi. She is a famous cosmetic and aesthetic doctor from Toronto, and we're gonna be asking her some questions.

SPEAKER_01 0:53

Yay, that's exciting. Thanks for the nice introduction. I'm excited for all the questions I'm gonna be asked.

SPEAKER_00 0:59

So I guess we'll start with a brief introduction. Um first of all, what made you go into aesthetic and cosmetic medicine? And what is it about that field of medicine that kind of interests you or piques your yeah, keeps you keeps you going?

SPEAKER_01 1:18

Um that's a great question, and I would say that came in pretty naturally for me. I always said um interest in the skin because I used to struggle with eczema growing up. It was very common for me to like see dermatologists, different specialists. So it was almost kind of natural in a way that I always had interest in the skin, and also knew how much impact it can have and was self-image. Um so and that was actually one of the reasons that actually made me go into medicine too.

SPEAKER_02 1:43

Oh, yeah.

SPEAKER_01 1:44

So like once I got into like the medicine aspect, just because I always had so much interest in the skin and how much impact it can have on the one's image, um I naturally almost like pursued training in that aspect, even without like hesitation. There was no second doubt. And I actually learned more about it. I was more intrigued because it's a very fast-evolving industry. As in there's always like newer treatments, newer products, um, there's different services that are coming out. Um, so intellectually it's very stimulating, but at the same time, I really like the idea of treating someone from inside out.

SPEAKER_00 2:18

Yeah, you're totally right. Like I feel like skincare is evolving so quickly. And unlike other areas of medicine, like dermatology and skincare and aesthetics, is there's like such a close integration with private products and industry that are like constantly pushing the envelope, right? So that's really interesting. I honestly I never would have guessed that you had eczema because your skin looks great.

SPEAKER_01 2:42

You know what? This is all the hard work. It doesn't come for free, and everyone, I'm telling you, preventative care and maintenance is the key. And I guess that's where the K-beauty comes in because um the philosophy really lies on preventative cares and the skin philosophy approach before you start seeing the signs of aging.

SPEAKER_00 3:00

I see a lot of people that come in with eczema flares in the ER. Oh, yes. Maybe we'll start with that. Um because I'm kind of curious. We talk so much about um, you know, keeping the skin moisturized so that it doesn't crack and get more inflamed. But what was it for you that helped to get your eczema under control? And what is it that you typically recommend to your patients who come in with eczema flares?

SPEAKER_01 3:24

Yeah, for sure. So I would say in terms of eczema, one thing that a lot of the um people have to know about is the education piece because most of the time it is a chronic condition, as in it's not gonna go away and then never appear again. So I think people just have to know that it's gonna be a chronic condition, it can get better but can get worse, and they have to know what to do to maintain it and also what to do when it flares up.

SPEAKER_00 3:47

What do you do to maintain it?

SPEAKER_01 3:49

Yeah, for sure. So I would say, in terms of the maintenance, is where, like you said, the constant and adequate moisturized uh moisturization would be important. In terms of the choice of products, I would say there are so many products out there, but fragrance-free products would be uh what I would recommend for people who have sensitive and exhibited skin. Um, so common brands that I would recommend in my clinic usually would be like CeraVay or Cetophil products, anything that um really works on the skin barrier repair that has ceramides, that's going to help a lot.

SPEAKER_00 4:18

Okay. So I'm not too familiar with all the different um, I guess like products and ingredients inside the you know, skin moisturizers, cleansers, and all of that stuff. But you mentioned something in CeraVay and Cetophil that they have, was it Ceramide? Ceramides.

SPEAKER_01 4:36

Ceramide. Um so it is an ingredient that's going to, it almost like patches up because um people with the eczema, they have almost like a leaky skin barrier, meaning um whatever they come in contact with, it's more likely to actually react to those changes and then cause the flare. So ceramides almost um kind of block those uh leaky changes that are happening in the uh lipid barrier and the skin barrier. Um and then by doing that it's strengthening the barrier and also like reducing the flares that you may have.

SPEAKER_00 5:04

And so um non-scented um products, constant moisturization, and then only steroid creams or systemic steroids if you have a flare-up and need to cool down the inflammation?

SPEAKER_01 5:16

Right, and then um there are also a lot of new topicals that are out um in the market right now that are non-steroidal, so like protopics, L, those would be um ointments that you could also, you know, recommend as a maintenance. They can use like two, three times per week. Um, and then if that doesn't control it or if someone is having like a severe flare-up, then you can recommend topical steroid. And most of the time I wouldn't recommend oral like systemic steroids just because the rebound effect can be pretty severe in a sense that it does help to bring down rapidly the flares, but when they stop it, it can come back again.

SPEAKER_00 5:50

Yeah. You know, it's so interesting because I was just chatting with um an acquaintance of mine that suffers from severe eczema all over her body. And she told me that she actually had to wean herself off steroids recently. Like I think she was on like low-dose prednisone for I think it was like years or something like that. And when she started weaning herself off, uh her eczema flared up. But she's been I forget what it was that she was using. Um it was something like natural, like maybe like garlic or ginger or something like that. Does that ring a bell? I don't know. She said that she was using something natural, and that's what was like helping to keep her eczema at bay.

SPEAKER_01 6:29

Oh, interesting. So, you know what? That one I'm not too sure. And then um I don't want to go and provide any information that I'm not too confident about. Obviously, I'm not too sure whether there's a lot of clinical evidence behind um different ingredients, but I do know um for a fact that linosteramides or anything ingredients that really strengthen the lipid barrier, and the skin barrier can help in terms of reducing the flare, and um I would say adequate moisturization and also using lukewarm water and no prolonged like hot shower that can rip up the skin barrier and lipid barrier so it can help that lukewarm water, um you know, not too long, maybe maximum like five minutes.

SPEAKER_00 7:06

Wow. Okay, yeah. Five minute showers?

SPEAKER_01 7:09

Yeah, five minute showers. I know, you know, personally, personally, I I appreach it, but like I don't know if I can do it. I do have to say a hot shower is my relaxation therapy.

SPEAKER_00 7:20

Uh that's awesome. Okay, great. That's really good information. Should we walk a little bit? Sure, let's go. Okay, let's do it. A lot of people come into my comments being like, oh, like share your skin care routine. And honestly, like I feel like my skincare routine is actually quite basic.

SPEAKER_01 7:34

Like, usually it's just like we don't need a complicated skincare routine to be yeah.

SPEAKER_00 7:38

Yeah, it's just like it's pretty basic, right? Like in the morning and night, you just wash your face with a cleanser, moisturize it, and then during the daytime you wear sunscreen. Is that like pretty much it or what?

SPEAKER_01 7:48

Um, yeah, that's a minimum. That's the basics. Yeah. And then you can add just a little bit more, but not too much. Okay. Because like one thing that I try to do whenever I'm like talking to my client is I don't want to overwhelm them with like so many skincare routines, right? That's they will never follow up.

SPEAKER_00 8:03

I feel like there's so much information out there on like different products, and I have no idea. Like, okay, I I don't even know what serums and toners and all this different is. Like, what how do you use that stuff?

SPEAKER_01 8:15

So, you know what? The most um I guess like basic tip that I want to give to anyone that are not familiar with all this like different skincare products and steps is like always start with the most liquid products and then move on to something thicker.

SPEAKER_02 8:30

Uh-huh.

SPEAKER_01 8:30

Yeah, so that's like an easy way of remembering. Okay. So, like, if you don't know how to layer up the products, like just feel the consistency and the texture, and then you always start from the lightest to the thickest.

SPEAKER_00 8:40

For example, then I would cleanse my face with some kind of soap.

SPEAKER_02 8:45

Yeah.

SPEAKER_00 8:46

Then I would use toner, and then use serum, and then go to your moisturizer. Moisturizer, and then put sunscreen on top.

SPEAKER_01 8:55

That's like that'll be during the daytime.

SPEAKER_00 8:56

And you just go boom, boom, boom, boom. As soon as like it absorbs, you go on to the next one.

SPEAKER_01 9:00

Um, yeah, you can. Um obviously, I think some products it's better to um give a little gap for full absorption. Yeah. Um, but like once it's like padded dry and then once it's like fully absorbed, then yeah, you can definitely do that.

SPEAKER_00 9:12

What is K-Beauty? Like, just for anyone who isn't aware of K-beauty, like what is the appeal of it? Because people are going crazy over the s right now, right?

SPEAKER_01 9:20

Yeah, that's true. So I would say the key highlights of K-Beauty are obviously it originates from Korea, and Korea is already, I would say, one of the world's leaders when it comes to driving and shifting the aesthetics and skincare markets. Yeah. I think the key principles of K-Beauty that's really making it stand out is the fact that it's preventative. So people are starting this very early. They're not focusing on, you know, um corrective changes, it's more preventative maintenance. Um, the other thing is the natural and undetectable results.

SPEAKER_00 9:52

Natural and undetectable results as well.

SPEAKER_01 9:54

Yeah, when it comes to like aesthetic treatments, or even when it comes to the ingredients themselves, like a lot of the Korean like K-Beauty products focus a lot on the natural ingredients, organic ingredients, that are very friendly on all skin types.

SPEAKER_02 10:09

Ah.

SPEAKER_01 10:10

So um for any consumers like who are looking to try like different products, like K-Beauty skincare products will be one of the easiest ones to try because um they're naturally going to have a lot of like calming, hydrating agents that are not irritating.

SPEAKER_00 10:24

Okay. You were telling, you said something about skin types. Like, what are the skin types? Because I that's something that I never ever learned about in medical school.

SPEAKER_01 10:34

Yeah, because we're really never caught on that off. Nope.

SPEAKER_00 10:38

Um it's like the least applicable thing in emergency medicine.

SPEAKER_01 10:41

So you never know, it can come in handy, right? Um so I would say there are um, let me see, like three broad categories. So there's a dry skin, um, and then there's oily or acne-prone skin. Yep. And the last one would be like combination. As in, like people, I think most people have combination skin type, meaning the T-zone will be slightly more oily.

SPEAKER_00 11:04

This is the T-zone, right?

SPEAKER_01 11:05

Yeah, so in the forehead, um, your nose area, and everything else would be more like a normal to slightly dry. So I would say those three would be the biggest like skin type categories that you can think of. And then I guess based on your skin history, hopefully you kind of know where you fall into.

SPEAKER_00 11:21

Just looking at my skin, can you tell what type of skin type I am?

SPEAKER_01 11:24

You know why? Sometimes it is hard to um just kind of like pinpoint in terms of like what skin type, but based on what you said, you said you only use cleanser, like a light moisturizer, and SPF, and that's about it, right? Your skin does feel hydrated after. Um, so I would say yours is probably normal to maybe slightly like combination, because I did feel like it's a little bit oily.

SPEAKER_00 11:45

Yeah, it's a little do I need to like powder my nose or something?

SPEAKER_01 11:49

Only if you have time, extra, extra stem.

SPEAKER_00 11:51

Another thing I heard from someone is that um Asian people tend to have like thicker skin. Yes. As opposed to like Caucasian or white people who have thinner skin, and that's why white people get more like wrinkly. Yeah, for sure.

SPEAKER_01 12:04

Um, so I actually talk about that a lot because even in the clinic that I um you know run, and then in terms of declines that I see, I see a lot of difference in terms of like how people age depending on their ethnic backgrounds. Yeah. So I would say Asian people, like you said, we have a higher density of collagen and thicker skin. Okay. Um men, um usually on average more than women, because women go through rapid changes after menopause.

SPEAKER_02 12:30

Yeah.

SPEAKER_01 12:30

Um, and I would say that actually impacts some changes in terms of what we see as we age. So, like you said, Asian people are less prone to like forming wrinkles compared to like Caucasians.

SPEAKER_00 12:41

Tell me again, like the skin skin types go from one to six isn't?

SPEAKER_01 12:45

Yeah, one to six. Okay. Um, so I would say one to three would be more like Europeans, Caucasian skin. Um, they're more likely to burn when they're exposed to the sun. Oh ginger. Yeah, so it's gonna go from the lightest, and then skin type four or three to four is like where East Asian skin type will come in. So they have more melanin, um, and then they're less likely to burn, but they could burn if they're exposed to the sun for a long time. And then skin type six will be no black. Um, so depending on the skin type that you have, um, I would say you may present with different concerns and presentations in the clinic. Okay. So when it comes to Asian uh skin, where people who have skin type 4 or 6, a lot of the time they actually struggle with pigmentation because we have more melanin. But melanin is also what protects your skin from the sun, as in like it's going to protect and slow down the you know photo aging that are related to sun exposure. However, that also makes us more prone to forming pigment when there's a tissue injury. So let's say like if they had acne scars, then we are more likely to form like hyperpigmentation.

SPEAKER_02 13:52

Yeah.

SPEAKER_01 13:53

And the other common presentation would be any kind of sunspots but also melasma.

SPEAKER_00 13:58

So if I'm understanding this correctly, skin type one to six isn't just about melanin, it's also about moisture.

SPEAKER_01 14:07

Like how does the one is actually more so uh to do with the shades of skin color. Okay. And then how it responds to the sun exposure. So like your likelihood of tanning or burning.

SPEAKER_00 14:19

Okay, so you could have uh say like uh one person has skin type type six who is super dry and needs to moisturize, and another person with type six who's super, super oily and never needs to moisturize.

SPEAKER_01 14:32

Yeah, that's right. So like skin type is totally different from the I guess, oh I see what you're confused about because I named it the same way, right? Um so I guess the Fitzpatrick type, that's like what we're talking about when we're talking about the um skin type one to six.

SPEAKER_00 14:48

Ah yeah. Okay, okay, huh, interesting. Okay, I'm learning a lot right now. So we're heading to the shopper struggle, which is a good one. Yeah, which is a Canadian um pharmacy.

SPEAKER_01 15:02

Yeah, pharmacy, drugstore that carries like all the skincare products. I would say they um carry more European skincare products better than the Korean This is the one that I use the full.

SPEAKER_00 15:25

Okay, perfect. Yeah, no, I love that. Either hydrating? Hydrating cleanser. It's one of these green ones that I think.

SPEAKER_01 15:32

Okay, there really shouldn't be much of a difference between the men's and the woman's. I know like a lot of the people do ask about it like, is there any like specific skincare routine that men have to follow? But you know, it's really about understanding the skin philosophy, how like skin basics work, and then there's really not much of a difference between men and women.

SPEAKER_02 15:49

Okay.

SPEAKER_01 15:49

Yeah. So whatever your wife, your partner, your girlfriend is using, probably you can benefit with it too if it's the same skin type. But obviously, if someone has an oily skin type, the other person has a dry um skin type. If they're trying to share the products, it's probably not gonna go well. Yeah, when you don't know where to start, when it comes to building your skincare, I would say um things where you can save money probably will be like cleanser, um, SPF, um, and even moisturizer. And if you really wanna like put in the money for where your money is worth, especially if you're over like the age of 30s, um, then I'll put in a serum because they yeah, because they actually have an active ingredient that's going to make changes in a higher concentration.

SPEAKER_00 16:31

Yes. So serums aren't just moisturizing, they're they actually like do what do they do in your skin?

SPEAKER_01 16:36

They do different things depending on what they have. So let's say let's say if they have like hydroaluronic acid, that's going to help with their hydration and moisturization. Um, if someone struggles like more with like pigmentation, um then they're gonna have a lot of brightening ingredients, including like trinatomic acid, niacinamide. Um so kind of depends on what your skin concerns are, and you can actually target and layer up and customize it to address your underlying skin concerns.

SPEAKER_00 17:03

Okay. Gotcha.

SPEAKER_01 17:04

But otherwise, I would say when it comes to like cleanser, even toner, um, and moisturizer, um, it's pretty basic. Okay. So if you do want to save money, I would say save on those. Okay. And even for SPF, like whatever you apply daily, that's what matters the most. So you start with the cleanser, and then you're going to um do, I guess, moisturizer, and then SPF, I guess for the morning routine. And then if you want to add extra stuff in the morning skincare routine, I would add antioxidant.

SPEAKER_00 17:35

Antioxidant.

SPEAKER_01 17:36

So that's usually like vitamin C. Okay.

SPEAKER_00 17:38

So you have antioxidants. There's actually like truth and evidence to the back that one.

SPEAKER_01 17:42

Yes, yes, that's evidence-based.

SPEAKER_00 17:44

Okay. Yeah. Interesting.

SPEAKER_01 17:45

Um, so antioxidant is going to protect your skin from free radicals that your skin is exposed to during the daytime. So it actually helps to repair and protect your skin. And when you layer it up with the SPF, the um, I guess, potent or the sun protection that you get is even more powerful. So that's why you only apply in the daytime. The common uh mistake that I see is sometimes people apply that in the nighttime, but that's not gonna do its job. So make sure you do it during the daytime.

SPEAKER_00 18:09

So it's like it's it doesn't do harm if you do it at nighttime, but it's like you're wasting it.

SPEAKER_01 18:13

Yeah, you're wasting it. Yeah. So cleansing vitamin C or antioxidant, and then you do your moisturizer and SPF. That's it for the morning skincare routine. For the nighttime, um, you will do the cleansing within the moisturizer, and then add retinol. Again, that is um also evidence-based. Retinol, um, or retinoids, any prescription-based, like tretinoids, like those will all work.

SPEAKER_00 18:35

Okay, what is retinol?

SPEAKER_01 18:37

So, retinol is an ingredient that actually helps to accelerate um cellular turnover. So your skin is supposed to renew every 28 days. But unfortunately, that cycle does get longer um as you get older, meaning you're just gonna have a lot of dead skin just kind of like piling up. Um, so retinol will actually help to sloth out all the dead skin so that the new skin comes up to the surface. Okay. Um, so uh, when you look at a lot of the anti-aging like skincare lines that you see here, they're likely going to have some sort of retinol in it as a key ingredient. Yeah. The one thing that I didn't want to like say out though is that um they tend to be slightly irritating and drying. Um, so if you have a dry skin or sensitive skin, you may have to work your way up in terms of like building your tolerance. Um, but if your skin is able to, then I would say that could be a three ingredient that you can add to your nighttime or evening skincare routine. One thing I also want to add is um if you're applying SPM, you should do double cleansing. And then for ladies who are um applying makeup, of course, you have to do double cleansing, especially in the evening.

SPEAKER_00 19:39

So you just like wash it with soap and water and then rinse it off and then wash it with soap and water, the same soap and water again.

SPEAKER_01 19:45

Um usually I actually recommend using two different products. Um, so the first one would really have to target like getting rid of the diaper's, like including makeups or SPF.

SPEAKER_02 19:55

Yeah.

SPEAKER_01 19:56

Um so that can be either gel-based. Some people um some products are more like a water-based. So there's like a micellar water. So depending on your skin type, I would recommend one of those. And then the second step, you can use any of the cleansers that you have. It could be form, it could be gel type, like whatever you have, but you will use that as a second step.

SPEAKER_00 20:15

You know, if I'm being honest, for many, many years, uh huh, many decades, I would only wash my face once a day.

SPEAKER_01 20:24

Like, you know, to be honest, though, that's okay. Is that okay? Yeah, yeah. Let's say, like, if you weren't applying, well, I mean, I do want you to apply SVM, but like let's say if you weren't really applying anything, then you could do once daily cleansing, but I would definitely do that in the evening time before going to sleep.

SPEAKER_00 20:39

Now we're uh on the topic of Botox.

SPEAKER_01 20:42

Oh.

SPEAKER_00 20:42

So, first of all, what are your thoughts about Botox? What are the pros and the cons? Um, what are the potential side effects? Yeah, what are your thoughts?

SPEAKER_01 20:53

Um, so I mean, just to kind of give one sense I do it all myself, that means I actually believe in the product and I trust the product. Yeah. Obviously, when it's done well, when it's needed, I think it only has benefits. Okay. But when you do it when you don't need it, or if you actually choose a wrong injector, I think that's when it can cause a problem. So um the reason why I believe in the product is that it can actually help in terms of the preventative approach to smoothing the wrinkles and the lines. It also has a lot of other indications when it comes to medical condition as well. So, you know, excessive sweating.

SPEAKER_00 21:28

Oh, what?

SPEAKER_01 21:28

Yeah, hyperhydrosis, yeah. You can actually treat um hyperhydrosis or excessive sweating. Um, the common areas will be like palms, armpits.

SPEAKER_00 21:37

People Botox their hands?

SPEAKER_01 21:38

Yeah, yeah, yeah. That's actually a medical indication. The other indication will be for like teeth grinding, um, people who struggle with TMJ syndrome. Um I guess the other common indication for a medical uh reason would be like migrant headache. So I think cosmetically and also medical um indication-wise, if it's indicated, then I would say it only has benefits. But again, when you choose a wrong person for actually providing the services, and if they overdose you, or maybe you know put it in areas where you don't necessarily need, it's like when it can create maybe adverse events. Yeah. Either like heaviness, drippy eyelids.

SPEAKER_00 22:19

Just say you overdose in a particular area. Is there any way to like reverse the effects? Or you're just screwing up the street.

SPEAKER_01 22:26

So you know, for the neuromodulator, um, you know, after you inject, around within like five minutes of injection, it's gonna get fully absorbed into the muscle.

SPEAKER_00 22:35

Yeah.

SPEAKER_01 22:35

Um, so there's really no clear way of actually flushing it out. Okay. Let's put it that way.

SPEAKER_00 22:40

So you're screwed for the next like three, four months.

SPEAKER_01 22:43

Three, four months. But um, you know, there are a few things that you can do, depending on where you inject it, that is causing the problem where you can mitigate it to make it less pronounced. So let's say if someone injected too heavy in their forehead, they're having a droopy eye, uh, droopy eyelids, they feel very heavy in their eyes when they're trying to open their eyes, then we can actually relax the cross-feet area or we call it a brow lift to relax that muscle that's pulling the eyebrow down, and by doing that, we're almost like relieving that heaviness that they feel in your eyes. Yeah, so I guess like there's a way to mitigate it, but there's no uh way of totally reversing it. But the good thing is it's not permanent. Okay, so it will get better with time, but I guess you just have to be patient, and that's why you have to choose a right person to get injections.

SPEAKER_00 23:30

Yeah, so I think every single dermatology resident and attending I've ever met swears by Botox, and they all get Botox. Like, I saw a dermatology resident in the ER a little while ago, and I was like, God damn, your skin looks fing perfect. And she's like, Oh yeah, that's all Botox. I was like, oh like she's like so open about it, you know?

SPEAKER_01 23:51

Oh yeah, of course. Like in the study industry, we're like, we talk about like all the treatments that we do, where like you have to be the guinea pigs, or like you have to be the one. I um believe that whoever's providing it, you have to experience it yourself. It's almost like you know, for you to be a better doctor, you have to be a patient first. Yeah. Because you actually understand what it means, right? Interesting. So I actually follow by the principle even when I'm providing the services. So everything that we provide at my clinic, um, we I've actually tried it and I've actually seen the results. Because otherwise, like I don't want to recommend anything, you know, by textbook, right? That I've never tried. If I truly endorse it, then I should be the first one to try and see the results.

SPEAKER_00 24:28

I don't think that principle applies to emergency medicine. Because if you imagine me giving myself like ketamine and fentanyl, something like that.

SPEAKER_01 24:36

Definitely not bad. Yeah.

SPEAKER_00 24:39

Tell me about melasma. What is it?

SPEAKER_01 24:41

So melasma is a very um tricky and challenging condition. So that's a condition where your skin, even from the heat and even mild exposure from the sun, you are prone to forming pigmentation. Okay. And those are very um tricky in the sense that like anything that you do that triggers heat or sun exposure can always like bring up new pigment. So it's almost like an inflammatory condition that's chronic. And that's what's harder because it's not just like one um thing that you do a treatment and it goes away. Like it is something that people have to deal with lifelong when it comes on.

SPEAKER_00 25:14

And this is more common in like post-menopausal women?

SPEAKER_01 25:16

Postmenopausal from hormone changes and also again skin type 4 to 6. So people who have more melasma, um, they're gonna be more prone or more pigmentation, they're gonna be more prone to struggling with this kind of conditions.

SPEAKER_00 25:31

So, what do you do to treat it?

SPEAKER_01 25:32

Um, you know, honestly, like I would say like internal treatment options, it's not an absolute cure, again, right? It's more of a maintenance. Um, so you can do, I guess, proven treatments include like chemical peels. Um, there are some hydroquinone-based compounded topicals that you can try. Um, there's also certain type of laser, but I would say the Pico laser is the only laser that's indicated for melasma. Everything else that induced heat, it can actually trigger more pigmentation.

SPEAKER_00 26:02

What skin changes happen as you grow older? Like once you hit menopause, like how does the skin change?

SPEAKER_01 26:08

I would say probably the biggest change that you're gonna notice is the collagen, um, amount of collagen, like in your skin. Okay. So as you lose collagen, that means your skin will become more relaxed.

SPEAKER_02 26:19

Yeah.

SPEAKER_01 26:19

And then it's going to also have enlarged pores, you're gonna notice more sagging. Um, and because you don't have as much of a thickness in your skin, um, it's gonna become more reactive to whatever um, you know, stimuli that it's exposed to.

SPEAKER_00 26:34

Okay. So walk me through how the the skin routine, skincare routine is gonna change if you're postmenopausal. Because you said the main thing that changes is the collagen decreases, right? So your skin becomes more droopy and saggy?

SPEAKER_01 26:47

Yeah, droopy and saggy, and I'm not gonna lie, like when it comes to skincare, there's gonna be a limitation in terms of the effects that you're gonna see when you're trying to reverse those changes. Okay. And I do have to say that that's where I would say in-office treatments will really come in to mitigate those changes that you see when it comes to sagging, the laxity to really promote the collagen production. Um, in terms of the principle, when it comes to skincare, it actually stays the same. As in, you're going to um do the cleansing, right? The cleansing to get rid of all the excess debris. And then after that, you're gonna do the vitamin C or antioxidant. You moisturize your skin in the morning, you're gonna finish it out with the SPF. In the evening, you're going to include retinols, which is proven for anti-aging. Okay, and when it comes to serum, it's like when I will want people to invest a bit more when it comes to actives. Um, so anything that's like retinol, is it? Yeah, retinol or like hyaluronic acid, um, different ingredients um that will target different skin uh skin concerns, but in higher concentration.

SPEAKER_00 27:48

Ah, yeah, okay.

SPEAKER_01 27:49

But in terms of the principle wise, it stays the same.

SPEAKER_00 27:52

So we're gonna finish this uh this interview off, this walking vlog interview off with um rapid fire questions from uh my followers. So we're gonna talk about current trends, uh face care trends on social media. So you're gonna tell me which ones are trash, which ones are evidence-based.

SPEAKER_01 28:12

Yeah, I mean like face mask uh maxing, we talked about it.

SPEAKER_00 28:15

I think that's face maxing is crazy. How people how do people actually think that that works?

SPEAKER_01 28:20

I know, like honestly, I think that's uh yeah, that's a scam.

SPEAKER_00 28:23

And like so what is it that essentially what people are doing is they're tapping their zygoma and their chin to actually make it more prominent?

SPEAKER_01 28:30

Is that I mean they do all sorts of different things, but again, it's like that's not evidence-based, it's not something that I would actually recommend, and then it's not going to create that results that you're looking for.

SPEAKER_00 28:40

Okay, so if someone wanted to get more prominent cheekbones, more prominent, I guess, jawline and cheek, is there anything that they can do to um I mean there are many in-office treatments, um, so that is actually proven to work, that's evidence-based.

SPEAKER_01 28:54

If you wanted to do something um that's going to just help with more of a circulation, then I would say lymphatic drainage or a massage could help with in terms of reducing the puffiness. Okay. That's like what's you know, maybe um blurring somewhat the contouring of the face that you have. Um, but I would say eventually what it comes down to is really um getting the enough treatments for those concerned. So the next one is I know red light is quite big in the social media. Um so I would say for the red light devices, there are so many out there. So again, you have to really look into what devices and then what kind of clinical data they have behind. Some are more superior than the other. Um, I would say don't expect to um see like a miracle result. Okay. Again, these are home devices. They are not produced at the same level and the same level of like power and efficacy as the in-office treatments. So be consistent if you're gonna invest to it. You have to use it for minimum three months. Three months every night? Yes.

SPEAKER_00 29:49

So you literally sit at home and you turn on this like mask. Yes, yes, what do you do?

SPEAKER_01 29:53

Like how you know for me, I don't do it because I'm not that diligent. So, like for me, I'm more of a type of a girl to like just go in the office once per month or once a week, and I actually get um, you know, that high-level, more efficac, like efficacious treatment. Yeah, but you know, for people like who are diligent and then you know you can be consistent uh with the treatments every day, you know, for 12 weeks, you are going to see some benefits when it comes to anti-aging.

SPEAKER_00 30:18

Okay, and is it significant, like actually noticeable, or is it gonna be pretty meh?

SPEAKER_01 30:23

I would say don't again expect like a miracle result, right? Like if you're looking for that, like of course, like nothing will replace the in-office treatments, but if you're looking more for like maintenance, maybe subtle like rejuvenation, then I think that's a route that you can definitely implement as a complementary to in-office treatments.

SPEAKER_00 30:40

Okay. What about uh CO2 treatment?

SPEAKER_01 30:43

Yeah, so you know there's so many different lasers out there. CO2 is just one of them. Um, I would say that's one of the older technology that's out there, and CO2 works, but it doesn't work for everyone, it's not the best uh laser for everyone. Okay, um, so let's say if someone wants more of a resurfacing, if they struggle with acne scars, then that could be something that they could consider, but it's not gonna be suitable for all skin types because it can cause hyperpigmentation for people who have a darker skin. You know what? Honestly, one thing that I tell to all the clients that are coming to my clinic is if you want to invest in one thing that's the cheapest and going to make a biggest difference in the long term, make sure invest in the sunscreen and start applying it every day.

SPEAKER_00 31:21

What SPF uh number would you recommend?

SPEAKER_01 31:24

Oh, you know what? Probably.

SPEAKER_00 31:25

So what are you wearing right now?

SPEAKER_01 31:27

Um, so I wear 50, but again, I think if you're not going on a vacation and if you don't live in like tropical countries, like 30 is good enough. But you may just have to reapply it every two to three hours depending on like what you're doing.

SPEAKER_00 31:40

You wear SPF 50 every single day?

SPEAKER_01 31:42

I do. Damn. That's actually part of my daily skincare routine.

SPEAKER_00 31:45

Wow.

SPEAKER_01 31:46

And you have to.

SPEAKER_00 31:47

Crazy. You don't find that it like goes on like kind of whitish?

SPEAKER_01 31:50

Oh, oh, so it depends on what sunscreen you're applying. So the um, so I actually use like mineral or chemical sunscreen, so it doesn't really have a lot of the white cast. I think the one that you're applying probably is more of a physical sunscreen, and then that's going to leave a bit more of a white cast. Both of them equally work. I think it depends on whether you can tolerate that, and obviously, if you don't like the white cast, then you can probably go with the chemical sunscreen.

SPEAKER_00 32:15

This is kind of uh a question from my own curiosity. Okay. Is I in general I feel like the beauty standards with social media have gone so far up that we're starting to see more people with eating disorders, people with body dysmorphia. So, my question to you is where do you draw the line between I guess like optimization, beauty optimization, and body dysmorphia? Like, how would you differentiate that?

SPEAKER_01 32:47

I think that's a very good question, and yeah, that is definitely something that a lot of providers uh when it comes to the aesthetic industry will encounter more and more as time goes by. I would say the way I um kind of draw the line is when it comes to optimization, it is more enhancing what's already there.

SPEAKER_02 33:05

Okay.

SPEAKER_01 33:06

Um whereas like let's say if it's more of a dysmorphia, like body dysmorphic disorder, we are chasing something that doesn't even exist. And I would say that's where um I would say assessment and the thorough consultation will be the key. Okay. Because while you're doing that, you want to really establish the realistic expectations. And as a provider and as a good provider, I think you have to be able to say no if it's not indicated.

SPEAKER_00 33:32

Have you been in that situation before where someone is like coming to you and wanting like obscene amount of say like filler or some kind of cosmetic procedure, and you feel like it's either not indicated or it's gonna make them look worse? Like, how would you broach that conversation in a sensitive and compassionate way?

SPEAKER_01 33:49

Yeah, for sure. Um so I mean uh that's where I take a lot of my time for a consultation. I do um give out my objective opinion in terms of like what they will benefit from. Okay. Um I still hear out their concerns and what they're trying to optimize, but if there's a bit of inconsistencies in terms of what I see versus like what they want, then I would actually walk them through. And I think that's where also that KVD philosophy comes in because it's more about the natural, undetectable result. Um, so I often come up with the long-term plan.

SPEAKER_00 34:21

Your real goal is to make it look as natural as possible.

SPEAKER_01 34:24

Natural, progressive result. And then that's more of a long-term plan, as in like we are not trying to um produce like a magical result in one session. Okay. And then because that often means that you're just you know putting a lot of syringes and fillers that can cause overcomplication. So what I try to do is I come up with a step-by-step plan. So in the first visit, we're gonna target whatever. Okay. Um, and then in the second visit, like which could be like two weeks or well, a month later, we target different things.

SPEAKER_00 34:50

Say hypothetically, you've walked, I'm the patient, you've walked me through all that stuff. Dr. Jew, I still really want you to put in fillers in my chin and make my lips like super big, and you know, I just I'm not gonna leave this clinic until you inject me with some. You know what?

SPEAKER_01 35:10

I would actually say no to those kinds because I do have to say um those people may potentially, you know, um cause even bad reputation to your own work in your clinic. Because any example of bad work that's done, like when other people see it, yeah, they know it's poorly done. Sure, sure, sure. And they'll be asking, like, where did you get it done? Because it's so obviously done. Yeah. Um then like they will rather want to stay away. Um, so I would so that's why I think as an injector or aesthetic provider, like your ability to say no is where it becomes important. And I think you have to draw the boundary.

SPEAKER_00 35:46

Yeah, see, I think that's one area where uh aesthetic medicine is just so drastically different from what I do in the emergency room because like literally what I'm dealing with is life and death and uh severe morbidity, but like really what you're doing is trying to get someone from somewhat normal or like near normal levels to optimal. Like optimize.

SPEAKER_01 36:08

No, I totally agree. So um, and I think that's where um you have to be very, you know, educational and also informative in a sense that like they understand that this is an optional treatment. Yeah, it's not medically indicated treatment, right? And then they understand um all the complications or risks that can come with it, and then also the realistic expectations.

SPEAKER_00 36:29

I think another interesting thing that you mentioned was how your reputation really determines, I guess, how much more business and clients that you'll get in the future. Because that's something that I never ever think about. Obviously, I want to provide the best possible care to my patients because it's like I'm there to save lives and I'm there to like get patients better and treat the ill and the dying. But uh I never think of it through the lens of like, oh, I need to do a good job so that I can get more patients in the future, right?

SPEAKER_01 36:57

That too, but it's almost about um, you know, you don't want to create that wrong um, you know, like impression from the public point of view. A lot of people don't necessarily understand the aesthetic treatments and what it can do. Yeah, but what's obvious in the social media or what they see is a poor job, right? Yeah. All the complications that are happening. So it's producing the fear. And it's not um common that those are happening. Um so I feel like as a society of aesthetic providers who are providing all the services, like I think we need to be educated, we have to know what we're doing. Um, and then we also have to stay connected and learn from each other so that you know we are providing the optimal high-quality care that you know that is more realistic in terms of what we are providing. Because I do feel like right now there's definitely that fear from the misunderstanding of what these treatments can do because they're only seeing the poor example when the work is done well, it's undetectable, like no one knows. Like they will just assume that oh, like she aged gracefully. But she has done a lot of treatments, but in the right way.

SPEAKER_00 37:59

Is there like a sniff test to determine who is a good aesthetic medical doctor versus who is a bad one?

SPEAKER_01 38:06

Um, I do feel like in general, um, it is safer to go somewhere that's run by MD or have a medical director on site. Okay. Um obviously, when um you're getting treatment, there could be a potential risk of complications. So you do want that medical doctor with the medical trainings and the backgrounds to be able to manage that. So I think that is the key. And also, um, you know, people who actually invest in the education, continuing education.

SPEAKER_00 38:31

Yeah, you know, I'm super important. That's that's actually a really good point because I uh obviously I'm biased because I work as an academic at an academic center. Yeah, but I definitely think that working with residents and medical students keeps me on my toes and I learned so much from them too, right?

SPEAKER_01 38:48

No, same thing in the aesthetic industry, like no one can know everything, right? Yeah, and then no one would know like well enough. So you're always like gonna learn from each other, and that's where I think that continued education, someone who's always pursuing higher education, uh, will likely provide the highest quality of care.

SPEAKER_00 39:04

For most lay people who are like looking to get Botox or filler or some kind of skin treatment, um, wouldn't know if someone is like an academic or still like teaching and going like to get regular continuing medical education, right? Like how else could someone tell if someone's good or bad?

SPEAKER_01 39:25

I know it can be a bit tricky, but definitely like going onto their website, like looking into their teams, like clinical teams of like who's providing the services, um, as well as um usually I would say in the aesthetic industry, a lot of people do list their designations with different like continuing education conferences that they are attending to. Um so like paying attention to that. And um, I think the highest or most trustable source is probably word of mouth.

SPEAKER_02 39:51

Yeah, right?

SPEAKER_01 39:52

Yeah, like someone who's already gotten a service, if they really like the provider and also the result, I would say that's probably yeah, the best source of information.

SPEAKER_00 40:02

Okay. And how about like rate my MD? Like, is that you know what?

SPEAKER_01 40:05

Rate my MD, not as much for aesthetic providers. Um, I would say usually like Google reviews, but again, I think when it comes to Google reviews, sometimes it can be promotional too, right? Hundred percent. Um so I think you just have to be a bit aware. But I would say the highest probably trustable source would be word of mouth.

SPEAKER_02 40:21

Yeah.

SPEAKER_01 40:22

Um, like if you know anyone who's already gotten service, they're satisfied with the results, probably that's the safest information. Gotcha. Um, yeah.

SPEAKER_00 40:29

So you think that people are all doing work on themselves or yeah, of course.

SPEAKER_01 40:32

In the aesthetic industry, yes.

SPEAKER_00 40:34

You you don't think that they'd go to a different aesthetic practitioner and like get the work done?

SPEAKER_01 40:39

I mean they may, but like they will still ask for what they think in their point of view, yeah, uh, is a center of beauty, right?

SPEAKER_00 40:46

How do you do this?

SPEAKER_01 40:47

Like you just stand in front of a mirror and you're like, oh yeah, I need some like Botox here, like I mean they're definitely like there are definitely treatments that I may not be able to do it myself, but yes, you would. And like holding a mirror in one hand, like the other hand, I'm actually doing it. Yeah.

SPEAKER_00 41:00

Damn. Okay, so you need like pretty steady hands to do that.

SPEAKER_01 41:02

Yes, for sure. Okay. And then I think good assessment for the eye.

SPEAKER_00 41:05

What do you mean a good assessment for the eye?

SPEAKER_01 41:07

Um, as in like you have to have a good visual assessment in terms of like where the patient requires how much or what kind of treatments. And I don't think that's something that comes naturally. So I think some people have a better aesthetic assessment.

SPEAKER_00 41:21

Oh, okay. Like if someone's like, it's almost like an artistic.

SPEAKER_01 41:24

It's honestly aesthetic um industry, it's like an art. It's not like a textbook black and white, right? Interesting. Like, you know, people do it differently, but you come up with your own protocols, treatments, um, but it is really looking at the overall assessment and how everything comes together to create that harmonized look.

SPEAKER_00 41:40

Do you have any final words, um, things that you want to share uh before we end this interview? And thanks so much. I I've I've learned so much already. Like, seriously, I feel like all the different skin types and different skin protocols and all the different things, like all this stuff is completely outside of my reveal house.

SPEAKER_01 41:57

So uh I guess like one thing I do want to say is start early. Um, preventative and maintenance is the key.

SPEAKER_00 42:04

How how early? Like someone in their like teens or 20s?

SPEAKER_01 42:07

You know what, teens and 20s, obviously, like what they're gonna do will be different. Like good moisturizer with the SBA will be plenty for people in their 20s. But once you start um going to 30s, that's when you really start, you know, noticing the signs from loss of collagen, which starts to happen from the age of 25. Okay. So I'll say maybe early 30s, um, you can definitely focus on optimizing your skincare routines. Maybe starting mid to late 30s, you can look into like in-office treatments depending on the concerns that you have. Um, but yeah, just having the right foundation and also right provider.

SPEAKER_00 42:38

Okay. Yeah, because um I another thing I see on social media is like baby Botox, right? Oh yes. What is that? Like that's like a you know what?

SPEAKER_01 42:46

I think that's more like a marketing term.

SPEAKER_00 42:48

Um, but it's like microdosing of bothering. Yeah, it's micro-dosing.

SPEAKER_01 42:51

So it's the same uh neuromodulator, same um product that we are using, but we're just using tiny amounts for people who don't have like a set uh deep wrinkles, but we are using it more as a preventative when we're actually starting to notice early signs of wrinkles.

SPEAKER_00 43:04

Okay, thanks so much for uh sharing all your knowledge.

SPEAKER_01 43:07

No, thank you so much for having me.

SPEAKER_00 43:09

Check her out on Instagram or TikTok.

SPEAKER_01 43:11

Yeah, with Dr. G.

SPEAKER_00 43:12

With Dr. G, I'll take it in the video over there.

SPEAKER_01 43:15

But yeah, great. Amazing. Thank you. Thank you.