The Truth About Injectables

Summary

Podcast Summary: "The Truth About Injectables"

Introduction

In the January 1, 2025 episode of Am I Doing It Wrong?, hosts Raj Panjabi Johnson and Noah Michelson delve into the nuanced world of cosmetic injectables. Exploring societal pressures, misconceptions, and the practicalities of injectable treatments, the episode aims to demystify procedures like Botox and dermal fillers. With expert insights from Dr. Sherwin Parikh, a renowned dermatologist, the hosts guide listeners through making informed decisions about enhancing their appearance safely and effectively.

Types of Injectables

The discussion begins with a clear breakdown of the two primary categories of injectables: toxins and fillers.

• Toxins: Commonly known as Botox, Juvederm, Xeomin, and Dysport, these substances work by temporarily paralyzing muscles to reduce the appearance of wrinkles and fine lines. As Dr. Parikh explains, "Botox was first to market at the turn of the century" (03:29), becoming a staple in cosmetic dermatology for achieving smoother skin.

• Fillers: These are used to restore volume, fill in creases, and add projection to various facial areas. Fillers vary in their composition and viscosity, allowing for tailored applications depending on individual needs. Dr. Parikh notes, "They come in different varietals, different G prime, different forces, different viscosities" (04:00), emphasizing the importance of selecting the right type for desired outcomes.

Risks and Common Misconceptions

The hosts address prevalent misconceptions and potential risks associated with injectables:

• Bruising: One of the most common side effects is bruising at the injection site. To minimize this, Dr. Parikh advises staying hydrated and avoiding blood thinners like alcohol and aspirin before the procedure (11:05).

• Overuse and Reversal: Concerns about overuse are discussed, with Dr. Parikh assuring that most fillers can be reversed using hyaluronidase if results are unsatisfactory (09:44). However, Botox effects are temporary and cannot be undone, only waiting for them to wear off naturally (10:28).

• Drooping Eyelids: A rare but serious complication, often resulting from improperly placed Botox, leading to temporary drooping (12:19). Dr. Parikh emphasizes the importance of choosing a skilled practitioner to avoid such issues.

Age and Suitability

A significant portion of the episode focuses on the appropriate age for starting injectables:

• Young Adults: The concept of "preventative Botox" for those in their 20s is debated. Dr. Parikh suggests it should be considered only if there are visible lines that persist across photographs over several seasons (15:58).

• Older Adults: There's no upper age limit for injectables, but the approach must be tailored. Older skin may require different treatments, and excessive use can lead to unnatural appearances (21:12).

Raj shares her openness to considering injectables in her 40s, influenced by friends who feel more confident and radiant thanks to these treatments (01:50). Noah, while intrigued, remains cautious due to cost concerns but remains open to changing his perspective based on expert advice (02:25).

Cultural and Social Perceptions

The episode delves into the societal stigma and varied perceptions surrounding injectables:

• Celebrity Influence: Instances where celebrities' appearances change due to injectables are discussed, highlighting both positive and negative public reactions. For example, Raj references a situation where Jennifer Aniston's appearance led to speculation about excessive fillers (13:17).

• Gendered Views: Raj observes that perceptions of injectables can be gendered, with women often facing more scrutiny than men (22:55).

• Psychological Impact: The hosts touch on how increased self-scrutiny, especially post-pandemic with more time spent looking at oneself via screens, has led to a rise in cosmetic procedures (17:36).

Practical Advice for Beginners

For listeners considering injectables, Dr. Parikh offers practical advice:

1. Communicate Goals: Instead of specifying a particular injectable, describe the desired outcome to the practitioner (48:44). This ensures personalized treatment tailored to individual needs.

2. Choose the Right Practitioner: Expertise and certification are paramount. Avoid bargain offers and prioritize practitioners with proven credentials (30:14).

3. Start Conservatively: Begin with minimal injections to assess how your skin responds and adjust accordingly (25:38).

4. Maintenance and Longevity: Understand that while injectables are not permanent, their effects can last from six months to over a year depending on the treatment. Regular touch-ups can maintain desired results without the need for indefinite use (26:43).

5. Combining Treatments: Integrating injectables with other skin treatments like lasers can enhance overall skin health and prolong the effects of injectables (27:48).

Conclusion

The episode wraps up with the hosts reflecting on their newfound understanding and openness towards injectables. Raj feels more equipped to consider injectables with the right practitioner, while Noah remains cautiously optimistic, valuing natural lines but open to future considerations (49:23). The conversation underscores the importance of informed decision-making, personalized treatments, and the role of skilled professionals in achieving satisfactory cosmetic outcomes.

Notable Quotes

• Raj Panjabi Johnson (03:02): "I'm really, really excited about this topic because I am an injectables virgin."

• Dr. Sherwin Parikh (03:29): "In broad strokes, you break down injectables into two categories, mostly toxins and fillers."

• Ryan Reynolds (09:44): "Filler is based in hyaluronic acid. It's a naturally occurring gel that you can put under the skin."

• Noah Michelson (27:35): "It's a luxury. Good to be sure."

• Raj Panjabi Johnson (48:44): "If you're a beginner, it's better to tell your doctor what you're hoping to achieve rather than what kind of injectable you want and where."

Key Takeaways

1. Communicate Desired Outcomes: Focus on the results you want rather than specific injectables.

2. Eyes Area: While Botox can be effectively used around the eyes, fillers are generally not recommended in this area.

3. Age Inclusivity: There's no age limit for injectables, but treatments should be tailored to individual skin conditions.

4. Expertise Matters: The skill and certification of the practitioner are critical for safe and effective results.

5. Word of Mouth: Recommendations from friends and trusted sources can lead to finding reputable practitioners.

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This comprehensive summary captures the essence of the episode, providing valuable insights for listeners considering injectables while addressing common concerns and misconceptions.

Transcript

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[Ryan Reynolds]

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[Raj Panjabi Johnson]

Hi, I'm Raj Panjabi Johnson, head of identity content at HuffPost.

[Noah Michelson]

And I'm Noah Michelson, head of HuffPost Personal.

[Raj Panjabi Johnson]

Welcome to Am I Doing It Wrong? The show that explores the all too human anxieties we have about trying to get our lives right.

[Noah Michelson]

Okay, Raj, what is your experience with injectables?

[Raj Panjabi Johnson]

You know, I just turned 40. I haven't done any yet, but I see that stuff in my future because I have a lot of friends who they feel really confident and happy because they get a little thing injected once in a while and I love that glow about them. So, you know, I'm open to it. What about you?

[Noah Michelson]

When you look in the mirror now though, do you feel like you see stuff that you want to change?

[Raj Panjabi Johnson]

Oh, that's a good question. About my body. Yes. Not so much my face as Much.

[Noah Michelson]

Okay.

[Raj Panjabi Johnson]

Yeah.

[Noah Michelson]

I'm still pretty happy with my face.

[Raj Panjabi Johnson]

Yeah, you look good.

[Noah Michelson]

I'm pretty happy with my face, actually. I'm 46. I haven't had anything done yet, but I never say never.

[Raj Panjabi Johnson]

Yeah.

[Noah Michelson]

Here's the thing, though. I'm cheap. All I want to do is spend money on tattoos.

[Raj Panjabi Johnson]

You're responsible.

[Noah Michelson]

Yeah.

[Raj Panjabi Johnson]

Okay.

[Noah Michelson]

And I can't imagine forking over 500, $800 every six months or more. It's a lot to do this. But I also know nothing about injectables, so I'm super curious to hear. Maybe my mind's going to be changed. We'll see.

[Raj Panjabi Johnson]

Yeah. We've got the best experts ever. Dr. Sherwin Parikh. He's a dermatologist, founder of Tribeca Skin center here in New York, and a professor of dermatology at Columbia Presbyterian.

[Noah Michelson]

Let's do it.

[Raj Panjabi Johnson]

Dr. Parikh, thank you so much for being with us again. We're so excited.

[Ryan Reynolds]

So excited here, too. Thanks.

[Raj Panjabi Johnson]

Let's get started. I'm really, really excited about this topic because I am an injectables virgin.

[Noah Michelson]

Me, too.

[Raj Panjabi Johnson]

And I have not yet. I have not yet tried them. I really want to. There's so much stigma. I don't exactly know what the difference is. So let's get into first, the different options. What's the lay of the land? What categories of injectable are there out there?

[Ryan Reynolds]

In broad strokes, you break down injectables into two categories, mostly toxins. Botox, Juvo, Xeomin, Dysport. Those are the toxins that help stop muscular contraction to create, like, the sort of placid, smoother skin, face where you want to. And the second one is fillers, but they also come in different varietals as well, and those are even more specific. All the varieties of fillers. So that's your broad brushstrokes. Two separate categories. They're completely different. They do different things entirely. And you choose based upon what your desires are.

[Raj Panjabi Johnson]

Okay. So the toxins, which. That's terrible marketing, 100%.

[Ryan Reynolds]

But in our field, we say tox is a shorthand. But yeah, Botox was first to market.

[Raj Panjabi Johnson]

Right. Okay.

[Ryan Reynolds]

So it was the first thing at the turn of the century.

[Raj Panjabi Johnson]

I'm going to rebrand. They're going to be called toxies.

[Noah Michelson]

Toxies. That's cute.

[Raj Panjabi Johnson]

So you told us what toxies do. What do fillers do? I expect they fill.

[Ryan Reynolds]

Yeah, exactly. Right. So they take up volume loss, or they fill in creases or crevices, or they give a Little bit of projection to the face. Or other places where people are putting fillers now too, which is a whole deep dive.

[Raj Panjabi Johnson]

Oh, we'll get to that.

[Ryan Reynolds]

Yeah, yeah, yeah. They come in different varietals, different, like G prime, different forces, different viscosities. Whether they're. Well, this gets really detailed. But whether they're cross linked or non cross linked, how thin the filler is, how thick the filler is, where does it hold, where is the best placed? So that's really kind of interesting and exciting for people who know how to use them really, really well. And a little daunting for people who don't know what they want.

[Raj Panjabi Johnson]

Yeah.

[Noah Michelson]

And the general idea is that as you get older, one, you wrinkle and two, you start to hollow out. So that's why you would be doing these.

[Ryan Reynolds]

Yeah, you're right, exactly. You have your. When we get to be 95 years old, God willing, we're skin and bone, right? What we're missing is the subcutaneous structures like the fat. And our muscle isn't as thick. Everything kind of goes between the skin and the bone. That kind of keeps things looking plump. That's why people will say, oh, you know, I got a little bit of weight on me, I look a little bit younger for a little bit longer, or I ran the marathon. I look really gotten old now. I mean, you hear these kind of things all the time at the practice. And we find out that people have reasons why they want to have filler very specifically. Not just non discriminately, just I don't want filler or I want filler. You're like, what exactly are you looking at that you think is a problem? And if it's volume loss, people will say, traditionally there's anecdotes of like, oh, people lose a teaspoon of collagen every year after 30. I mean, these are all like odd scare tactics now based in some kind of science. But the truth is, yeah, no matter what, we start to lose our baby fat probably like late 20s to mid-30s. You don't have that same roundness to your face you had in your teenage years or twenties. Some people retain it, some skin is a bit thicker. They look a little bit younger for a little bit longer, if that's the word that you want to use. You know, like that's. But people lose their volume.

[Noah Michelson]

Correct.

[Raj Panjabi Johnson]

Okay, so what I'm hearing is if you're like me and you haven't tried anything yet, you don't want to go into the derm and be like, I want this filler I've heard about. You want to say, this thing is happening. What can I do?

[Ryan Reynolds]

Correct. It's really easy if you know your face while you're. Your body, while you say, this doesn't seem fun for me, or I don't love this part.

[Raj Panjabi Johnson]

I'm feeling self conscious.

[Ryan Reynolds]

Self conscious about this. Great. Tell us what it is and, you know, we can talk about it.

[Noah Michelson]

Right?

[Ryan Reynolds]

Yeah.

[Noah Michelson]

We got so many questions from people, so we're gonna sprinkle some of them in from other people. So this is based on a question from Lizzie. She's saying, is it risky to do filler near your eyes, like your crow's feet? And what kind of filler can be used safely for under eyes? Basically, I need my eyes fix.

[Ryan Reynolds]

Help me. Eyes are definitely a holy grail, and that's that people often conflate Botox and filler in that area too. And truth be told, for crow's feet, those are around the sides of the eyes. When your eyes smile and squint and you get little creases that come out, that's where you put two drops of Botox, three drops of Botox, and those wrinkles don't happen. And it keeps them at bay for five, six months. And you repeat it if you like the way it looks. Super easy. Filler is not great for crow's feet. And some would argue that filler, myself included, isn't amazing for under eyes easier either. Right. But there are a lot of people who do put filler under their eyes, and some people can handle it more than others. But, yeah, filler under the eyes isn't our favorite thing to do at the center. Amongst the five dermatologists. We do do it for select people who have really naturally hollowed eyes. They're younger, they have great bone structure to support the filler where it can sit. But on someone who's a little bit older, there's not a place for filler to sit. Well, it won't look good. It can sort of pool or look a little bit unattractive. Is that what you've seen that?

[Raj Panjabi Johnson]

Is that what migration is?

[Ryan Reynolds]

It's not a great word for it, but yes, exactly right.

[Raj Panjabi Johnson]

It's like moving.

[Ryan Reynolds]

It's moving, but it's not. It was already put there by somebody where it shouldn't have really been. It wouldn't have worked for them because that person's mid-40s or 50s and they are naturally. That skin is getting thinner under the eyes. So how will it hold the filler? Well, you need A certain amount of viscosity under that thinner skin to hold the filler and a good amount of bone structure to put the filler on deep in the skin so it puffs up that area super gently.

[Raj Panjabi Johnson]

Okay.

[Ryan Reynolds]

And you don't want to cause more problems with filler.

[Noah Michelson]

So some of this, as a doctor, you can see you don't have the right anatomy for Correct. But it's some of it trial and error where you're like, I don't know what's going to happen when we put this here. We can do a little. So you would never do that?

[Ryan Reynolds]

Absolutely not.

[Noah Michelson]

Okay.

[Ryan Reynolds]

I mean, that's a hard. No. I don't think that anything with fillers should be trial and error.

[Noah Michelson]

Okay.

[Ryan Reynolds]

And also not with Botox. And again, in this day and age, everyone should know how to do this stuff well enough if they're a practitioner of it. So, no, it's predictive.

[Noah Michelson]

What about trial and error in terms of how much you're getting? Would you ever say, okay, this is your first time, we're going to do a little tiny bit and then we'll increase. Sure.

[Ryan Reynolds]

And also you want to let stuff settle for a week or two and see how you like it. And it's totally fine to say, oh, I'm a little bit underdone. I'd like a little bit more. That's totally fine. It's a little bit more annoying or even problematic when you're like, I think it was just too much. Now what do I do? Do I wait it out or do I reverse it? Yeah, again, those are the two options. Yeah.

[Raj Panjabi Johnson]

I didn't know you could reverse it. That's one of my friends asked.

[Ryan Reynolds]

Filler. So most filler is based in hyaluronic acid. It's a naturally occurring gel that you can put under the skin. It's the same thing you see in moisturizers, hyaluronic acid. It's a gel based thing and it's very small aliquots place strategically. I like to call it my favorite spf.

[Raj Panjabi Johnson]

Okay.

[Ryan Reynolds]

Strategically placed filler. And if you do it correctly, it looks really, really good. But if for some reason someone's had it done because they, you know, went to some bargain basement situation or they got controlled into it by some random place and they don't like it, you can have it reduced or removed with hyaluronidase enzyme, which can dissolve it quickly and safely so it can be undone. What is why you see people changing on social media from having too much filler to all of a sudden Looking better, right?

[Raj Panjabi Johnson]

Yes.

[Ryan Reynolds]

Because they may have very well decided I have too much filler in my cheeks or in my lips. That's their choice. And they want to reduce it so they do it.

[Raj Panjabi Johnson]

Okay.

[Ryan Reynolds]

They look so good, you know? Yeah, yeah.

[Noah Michelson]

Can you reverse Botox or you just Botox?

[Ryan Reynolds]

You have to wait out.

[Noah Michelson]

Okay.

[Ryan Reynolds]

Correct. And again, there should be fewer mistakes with any of these things if they're done by a certified professional who's got a board degree, board certification, I mean, dermatology or.

[Noah Michelson]

Yeah.

[Raj Panjabi Johnson]

Okay. I am excited about this topic also because I feel like it has been injectables, have been stigmatized sometimes. And also people have a lot of misconceptions about them. So let's start with just, like, things that could go wrong. And then we'll, like, build up to, like, some of the more positive stuff.

[Ryan Reynolds]

Sure.

[Raj Panjabi Johnson]

So if I'm like, starting out and you want to make sure they have the best experience possible, what will you tell me to watch out for?

[Ryan Reynolds]

So we always say anytime you're getting an injection, very much like, anytime you have any needle put in your skin or even a drawn blood, blood draw, you could get bruises. So if you want to mitigate bruises, stay hydrated, maybe take some Arnica supplements before. Don't have any alcohol, Advil or aspirin 24 hours before because that increases bleeding. And for the day afterwards, try to avoid it. Not a big deal. If you don't. Yeah, a bruise will go away. And that's probably one of the most common things people will see from any injection.

[Raj Panjabi Johnson]

I have definitely seen one of my girlfriends have, like a little bruise one from her, like, lip stuff.

[Ryan Reynolds]

I'll tell tale. You know what I mean?

[Raj Panjabi Johnson]

Yeah, yeah.

[Ryan Reynolds]

And again, there's no shame in the game. Like, if you're like, that's what I had done. It's what it is. But some people are like, I don't want blah, blah, blah to know at work or at home. And you're like, okay, well, we can try to do our best. You can camouflage her, put some makeup on. Bruises will fade.

[Raj Panjabi Johnson]

I mean, all of my girlfriends who do do the lips, absolutely love them. They have like, great people and they're like, fuck this bruise. It'll be gone tomorrow. My lips look big as hell.

[Ryan Reynolds]

Yes. People, you know, some people aren't born naturally with those lips, you know what I mean? And they want them and they get them.

[Raj Panjabi Johnson]

I am all for that life. Yeah.

[Ryan Reynolds]

I mean, right? And some people also begin to realize their lips were bigger, like 10 years ago, and they miss Them. They want them restored. There's reasons for that. Yeah.

[Raj Panjabi Johnson]

Yeah, Fair. Okay. So anything else you would tell me to watch out for?

[Noah Michelson]

Yeah, someone was asking us about drooping eye syndrome or something.

[Ryan Reynolds]

That's usually with badly placed Botox.

[Noah Michelson]

Okay.

[Ryan Reynolds]

That really should not be happening in 2024. 5.

[Noah Michelson]

Got it again. If you're seeing someone who knows what they're doing.

[Ryan Reynolds]

Yeah, yeah, that's. That's Botox placed a little too low or a little too lateral, just like you. Where all of a sudden it's hitting some muscles where it shouldn't be hitting, and it just knocks them out so the, like, lid droops instead of going up. No, no, that's kind of amateurish. Shouldn't happen. Could happen, but shouldn't. And we'll go away, right?

[Raj Panjabi Johnson]

Oh, good. That's what I get, the sense that you can wait some stuff out. I feel bad for celebrities, though, because I feel like their picture is being constantly taken. There was this one that circulated of Jennifer Aniston a few months ago where her face looked a little wild. It looked like, to me, who doesn't know this? That too much filler. It was very puffy. And, like, people rode her in all the tabloids. They were just like this. What happened to her face? And then a dermatologist was interviewed, and he was like, you know, it could be that she got too much filler and she looked deflated a few days later. Is that what. Have you seen that picture?

[Ryan Reynolds]

She is my ride or die. Like, Rihanna's yours and mine too. I can't with her. With her. Ever since retro de force of Rachel Green and that performance in Good Girl, I'm like, I can't With Jennifer Aniston. Can do no wrong in my book. But, yes, I know what you mean.

[Raj Panjabi Johnson]

Yeah.

[Ryan Reynolds]

Conceptually, when you see a celebrity girl look like something, you're like, why? And whatever. Could it be too much of that or too little that it can all be undone or it can be waited out and you can return to your normal state? None of this is irrevocable. We're not looking at the faces that we used to see from about 20, 25 years ago. We're like, oh, my God.

[Noah Michelson]

Right?

[Raj Panjabi Johnson]

Yeah.

[Ryan Reynolds]

Was that silicone that was put in the face that was really being done? Like, I did not know that. Oh, sure. And it probably still is in certain communities. Some people still using it because it's less expensive or whatever. Or was that bad plastic surgery? Sure, that's irrevoc. Those kind of things are. But these Things all slowly over time can let you return back to normal. So you can make a choice to sort of stay away from the, from the dermatologist, plastic surgeon for like a year or two and you can kind of get back to what you wanted.

[Noah Michelson]

Yeah, yeah. Danielle's wondering, and I'm wondering this too. You hear about young people getting preventative Botox now. Does it actually prevent anything? And how young is too young? I mean, you hear people who are getting like, I guess they call it baby Botox. They're like in their 20s. They don't really have wrinkles yet. Is that preventative?

[Ryan Reynolds]

I think they have nothing else to do. You're like, really? Do you really need to do that? I guess there are people who you see are really sun damaged. They grew up as cheerleaders or playing tennis stars or they were outdoors for like years at a time, got a lot of sudden, they get a little extra wrinkled or they have a kind of a movement line that's just in their family. A deep furrow in the middle of their brow that you see on 20 year olds. They want to Botox out. So is it too early? That's super personal. I do think that it's nice to see what your face looks like from 2025-30 and just watch it kind of change naturally. But I totally get people like, oh, I do have this deep crease. I frown so much. There's a deep right in the middle of my brow that you could have seen when I was 12 years old. And it's getting so deep. So conceptually, yes, you're right. No, if you Botox it, you will teach your body not to make that face for a good four to five months. Right. It's very akin to someone wanting to get a six pack or eight packs of abs. If they keep doing crunches, they'll get those lines in between their muscles that's no different from what's happening in the middle of your eyebrows. When you keep, keep crunching your eyebrows, you get a little crease in the middle. So we're undoing that. And it teaches a lot of people. They're like, oh, if I don't make that face. Yeah. Like, I haven't Botox my forehead yet and I probably should, but. But yes. I had a mom at age when I was 12 years old. Don't move your forehead. Don't crinkle. Because when I blow dry my hair, you'll get a wrinkle in your forehead. And she's not wrong. If you go like this, they're always right.

[Raj Panjabi Johnson]

Unfortunately.

[Ryan Reynolds]

Oh, my God. Indian mothers.

[Raj Panjabi Johnson]

Yes.

[Ryan Reynolds]

Telling you. You know, it must say, though, that.

[Noah Michelson]

I am 24 years old, no wrinkles in my forehead. I don't have that deep, like, crevice. I start getting Botox, will I never get wrinkles?

[Ryan Reynolds]

You'll get wrinkles in other places that you don't care about.

[Noah Michelson]

Your neck or your wrinkles are going to find us.

[Ryan Reynolds]

No, it's not that. It's just that the idea that you're you. I don't think that people should do Botox if they don't have some right visual sign that they're making lines and furrows on their face. Right. I often say to patients, I'm like, listen, look at your photographs for two to three seasons in a row, spring, summer, fall. And if at every season over the course of one year, you're like, I can still see that line in every picture, at least a bunch of pictures from three or four seasons in a row. It wasn't just hydration. It wasn't just the water. It wasn't just the humidity outside. I got a line forming. It's never. It's not too late. Right?

[Raj Panjabi Johnson]

Yeah.

[Ryan Reynolds]

It isn't a great idea to do Botox where there's. When there's no lines or wrinkles, because what are you doing it for, right?

[Raj Panjabi Johnson]

Yeah.

[Ryan Reynolds]

What's the point?

[Raj Panjabi Johnson]

I totally agree with that.

[Ryan Reynolds]

Watch how your face moves and decide, okay, I'm not going to do that. I'm not going to furrow my brow or I'm not going to crinkle my eyes so much. And if you're like, you know what? I can't. I always do that. And fine, get your Botox because you know that you keep moving your forehead or your eyes, your face too much in a certain way, and you just don't like the way it looks. But also, you don't look at your face that much. Yeah, but we do a lot more because of zoom now.

[Raj Panjabi Johnson]

Yeah. It's crazy.

[Ryan Reynolds]

So we're looking at our own faces while we're talking.

[Raj Panjabi Johnson]

Have you noticed an uptick in.

[Ryan Reynolds]

Okay, 100% since the pandemic?

[Raj Panjabi Johnson]

I truly have been reading about, like, more surgery. More, like, everything. Because we're just. We're staring at our own faces, not other people.

[Ryan Reynolds]

Low key. It's like mental. It's like, how that it's bad. It's not that it's not good for us. We should not be looking at ourselves while we talk to people. We should be just on podcasts talking to people. So if we can look at ourselves. Podcasts are the best, you guys.

[Raj Panjabi Johnson]

I totally agree. I totally agree. Let's take a quick break and we'll be right back. This podcast is brought to you by eharmony, the dating app to find someone you can be yourself with.

[Noah Michelson]

Okay, let's be honest and talk about doing dating wrong. So, Raj, have you ever pretended to be into something that you're not actually into when you're on a date just so you keep the person's attention?

[Raj Panjabi Johnson]

Oh, absolutely. I once was on a date and I am a Knicks fan, but I was pretending to be this, like, hardcore sports girly because that's what the dude was into and I am not a sports girly.

[Noah Michelson]

Right? So I bet even despite doing all of that, the date didn't go anywhere.

[Raj Panjabi Johnson]

It certainly did not.

[Noah Michelson]

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[Noah Michelson]

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[Raj Panjabi Johnson]

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[Noah Michelson]

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Welcome back to Am I doing it wrong?

[Raj Panjabi Johnson]

Can you be too old to start injectables? Can like a 75 year old start or is the skin already kind of soft and it's like harder to hold stuff?

[Ryan Reynolds]

No, but I do think that probably, and this is again, this is more my philosophy and the terms that we all work together at Tribeca, Schindler, we kind of have this feeling that like, you know, you bank all this stuff up in your sort of mid year is your 30s, 40s, 50s, so that you dividends are later where you don't have to do that much work to kind of look good. It's like everything else.

[Raj Panjabi Johnson]

Yeah.

[Ryan Reynolds]

If you land up at the office at 70 years old having done nothing, I'll be like, all right, why don't we do a little bit less, not more.

[Raj Panjabi Johnson]

Yeah.

[Ryan Reynolds]

Because if we do too much, it's going to be A, jarring to people who know you to look so different. And B, yeah. It won't look natural to you yourself when you look in the mirror like, oh my God, I'm wrinkle free everywhere. It's not fun for people. Okay, so it's not that you can't do it. No, you can. I can have a 7 year old come in first time and say, oh, you have like a little vertical crease or a couple horizontal creases. We'll put in a few drops of Botox. They'll soften beautifully. They may not go away completely. Yeah, we'll all be happy. You'll be happy, your friends will be happy. No one will call you out.

[Raj Panjabi Johnson]

Yeah. It's funny how different people react to this. And I do feel like it's gendered. I went to a restaurant a couple of months ago. And one of the owners came up and said hello to our table. And she was gorgeous, older Cuban woman. And I was like. I was just like, I can't tell exactly how old you are, but you're like, she was sexy. And then she's like, injectables girl. She's like, I'm 73. And I was like, what? Like, slack, Josh, I will show you a picture after this. She's a stunner. And, like, Calvin was like, oh, I can't totally figure it out. She looks kind of older, but she doesn't have wrinkles. And, like, whatever. And I'm like, sometimes I think, like, straight men are perplexed by that, and women are just like, yes, yes, yes. More. We all perceive these things differently, too. And, like, the concept of what you're supposed to look like as you age.

[Ryan Reynolds]

Yeah, that's definitely changed, right?

[Noah Michelson]

Yeah. And I think for a lot of people, that feels difficult. You know what I mean? In terms of, like, we are seeing more people getting these procedures done, especially in Hollywood or on TV and things. I think some people feel like they have to get them, too. Even maybe they don't want them.

[Ryan Reynolds]

I don't know. It's the worst position to be in. You're right. Yeah. It really should be from the heart where you're like, this would feel fun for me. And I think I might enjoy it. It might be really great. And also, not so much chasing youth, but it's okay to sort of want to feel vital, to feel energetic, to look glowy, to get a sense of your own. Like, I feel up and alive and awake.

[Raj Panjabi Johnson]

Yeah.

[Ryan Reynolds]

I'm not trying to look young. Young is for people. And that's, I think, probably what you're describing with this woman at the restaurant where you're like, she just looks kind of fantastic.

[Raj Panjabi Johnson]

Healthy and healthy. Alive.

[Noah Michelson]

Yeah.

[Ryan Reynolds]

Happy. Yeah. Not trying too hard.

[Raj Panjabi Johnson]

Exactly. Like, good injectables can be injectables to the soul, too. I think, like, you feel sexy.

[Noah Michelson]

That's a different show, Ro. Yeah, no, you're right, though. And I think, like, you said, like, people should do it if they want to do it.

[Raj Panjabi Johnson]

Yeah.

[Ryan Reynolds]

There are places where it also looks really good and places where I think your eye will catch it a little bit more. And that's also what you have to sort of look for for yourself.

[Raj Panjabi Johnson]

Can you tell us where. What's a place you want to be careful your eye will.

[Ryan Reynolds]

People's eyes under eyes, for sure. Definitely. And I think lips have become. Have now become that thing where people like, oh, my God, they inject their lips.

[Raj Panjabi Johnson]

Yeah.

[Ryan Reynolds]

And you're like, yeah, they do.

[Raj Panjabi Johnson]

So, yeah.

[Ryan Reynolds]

Or. Or, yeah, that's not for you. It's for them. They like it. You don't have to like it, which is one of those things. But people just assume then that filler is always terrible, but it's not. You place filler strategically in the cheekbones and you make someone have like a bella hadid moment. Like, it's great. Like, there's nothing wrong with that, people, because we naturally. Our malar fat pads naturally kind of like get a little bit more flattened and they sink. And for some people, that's a little bit attractive, that kind of like slightly gone to kind of getting into the middle age. But other people are like, I don't really like it. I want my baby cheeks back. And they'll suit me right now because I have a voluptuous this or that or this is my vibe and it works well. Or little smile lines that happen between the nose crease and the mouth. People say, these are really deep on me because my dad had a really deep one. And they'll just again, if we strategically place little aliquots of filler, like just a little hyaluronic gel, like putting earth into a valley. It's like just spackling it up to level. And nobody in your world is going to be like, oh, you did that. Because there's such small little things. There's places where people are not going to see it. They're not going to know that you did that. And other places where you do it, they'll be like, oh, girl, love your filler. And you're like, oh, thanks. So it depends on which person you want to be, right?

[Noah Michelson]

Yeah.

[Raj Panjabi Johnson]

Yeah, I love that.

[Noah Michelson]

So this might sound like a dumb question, but once you start doing these things, you have to do them forever.

[Ryan Reynolds]

Not a dumb question at all. I think that the answer is no.

[Noah Michelson]

Okay.

[Ryan Reynolds]

You also do them a lot less often, I think, as you start to bank what you've already done. Because I do think there's a longevity of these things on some level. Even the idea of the injections themselves, just that the needle itself creates a slight bit of trauma where the skin responds by forming collagen. That's the theory behind microneedling. Right.

[Noah Michelson]

Okay.

[Ryan Reynolds]

So if you, like, disrupt the skin through a little bit of organized trauma, it'll grow back a little firmer, a little thicker. But now that's it with the fillers as they slowly wear off, whether it's a year And a half, two years, or even longer. We know. Now you can sort of decide to not do it yet or do it now because I've lost too much weight, or I've actually gained some weight, so I'm not going to do it. But it's about sort of forming a relationship with your provider and them knowing you for a period of time and going, I remember your face when you're 28 and I know you. You're 37 now. You ready? And then you'll be like, yeah, I'm ready. Great. You've known each other for, like, less than or about a decade, and you kind of figure out that this is a good time. Do you know what I mean?

[Raj Panjabi Johnson]

Oh, can you do that for me?

[Ryan Reynolds]

100%. You still look like a baby.

[Raj Panjabi Johnson]

Oh, my God. From your lips to God's ear.

[Ryan Reynolds]

But I have met your mom, too, so, like, I know. What? What's up?

[Noah Michelson]

Yeah. The future.

[Ryan Reynolds]

Yeah. Yeah. Which also helps.

[Raj Panjabi Johnson]

Okay. Okay. You're gonna be great. You're the oracle.

[Noah Michelson]

What about with Botox? Once if you stop doing that.

[Ryan Reynolds]

So same thing. A lot of people stop doing Botox because they're pregnant or they don't want to, or they moved out of the country and they didn't find a provider for two years. It doesn't make a difference. You can redo it again two years later. I mean, will it wear off? Of course. Yeah. Then you're on the hook because it's not gonna last. It's four to six months. Maybe a little longer if you're lucky, a little shorter if you're not as lucky. But I would say that, yeah, twice a year, thrice a year maintenance for people who end up lik. Yeah, you're on the hook for it. You don't want to open that box until you're ready to be like, oh, this looks really good. That makes sense, because then it wears off.

[Raj Panjabi Johnson]

How do you make it last as long as possible? Because some of us are on a budget.

[Noah Michelson]

It's, like, with my contacts, where I wear them for an extra three or four days. Trying to, like, you know. Yeah.

[Raj Panjabi Johnson]

Unbelievably terrible.

[Noah Michelson]

It's so unhealthy.

[Raj Panjabi Johnson]

You know the same, though. This shit's just expensive.

[Ryan Reynolds]

Yeah. Yeah.

[Noah Michelson]

So is there anything we can do?

[Ryan Reynolds]

That's a tough one. I do think the whole thing about diet and exercise and sleep and, like, just hydrating and drinking lots of water and, you know, there are all these random supplementals that might make things last longer. Taking zinc supplements for your Botox or Taking collagen supplements for your filler. Fine, fine. We can't tell you it's definitely going to work. But the truth is, just go slow and steady, see what works for you, and then see what a clip it lasts as. Right. But there are other skin treatments that'll help, like lasers and heat treatments can help produce collagen and promote collagen without injectables or in conjunction with injectable. Injectables.

[Raj Panjabi Johnson]

Yeah.

[Ryan Reynolds]

So all of a sudden, you're buying yourself more time.

[Raj Panjabi Johnson]

Okay.

[Noah Michelson]

Right.

[Raj Panjabi Johnson]

I love that. How much are these things supposed to cost? Because, like, no one has told me anything. They're just like, this is really expensive.

[Noah Michelson]

Yeah.

[Raj Panjabi Johnson]

But we all. We all choose to spend our money where we choose to spend our money. Yeah.

[Ryan Reynolds]

It's a luxury. Good to be sure. And you can find a range from borough to borough, I'm sure. Right. But stuff in Manhattan is expensive. Yes.

[Raj Panjabi Johnson]

Okay. Okay.

[Ryan Reynolds]

And so people will charge, you know, what they think is worth their value as the practitioner.

[Raj Panjabi Johnson]

Also the practitioner. And like, how, you know, how experienced you are.

[Ryan Reynolds]

There's no doubt that you're. If you're on the upper. If you're on Madison Avenue somewhere in the 70s or the 80s, you are going to pay a premium. But you are. That's just what it is to step foot on the real estate. I think, you know, we are in Tribeca. I think we're reasonable, and people mostly seem to agree. Right.

[Raj Panjabi Johnson]

Okay.

[Ryan Reynolds]

But that's a tough one, because you're right. It's a luxury. Good. How much do you want to spend? I feel like you also don't want to cheap out on your face.

[Raj Panjabi Johnson]

This is it. This is the thing. Right. It's like, this is your body. You're putting something in your body. This is not the same thing as, like, our last episode is bargain shopping, where, like, you know, you have to get a deal. Yeah, jeans, great. No, you're putting something in your body. Yeah.

[Noah Michelson]

Yeah.

[Ryan Reynolds]

If you got something for 300 bucks, an injectable 300 bucks, and you were like, it worked out really great. Great. Thank your lucky stars. Right? It went well for you. You got it for 3, 400 bucks, and it worked out well. Awesome. Maybe get you six months or a year of beauty and enjoyment. Great. It may not. You may not be as lucky the second or third time. Totally fine. If you formed a relationship and that situation seems really good, but.

[Raj Panjabi Johnson]

Okay, that's fair.

[Noah Michelson]

Yeah. Someone was asking one of our listeners, how do you feel about a dermatologist like yourself versus a med Spa. And maybe you're biased because you are a dermatologist, but what would trigger someone to think, I shouldn't go here?

[Ryan Reynolds]

I think you get triggered when you get upsold with coupons or groupons. Like you get triggered. You should kind of take that as a bit of a orange flag, I guess.

[Noah Michelson]

Okay.

[Raj Panjabi Johnson]

I don't want Groupon.

[Ryan Reynolds]

I think you want to like your practitioner first for their capabilities, for their education and for their communication with you first. Just get that sorted out first. Meet somebody, decide you like them. It's totally fine if you're going to a nurse practitioner and she's. Or he's not an MD or a do or not has a board certification in dermatology. If you've decided they're really good at what they do.

[Noah Michelson]

Yes.

[Ryan Reynolds]

And it suits your vibe. Terrific. It can work.

[Raj Panjabi Johnson]

Okay, excellent. Lindsay asks who is not a good candidate for filler or Botox? Any surprising factors aside from pregnancy that mean you absolutely shouldn't get this kind of treatment?

[Noah Michelson]

Good run.

[Raj Panjabi Johnson]

Yeah.

[Ryan Reynolds]

And weirdly, Allergan even did studies on pregnant women and like, it's considered safe even in pregnancy. So that goes to show you how much people like Botox that they signed up for these.

[Raj Panjabi Johnson]

Yeah. Voluntarily.

[Ryan Reynolds]

Yeah, totally. But. And filler you shouldn't get because you're going to be gaining weight during pregnancy so you wouldn't really know what your face is. Now who's not a great candidate? I think people have incredibly thin or sun damaged skin that is sort of papery and you've seen that on some people. Lots of brown spots. Other things that you'd rather fix first to create a glow in someone's skin.

[Raj Panjabi Johnson]

Yeah.

[Ryan Reynolds]

There's so many other ways to make someone feel and look more vital. Lasers are one of them. Tixel is another one. These sort of treatments that are used heat, radio frequency ultrasound, these treatments that use heat and these kind of modalities to kind of tighten the skin more naturally without the use of effectively subjective things like. Subjective things like injectables are like how much and where that's so dependent on the person who's doing it. And you have to trust their eye or their art. Whereas lasers and heat modalities, the person who's getting it done is just waiting for their body to respond three or four weeks later.

[Raj Panjabi Johnson]

So you're never going to look very different. Yeah.

[Ryan Reynolds]

Strange or different from yourself. You're always going to look a little bit better. A little bit better. A little bit better. And you'll improve things like brown spots or dullness. Or roughness. That alone can be gorgeous, right? You see so many beautiful actors who are of a certain age who have tons of little wrinkles. You're like, God, she's gorgeous because the skin is one milky tone or one creamy tone. And you're like that skin tone is what also attracts someone else's eye. Having pretty skin, wrinkles or not, gray hair or not, that's not what it's about. It's having pretty skin. So you can achieve that with good skin care and even lasers if need be. And you don't have to touch injectables if that's not your vibe.

[Raj Panjabi Johnson]

Okay, let's take a quick break and we'll be right back. This episode is sponsored by hers.

[Noah Michelson]

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Welcome back to Am I doing it wrong? Can we talk about some of the other things that people are getting injected? I just saw Heather Gay from the Real Housewives of Salt Lake City at a talk, and she owns a med spa in Salt Lake City. And she was saying the two craziest things that people are asking for now. And I guess she does them. One is women are getting fillers injected into their feet, the balls of their feet, because then they have a little pad there and it makes it less painful.

[Raj Panjabi Johnson]

That's kind of genius. To wear high heels.

[Noah Michelson]

Yeah.

[Raj Panjabi Johnson]

Designer shoes are very painful.

[Noah Michelson]

Yeah.

[Ryan Reynolds]

Wait until you try to get injections in the bottom of your feet with filler. It's a lot more painful.

[Noah Michelson]

Have you done that or seen that?

[Ryan Reynolds]

No one. No one in our practice asked for that kind of stuff. Have I even seen it? Not really. Am I. Do I believe that there's four people in the world in one town who do it? I suppose I feel like these things are, like, often overblown. And I just. I, in my, like, feeble brain, can't believe that there's a buttload of people who are doing It. But sure enough, there probably are.

[Noah Michelson]

Does that seem medically unsound to you?

[Ryan Reynolds]

I mean, as long as it's done safely, you're not, you know, hitting a tendon or a blood vessel and you know what you're doing. I suppose it's totally fine.

[Noah Michelson]

Okay.

[Ryan Reynolds]

But again, really, you can't just put in some insoles? But, like, look, you're right. Maybe it is.

[Raj Panjabi Johnson]

I mean, insults would do the same thing.

[Noah Michelson]

Yeah.

[Ryan Reynolds]

Put some band aids if. I don't know.

[Raj Panjabi Johnson]

Yeah.

[Ryan Reynolds]

Don't wear those shoes.

[Noah Michelson]

The other thing that I've been hearing about is where the shoes. The p. The pee shot. So you can make your labia and your penis puffier.

[Ryan Reynolds]

Do see it?

[Noah Michelson]

Or bigger.

[Ryan Reynolds]

Really? Don't you think you have other problems at that point? Point.

[Noah Michelson]

I would think so.

[Raj Panjabi Johnson]

Puffier. Is that hot?

[Noah Michelson]

I guess. I guess malabia can be less puffy as you get older.

[Raj Panjabi Johnson]

Okay.

[Noah Michelson]

And so it makes your vagina look younger.

[Raj Panjabi Johnson]

Okay. If I were a. This is. I think, like, sex workers might be, you know, And I think.

[Ryan Reynolds]

I think that's what you see it on. Yes.

[Noah Michelson]

Okay.

[Ryan Reynolds]

I've seen this on social, where they're. It's an enhancement of an area to make it look more aesthetically. Aesthetically? Yeah. 3D. I mean, out there more. You're filling something or you're puffing it up.

[Noah Michelson]

That makes more sense to me in terms of, like, labia. But I don't think I would inject my penis with filler. That seems like there's more things like my penis. But I just feel like your penis is doing more things. Your labia is, like, decorative in a lot of ways.

[Raj Panjabi Johnson]

It is decorative. Absolutely.

[Noah Michelson]

You're not peeing through your labia or doing other things. I'm using my penis for things.

[Raj Panjabi Johnson]

It's not like the door.

[Noah Michelson]

Do you feel like injecting injectables into a penis is medically sound?

[Ryan Reynolds]

I don't love it.

[Noah Michelson]

Okay.

[Ryan Reynolds]

I don't think that people should do it, but you're right. If it's. If that's your source of income.

[Raj Panjabi Johnson]

Yeah.

[Ryan Reynolds]

And you can definitely see an uptick in your subscribers and your rate. Your rates. Then, like.

[Raj Panjabi Johnson]

Yeah.

[Ryan Reynolds]

God bless.

[Noah Michelson]

Yeah. I was sent a PR email about this.

[Ryan Reynolds]

Okay.

[Noah Michelson]

And I had to sign up to look at the photos they had before and afters, and they sent me, like, 100 photos of it. And I was doing just my work.

[Ryan Reynolds]

And that was all.

[Noah Michelson]

Yeah, yeah, exactly.

[Ryan Reynolds]

Were you impressed with.

[Noah Michelson]

No, I wasn't really. They looked plumper. Girthier, I would say, but not Huge.

[Raj Panjabi Johnson]

I love girthier.

[Noah Michelson]

It didn't make them longer, per se, and I just felt like they looked kind of like.

[Ryan Reynolds]

Yeah. So I think that's what it's going to do. It's going to be that. It's not going to be that. I mean. Yeah.

[Noah Michelson]

But again, I guess if it's safe, which I'm not sure that it is.

[Ryan Reynolds]

I don't know that we know 100%. How do you know that? Like a couple years down the line, you're not having some trouble, which can happen just naturally. Anyway, you go, maybe it was from that.

[Raj Panjabi Johnson]

Yeah.

[Noah Michelson]

I will also say, though, maybe this is too much, too much information. But, like, I'm happy with the size of my penis.

[Raj Panjabi Johnson]

That's.

[Ryan Reynolds]

That's good stuff.

[Noah Michelson]

And if you aren't, I could understand why maybe this would be something that you would want. I. I just think you. It's hard to put yourself in someone else's shoes and understand why they want something.

[Raj Panjabi Johnson]

Yeah.

[Noah Michelson]

And what it's going to make them feel like. And that's what the bottom line is for me, for all of this.

[Ryan Reynolds]

Yeah. Yeah.

[Noah Michelson]

If it makes you happy.

[Raj Panjabi Johnson]

Yeah, yeah.

[Ryan Reynolds]

I mean, bottom line, people are putting their body injecting. Right. Sculpture into their buttocks. Right.

[Raj Panjabi Johnson]

As long as I do that safely. Because that's like, I.

[Ryan Reynolds]

You've heard. We did know.

[Raj Panjabi Johnson]

I've done a lot of research. Like, unfortunately, people put doing black market stuff and it's so dangerous cement.

[Ryan Reynolds]

You could actually legitimately die. Yeah, yeah. So, like, you've got to be careful with this stuff. You don't want stuff falling off your body or your limbs or appendages, necrosing or. No.

[Raj Panjabi Johnson]

So you referred to the injectables process as an art. And it really is. Right. Because you want to choose someone. Like, Noah and I love tattoos. We're very particular about the artists who do them.

[Ryan Reynolds]

Yes.

[Raj Panjabi Johnson]

This is similar. Right. Because you're creating a look how. If you don't have a dermatologist already, how do you find a person who's your friends?

[Ryan Reynolds]

Like, look around people to your point. Right. People do talk about it. Or also, like just after, you know, at the end of a night or after dinner or drinks, people start to get a little loose because they look, listen, hey, I'm thinking of this, like, I love your face. Do you do anything? People who are your friends.

[Raj Panjabi Johnson]

I love your face is so good.

[Noah Michelson]

Yeah, yeah.

[Ryan Reynolds]

Like, what should I do? Like, what can I do? And who do you trust? Like, what you will find your friends and what you. Like, they Will steer you. Right.

[Raj Panjabi Johnson]

Yes.

[Ryan Reynolds]

You know, that's the best. I mean, you could use social media, but then you end up seeing things you don't really want to see.

[Raj Panjabi Johnson]

Right. That's never the answer.

[Ryan Reynolds]

People's faces that actually scare you.

[Raj Panjabi Johnson]

And do you ever have to tell your patients like, this is too much, or if they come back and they can't see it anymore, it's kind of a dysphoria.

[Ryan Reynolds]

It's hard to confront someone with that because that's sort of part and parcel of other issues they may be having. Right. But it's nice to be able to say, maybe this isn't the best idea for you. Maybe we want to make you healthier in other ways first before we go down this route.

[Raj Panjabi Johnson]

It just feels like a really uncomfortable conversation. But I'm sure you'll see it.

[Ryan Reynolds]

You get used to doing it. And also not often. Not often. I think maybe it's a self selecting population of people who know us and who know me for so long and who know friends of friends who see me and patients and friends and physicians who refer to me. I think it's sort of over time. I mean, physicians, spouses come to me, like over time. People who come to you are of the same ilk. If there's a. This is the reason why I think that social media can be really problematic because if you're randomly choosing your doctor or you're randomly, as a physician, choosing your patients based on social media because it's a two way street, all of a sudden you just don't know who's in the room with you and you want to have some thread of connection where you're like, oh, I get, I get what you're talking about. But if someone comes at you, and that happens rarely where I go, ah, I feel as if you're not a great candidate for a lot of this stuff because there's maybe some other sadness or anxiety or worries about your body that are going on more globally. I think we're good at that. Right. Like physicians especially have been hopefully trained.

[Raj Panjabi Johnson]

Yeah.

[Ryan Reynolds]

To recognize those things.

[Noah Michelson]

If we do get the name of a doctor from a friend and we go to see them for the first time, we've never had anything done. What are some things we should ask that doctor before we have the procedure or before we do it?

[Ryan Reynolds]

You know, what are the side effects? You know, what are the downsides? And also, what will I look like in a few days or a few weeks? What should I expect to look like? How good will this be? How subtle Will this be. There are people who will say to me, I want my forehead to just not move, like, oh, you want that la look. You want that, like, whatever other people say, please, I still want to have expression. Everyone's different. And I'll say, I got you. I know exactly what you mean by that. Let's watch your face move. We're going to only do this much at this spot in these ways. And there's a certain expertise where you get to know somebody and even when you first meet them, you're like, oh, I get it. You are low key about this. You are super low key about this. We're gonna really be subtle, and if I'm too subtle, you can come back in two or three weeks. We can readdress it. You know what I mean?

[Noah Michelson]

Yeah.

[Raj Panjabi Johnson]

Yeah.

[Noah Michelson]

That's great.

[Raj Panjabi Johnson]

I love that. I do think when I get. The few times I get my makeup done for, like, an event, I really like a really dramatic smoky eye more than people usually do. So I tell them, I'm like, make me look like a French stripper, like, the morning after who, like, went out. And they get it. Yeah. And I'm like, lots of just smoke, smoke, smoke. I've been and, you know, out on the town. And they get it. And it's okay to be dramatic. It's okay to, like, if that's what you want, that's what you want.

[Ryan Reynolds]

I famously, like, famously. She wrote a book about it, but I did a little bit of filler on someone. I mean, 20 years ago, it was doing her lips. And I thought to myself, it wasn't even trendy. It was like, pre Kylie Jenner, pre, Like, all of that stuff.

[Noah Michelson]

Right.

[Ryan Reynolds]

And I was like, this is. You do know that if I do it this much and you want it bigger, it's gonna make you look a little bit like a. And she goes, what? What? And I go, I don't know, like. And she goes, what? Why do you think I pay you in cash? What do you think I do for work?

[Raj Panjabi Johnson]

Yeah.

[Ryan Reynolds]

And I was like, oh, my God, I got it.

[Raj Panjabi Johnson]

Yeah.

[Ryan Reynolds]

That's the look that you want. You work in an industry that, like, it really works for you. Right? And then.

[Danny]

Yeah.

[Ryan Reynolds]

And really, like, 20 years later, she's still hot and can still.

[Raj Panjabi Johnson]

Yes.

[Ryan Reynolds]

Do it.

[Noah Michelson]

Do what she does.

[Ryan Reynolds]

Yes.

[Raj Panjabi Johnson]

I love that.

[Noah Michelson]

As a doctor, what is one thing you would never do if you were getting an injectable.

[Ryan Reynolds]

If I were getting injection myself.

[Noah Michelson]

Yourself? Yeah. What's one thing you would never do?

[Ryan Reynolds]

I think we covered it with the under Eye filler is the most precarious, and that's fairly well known because of, like, how bad it can look and whether it can, like, you know, cause long term annoying issues of, like, visual and, like, congestion and puffiness and fluid retention. Because of the type of filler that's used in the area. That's sort of our least favorite amongst us. There are people who do it and do it really, really well, but it's not. It's sort of one of our least favorite. Okay. I think I. That's.

[Noah Michelson]

And what about what is one thing you would always do? And not in terms of, like, getting a procedure, but again, like, medically safety wise. Like, what is one thing you should always do?

[Ryan Reynolds]

I think when you get those little vertical lines right between your eyebrows.

[Raj Panjabi Johnson]

Okay.

[Ryan Reynolds]

And you're like, oh, my God, why is everyone saying I look mad? Why is everyone saying I look angry?

[Noah Michelson]

Angry. Eleven.

[Ryan Reynolds]

Yeah.

[Noah Michelson]

Yeah. Right?

[Ryan Reynolds]

It couldn't be easier. And it will. It's the most. You're not doing your whole forehead. You're not doing your crow's feet. You're not doing your whole thing. You're you. Nobody will know if it's done beautifully that you had those done. Do that. It's also a little. Dip your toe in the water and see if you like it, because you will. And you can stick with that for the rest of your life, twice a year. And you'll never have to go down some slippery slope, get your little, like, 11. Your little frown lines treated. I mean, not if you're Paul Mescal. Because that, like, that crease looks kind of amazing and. Right. But like, it does, but you never know.

[Noah Michelson]

Yeah.

[Ryan Reynolds]

At some point, 10 years from now, it might feel a little bit like you want to blunt it a bit. Right. You want to change that up. People have a look. It's true. You don't want to change your look, but I think that those are. That's an area that people can do really safely, really easily. Feel really good about it.

[Raj Panjabi Johnson]

Yeah.

[Ryan Reynolds]

And never feel like they've overdone anything or look like they look different from themselves.

[Raj Panjabi Johnson]

Okay.

[Ryan Reynolds]

Makes them look happier and friendlier and just gets through that little angry line. And it makes a big difference, people.

[Raj Panjabi Johnson]

All right, the starter pack. I'm ready. Where those needles at?

[Noah Michelson]

You are ready. I think you are. I think you are ready.

[Raj Panjabi Johnson]

Does it hurt? Do they hurt?

[Ryan Reynolds]

No.

[Raj Panjabi Johnson]

Okay.

[Ryan Reynolds]

No. This stuff is. I mean, yes, there's a little bit of discomfort, but we always. In our practice, we're always like ice first before, ice afterwards. And it's super quick. And in fillers, there's anesthetic in the syringe. Oh, that's going in. It starts to get a little numb, so.

[Noah Michelson]

And beauty is pain. And pain is beauty.

[Raj Panjabi Johnson]

It says, like the heavily tattooed coma.

[Noah Michelson]

Exactly. If you want it badly enough.

[Raj Panjabi Johnson]

Yeah, totally.

[Ryan Reynolds]

It's always worth it.

[Noah Michelson]

Four seconds, you know, is it really not the tattoo, but I'm imagining the.

[Ryan Reynolds]

Botox is over in four seconds, Fillers over in, like, three or four. Well, I mean, depends on how much you're doing.

[Raj Panjabi Johnson]

Longer.

[Ryan Reynolds]

But there's anesthetic in that syringe, so that's fine too. And it's all manageable. And like you said, if you want it and. Yeah.

[Raj Panjabi Johnson]

And if it makes you feel.

[Ryan Reynolds]

And what's nice about is you see it.

[Noah Michelson]

Yeah.

[Ryan Reynolds]

Like, you actually see what you've done. You feel like you know what it's for.

[Noah Michelson]

Yeah.

[Ryan Reynolds]

Different from just putting on a cream and you're like, is this really working?

[Raj Panjabi Johnson]

Yes.

[Ryan Reynolds]

Do I feel good enough with this? It's a binary proposition. Like, all of a sudden you see a little bit of a change or a dramatic change in your own mind and you know that something's happening.

[Raj Panjabi Johnson]

I love instant gratification.

[Ryan Reynolds]

That's it.

[Noah Michelson]

Thank you. This has been amazing.

[Raj Panjabi Johnson]

Yes.

[Noah Michelson]

And I can't wait to see Raja's new face. I love that. Me too.

[Raj Panjabi Johnson]

Me either.

[Ryan Reynolds]

Foreign.

[Noah Michelson]

It's time for Better in five. These are your top five takeaways from this episode.

[Raj Panjabi Johnson]

All right, number one, if you're a beginner, it's better to tell your doctor what you're hoping to achieve rather than what kind of injectable you want and where.

[Noah Michelson]

Number two, you can get really great results around the eyes, but it's usually not a great place for filler.

[Raj Panjabi Johnson]

Number three, you can't be too young or too old for injectables, but talk to a doctor about what you're a good candidate for.

[Noah Michelson]

Number four, when it comes to injectables, the practitioner and their expertise is the most important part of the equation.

[Raj Panjabi Johnson]

And number five, if you're looking for a provider, ask your friends who they see. Word of mouth can score you a great doctor. Or just ask a hot stranger.

[Noah Michelson]

Love that. Okay, Raj, so where are you at now with injectables? Has your mind been changed? Are you even firmer in your resolve? What do you think?

[Raj Panjabi Johnson]

Well, I would like my skin to be firmer. Well, you know what? I actually am feeling even more open hearted toward injectables than when we started this episode because I feel like, Dr. Parikh is right. Like, the practitioner is really important. Like, if you have someone you trust, they can help you be your best self. And I just don't believe I am the personality type to go overboard. We don't know what's gonna happen, but, like, yeah. What about you?

[Noah Michelson]

Yeah. I also was just thinking while we were talking that these things have gotten so much better, even in the last five years. Definitely in the last 20 years. And so I think that as we keep marching forward in time, it's just gonna keep getting better and better. Yeah, that makes me feel better.

[Raj Panjabi Johnson]

I love that science is cool.

[Noah Michelson]

It is. But I also remain very cheap. So as long as I keep getting up in the morning and looking in the mirror and thinking, you know, I like the lines I've earned, right now, I'm pretty happy with my face, I'm gonna save that money.

[Raj Panjabi Johnson]

Listen, Noah is feeling himself, okay? And there's nothing wrong with that.

[Noah Michelson]

And I'm gonna spend that money on.

[Raj Panjabi Johnson]

You know, tattoos and shoes.

[Noah Michelson]

Yeah. Food, like cookies. I don't know. Something. But again, never say never. We'll see what happens.

[Raj Panjabi Johnson]

Truth.

[Noah Michelson]

And until next time, as long as there are things to get wrong, we're going to be right here to help you do them better.

[Raj Panjabi Johnson]

I love y'all and y'all faces.

[Noah Michelson]

Do you have something you think you're doing wrong? Email [e-mail] and let us know.

[Danny]

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[Noah Michelson]

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[Raj Panjabi Johnson]

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