Your Questions Answered: Filler Migration, Lasers, and The Truth About Sofwave

Summary

Derm Approved – “Your Questions Answered: Filler Migration, Lasers, and The Truth About Sofwave”

Host: Dr. Sheila Farhang
Date: July 29, 2026
Episode Theme:
An energetic and expert “Ask Me Anything” episode, where Dr. Sheila Farhang – board-certified celebrity dermatologist and cosmetic surgeon – addresses listener and studio audience questions from Dear Media Headquarters. Covering everything from filler migration and new laser treatments like Sofwave, to real-world skincare routines, this episode breaks down what actually works for healthy, youthful skin, debunks popular myths, and shares practical dermatological advice for all ages.

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Key Segments & Discussion Points

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1. Skincare Struggles, Gut Health, and Ingrown Hairs

[01:19 – 09:05]

• Audience Q&A: A male Dear Media staffer discusses skincare dryness, persistent irritation, and painful ingrown hairs in his beard area, linking flares to gut issues and pre-workout supplements with whey protein. He shares past failed treatments and frustrations.
• Dr. Sheila’s Advice:
  • Gut-Skin Connection: Gut microbiome absolutely affects skin—breakouts, irritation, redness (03:26).
    • Notable Quote:
      “Your gut can absolutely affect your skin—breakouts, redness, irritation.” — Dr. Sheila, [03:26]
    • Suggested Changes:
      • Try cutting out whey protein (“pea protein is way better on the gut” [03:52]); dairy not always culprit.
      • Use benzoyl peroxide (5%) wash for beard area; try hypochlorous acid spray.
      • Avoid over-exfoliating, shaving against grain, and picking. Shave with the grain and use gentle aftershave.
      • If persistent, topical azelaic acid or clindamycin may help before returning to oral antibiotics.
      • Probiotics recommended for gut health.
    • On Hair Texture:
      • Curly beard hairs more prone to ingrown, especially with plucking.
      • Over-plucking and irritation can cause scarring or cyst formation.
  • Botox for Men:
    • Recommends “micro baby Botox” for men wanting a natural, rejuvenated “awake” look—not frozen.
    • Notable Quote:
      “A little mini, micro baby Botox helps with those fine lines, lifts you, makes you look awake…We don’t want to freeze you.” — Dr. Sheila, [07:55]
    • Stresses “less is more” in personal approach.

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2. The Truth About Sofwave (Also Called Zurf): Is It Worth It?

[09:07 – 14:45]

• Audience Q: Young participant asks about Zurf (Sofwave) – non-invasive radiofrequency skin tightening tech, gaining popularity for visible skin contraction.
• Dr. Sheila’s Insights:
  • How It Works: Radiofrequency energy contracts skin instantly; may stimulate collagen formation over time.
  • Comparison: Radiofrequency microneedling (Morpheus, Secret) yields deeper results, albeit with downtime.
  • Data on Zurf:
    • Still new; immediate results can fade (“I literally had Erica Taylor here yesterday…she was like, I did it and then everything came back down.” [10:54])
    • Verdict is out; not sure if the thousands spent are justified.
    • Candid skepticism: “I don’t know if it’s worth your money right now—especially if you’re young.” — Dr. Sheila, [11:32]
    • Marketing is strong; more results needed over coming months.
• Alternatives:
  • Focus on good skincare: retinols (gentle, like Medicaid’s), peptides (Medik8, SkinCeuticals), consistent red light therapy.
  • Microneedling is affordable/low-downtime collagen boost, especially for fine lines, texture, acne scarring.
  • For skin redness or rosacea, avoid devices that feel hot (risk of melasma/rosacea flare).

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3. Filler Migration – Dissolving and Refilling

[14:49 – 22:47]

• Listener Q: Dissolving filler (lips or under eyes) and re-injecting—what’s possible, limitations, and product choice.
• Dr. Sheila’s Protocol:
  • Fuller, migrated lips/undereye filler can and should be dissolved if unsatisfactory—esp. migration.
  • After dissolving, waiting at least 2 months (if possible) allows tissues/borders to heal for better results.
    • Notable Quote:
      “The longer, the better—because that skin border…can heal.” — Dr. Sheila, [16:09]
    • Analogy: Like tattoo artists fixing previous work—some injectors dislike touching “old” filler, but for Dr. Sheila, it’s about supporting patients (not ego).
  • Lips: Not as difficult; migration often a matter of too-thick product or over-injection/deep placement.
  • Under Eyes:
    • Requires advanced, multistep approach.
      • Dissolve in two sessions.
      • Tighten skin with RF microneedling or CO2 laser; heal with PRF (platelet-rich fibrin).
      • Only then, possibly refill (“Filler wasn’t the problem, it's just how it was filled.” [19:12])
  • Product Choice:
    • Avoid very thick fillers like Juvederm Ultra/Ultra Plus for lips.
    • Prefers Volbella (Juvederm) for its balance of structure and hydration.
    • Galderma Kiss for structure; Refyne for hydration.
    • Injection technique matters more than product alone.
      • “A lot of the issue is really how it was injected.” — Dr. Sheila, [22:41]
    • Internet horror stories about dissolving pain often exaggerated—pain and swelling are temporary.

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4. Skincare in Your Late 20s/Early 30s – Preparing for Longevity

[23:00 – 32:42]

• Audience Q: Female staffer asks for a “best practices” roadmap as she approaches 30, wanting to stay natural and avoid a stiff look.
• Dr. Sheila’s Game Plan:
  • Determine candidacy for “baby Botox” by looking for lines that persist after expression (“lines stuck after making that facial expression” [24:21]).
  • Botox subtly softens lines, prevents deep wrinkles, and can create brow lift by balancing muscle strength.
    • Dr. Sheila's own routine: injects for lift/movement, not total freeze.
  • Skincare: Peptides (esp. Medicaid for beginners), gentle exfoliation (1–2x/week), retinol or retinal for sensitive skin.
  • Microneedling: Non-laser, affordable option for collagen and fine lines—especially for those not ready for Botox.
  • Unit Guidance: Baby Botox (20-ish units) is enough; less than a full “frozen” dose.
  • If not interested in injectables, focus on elegant, hydrating skincare and mild chemical exfoliants (glycolic, lactic).
    • Paula’s Choice, SkinMedica, The Ordinary recommended for affordable exfoliators.
  • Layering skincare (retinol after exfoliant; oil after retinol) can optimize both efficacy and comfort—avoid using oil before retinol (interferes with absorption).
    • “Oil first is…like an occlusive barrier, so your retinoid’s not getting absorbed as much.” — Dr. Sheila, [31:53]
  • Retinoid “sandwich” method: moisturizer → retinol → moisturizer again for sensitive skin.
• Notable Quote:
  “Less units, you get a nice lift, it looks a little bit more natural.” — Dr. Sheila, [29:01]

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5. In-Depth: Lasers, Sculptra, and Preparing for a Facelift

[32:42 – 49:30]

• Listener Q: "If I plan to get a facelift, can I safely use Sculptra, radiofrequency, Sofwave, or threads beforehand?"
• Dr. Sheila’s Perspective:
  • All skin procedures cause some inflammation/scar tissue, but balanced, judicious use of non-surgical treatments does not compromise future surgical results.
  • Invasive treatments (e.g., Coolsculpting, Kybella, deep heating/“internal heat,” heavy threads, or excess filler) can make surgery more challenging, but the effect is not drastic.
    • “I don’t think anyone now should be worrying about not doing anything for a facelift they’re going to get 20 years later.” — Dr. Sheila
    • Non-surgical treatments can actually improve skin quality and support a better facelift result down the line.
  • Sculptra, liquid injectables, and standard radiofrequency can be used moderately with minimal long-term worry.
  • For energy-based tightening, properly applied RF and ultrasound are safe.
  • “If you’re not doing anything, saving it all for the facelift, you’re doing your skin and your facelift a disservice.”
• Laser Primer for Beginners:
  • “Laser” is an umbrella term for multiple energy-based devices (CO2, Erbium, pigment lasers, RF-microneedling, IPL).
  • For younger patients or newcomers:
    • Start with microneedling for texture, pores, collagen (more affordable; $200–$500).
    • Light lasers or chemical peels for small sun damage, mild lines.
    • More advanced “laser stacking” (triple laser regimen) reserved for older or more complex cases.
  • Key Point: Don’t get FOMO if you’re not doing laser yet—microneedling is big bang for your buck, lasers cost more and are best reserved for specific indications.
  • IPL (intense pulsed light) is technically not a laser, but good for brown spots/redness.
  • RF and ultrasound tighten deep tissue, minimally affect the top layer.
    • “The two main skin tightening energy devices are radiofrequency and ultrasound. They don’t do much on the top layer but go deep to stimulate collagen and contract tissue.” — Dr. Sheila

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Notable Product Mentions

[throughout]

• Peptide Serums: Medicaid Liquid Peptides Advanced MP, SkinCeuticals, The Ordinary
• Gentle Exfoliants: Paula’s Choice, SkinMedica, The Ordinary’s glycolic toner
• FDA-cleared Red Light Masks: SoloWave, Omnilux, Dr. Dennis Gross, Shark Beauty
• Retinoids (for sensitive skin): Medicaid’s range (retinal options)
• Sunscreen: EltaMD (praised for universal wearability and hydration)
• Under Eye: RoC Revive & Glow Eye Balm (vitamin C and peptides for puffiness, dark circles)

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Notable Quotes, Timestamps & Moments

• “Your gut can absolutely affect your skin—breakouts, redness, irritation.” — Dr. Sheila, [03:26]
• “Try switching to a pea protein… whey protein can cause breakouts for sure.” — Dr. Sheila, [03:52]
• “A little mini, micro baby Botox helps… We don’t want to freeze you!” — Dr. Sheila, [07:55]
• “The longer, the better—because that skin border…can heal.” — Dr. Sheila, [16:09]
• “Filler wasn’t the problem, it’s just how it was filled.” — Dr. Sheila, [19:12]
• “A lot of the issue is really how it was injected too.” — Dr. Sheila, [22:43]
• “Lines stuck after making that facial expression—that’s when you know you’re a good candidate for Botox.” — Dr. Sheila, [24:21]
• “Less units, you get a nice lift, it looks a little bit more natural.” — Dr. Sheila, [29:01]

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Summary Table of Key Segments

| Time | Segment Topic | Highlights | |-----------|----------------------------------------------|-------------------------------------------------------------| | 01:19–09:05 | Ingrown hairs, gut health, and skincare | Whey protein & gut triggers, beard ingrowns, benzoyl peroxide wash, don’t over-pluck; microbotox for men | | 09:07–14:45 | Zurf/Sofwave & skin tightening devices | Skeptical of hype, radiofrequency better w/ microneedling, peptides & red light are real alternatives | | 14:49–22:47 | Filler migration: dissolve & refill | Two-stage dissolve, time for healing, product selection, technique trumps product | | 23:00–32:42 | Skincare roadmap for late 20s/early 30s | When to start Botox, peptides & gentle exfoliants, retinoid layering, microneedling for beginners | | 32:42–49:30 | Lasers, Sculptra, and prepping for facelift | Non-surgical treatments okay, potential for minor scarring minimal, laser 101, don’t save “everything” for surgery |

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Final Takeaways

• Gut health, ingredient awareness, and lifestyle directly affect skin—sometimes more than “dieting perfectly.”
• Hype around new skin devices (like Sofwave/Zurf) may not match reality; invest carefully and ask your provider if you’re an ideal candidate.
• Filler migration is reparable; dissolving and refilling with expert technique leads to good outcomes—don’t let fear-mongering stop you.
• For healthy aging, combine evidence-backed skincare with minimal, targeted interventions (“baby Botox,” microneedling, gentle chemical exfoliation) rather than maximalist, aggressive approaches.
• Non-surgical interventions don't typically harm chances of a good facelift in the future—moderation and quality providers are key.
• When in doubt, start simple: peptides, sunscreen, retinoids, microneedling.
• “Less is more” yields natural, lasting beauty—both for injectables and skincare.

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For further questions or follow-ups, connect with @DrSheilaDerm on Instagram.

Transcript

[Podcast Host]

The following podcast is a Dear media production.

[Dr. Sheila Farhan]

I'm Dr. Sheila Farhan and welcome to Derma Proove, your insider access to skin that looks and feels its best. Welcome back to Derma Proved. We are now halfway through season two, which is insane. And I thought this would be a really good time to answer your questions. And we did this last season and you guys loved it. And so we're going to make it a little bit like fun today and we're going to have people from Dear Media Headquarters, which is why we're where we're filming right now, come in and ask their questions. They're all in their like 20s, 30s. We have girls, guys, we have all the things. And then I'm also going to pull up some of the questions that you guys asked me on Instagram and just answer the ask me anything. So stay tuned. I love recommending roc's new line smoothing two step heel pads as an at home alternative to a professional peel without the cost, the downtime or the irritation. It's a two minute treatment dermatologist developed, delivering the results of a facial at home. With over 250 clinical studies, 75 safety studies and 35 patents, every ROC formula is scientifically crafted and clinically tested to ensure the best results for your skin. Visit www.rockskincare.com for more information.

[Dear Media Employee 1]

You're so cool. Like the way you dress is so like, stop. Fun.

[Dr. Sheila Farhan]

I'm a cool doctor and I love it also too. She always calls me the sexy doctor.

[Dear Media Employee 1]

This isn't my question, but you do like Botox and stuff.

[Dear Media Employee 2]

Oh, yeah.

[Dear Media Employee 1]

I need like man Botox.

[Podcast Host]

Oh, okay.

[Dr. Sheila Farhan]

Have you had it before?

[Dear Media Employee 1]

I had it when I was younger, but like now I'm starting to get the forehead.

[Dr. Sheila Farhan]

Yes, yes.

[Dear Media Employee 1]

You know, I didn't need it when I got it, but now I need it.

[Dr. Sheila Farhan]

Yes. So why you know that you need like one reason. One thing that I look at if people ask me like, do I need it or like I feel like I need it is when you have those lines there when you're not making facial expressions, which you do, you have those static lines there.

[Dear Media Employee 1]

And I look dehydrated.

[Podcast Host]

Exactly.

[Dr. Sheila Farhan]

Which I mean we're. It's humid, it's summer. So skincare number one.

[Dear Media Employee 1]

Yeah.

[Dr. Sheila Farhan]

Tell me your skincare routine.

[Dear Media Employee 1]

I'm doing Dr. Dennis Gross face wash and then I do a Shardi Darden peptide cream.

[Dr. Sheila Farhan]

Love her and love that.

[Dear Media Employee 1]

And then the Dennis Gross eye underneath.

[Dr. Sheila Farhan]

Got it.

[Dear Media Employee 1]

But also to just like a general moisturizer.

[Dr. Sheila Farhan]

Perfect.

[Dear Media Employee 1]

But my skin. That was my question. About my skin.

[Dr. Sheila Farhan]

Does your skin feel dehydrated?

[Dear Media Employee 1]

No, it's so. I don't know if you can see here, but I have irritation. Very specific spot on my face. And I don't know if this is like hormonal. I've had my hormones checked, everything like that. And they're like, it's fine, it's fine. Yeah, but. And I guess it's probably to do with the gut as well, because anytime my gut feels off, it's like a weird cycle. But I notice my gut's bad for a month and then it'll be good for like three months. But I get like really bad ingrown hairs just in this patch here.

[Dr. Sheila Farhan]

Just that area, and then they turn

[Dear Media Employee 1]

into like these very hard lumps.

[Podcast Host]

Yeah.

[Dear Media Employee 1]

And I'm like, I want to grow a beard, but I can't because I pluck and it's patchy, but it's so painful.

[Dr. Sheila Farhan]

Yeah.

[Dear Media Employee 1]

I went to a derm and they derm in Sydney. So this was over five years ago. They put me on maybe doxycycline, like an oral medication. And I feel like that screwed my gut even more 1000%. So I don't know, I just kind of like went with it. And I. I've tried to cut out dairy. I've tried to cut out like all these things. And then I'm like, is it my pre workout spike spiking something within me, but it feels like it's a cycle, right?

[Dr. Sheila Farhan]

Yes.

[Dear Media Employee 1]

And I'm like, it's just this patch here.

[Dr. Sheila Farhan]

Yeah.

[Dear Media Employee 1]

Yeah.

[Dr. Sheila Farhan]

Okay.

[Dear Media Employee 1]

Like, what could that be?

[Dr. Sheila Farhan]

Great things. Great, great points. I'm sorry you're going through this, but I see this a lot. So number one, your gut can. Can absolutely affect your skin breakouts, redness, irritation. Some of the big food triggers include whey protein. I know you said pre workout. Do you have any like, whey protein, like shakes or anything?

[Dear Media Employee 1]

I do.

[Dear Media Employee 2]

Okay.

[Dear Media Employee 1]

Yeah. Because I'm like, I just can't eat enough.

[Podcast Host]

Yes.

[Dear Media Employee 1]

Like food to get my proteins. So I'm doing that as well.

[Dr. Sheila Farhan]

Try switching to like a pea protein.

[Dear Media Employee 1]

Okay.

[Dr. Sheila Farhan]

I know it doesn't have as much protein, but try that because that is way better on the gut. So try that. I'll tell you some of my faves, I mean, I'm like going through them as well. Some are like, eh. Like I go through like four sigmatic as a pea protein. Cachava is like one that people really like. I got this other one the other day. But yeah, try that first. Because whey protein can cause Breakouts for sure. In general, like dairy can, like, aside from like whey. It can, but it's not like a huge contributing factor. So I wouldn't like, I have people coming in there like, I'm on like the whole 30, like no gluten, no dairy, no nothing. Only whole foods. No like inflammatory foods and they will still break out. So I wouldn't say that. It's like it may contribute, but it's probably not causing it. Like you can saw cheese and all that stuff.

[Dear Media Employee 1]

Uh huh.

[Dr. Sheila Farhan]

If it upsets your stomach.

[Dear Media Employee 1]

Because that's another thing. I'm like, it feels like a cycle, as I said. So I'm like, is it a cycle though? Or is it just that I'm going off dairy to try and get rid of it or I'm doing all these things to remove it and then I'm not like actively properly tracking that because my hormones look pretty tip top.

[Dr. Sheila Farhan]

Yeah. No, it's probably like if we checked your labs. Yeah, they're probably perfect.

[Dear Media Employee 1]

Yeah.

[Dr. Sheila Farhan]

And this could be a few things. So. Yeah.

[Podcast Host]

Irritation.

[Dr. Sheila Farhan]

Any gut mic, you know, gut microbiome. I always tell patients like, get on a good probiotic, just cut out like whey protein first. Like you don't need to do the whole shebang.

[Dear Media Employee 1]

Yeah.

[Dr. Sheila Farhan]

And then you want to make sure it's only on one side. So you either might be. Do you sleep on that side?

[Dear Media Employee 1]

No. It's funny because I sleep on this side. So like I sleep here and it's like. Can you see?

[Dr. Sheila Farhan]

Yes. Come in and come in here. Come in here.

[Dear Media Employee 1]

And it's starting to scar.

[Dr. Sheila Farhan]

Yeah, yeah, yeah, yeah. They are a little bit bigger, so they're a little inflammatory. So I'm thinking, do you use a benzoyl peroxide wash?

[Dear Media Employee 1]

No.

[Dr. Sheila Farhan]

Okay. Start with that like a 5%. That's going to help decrease the bacteria just from like razor burn almost.

[Dear Media Employee 1]

I also heard that like a sulfur wash is good.

[Dr. Sheila Farhan]

Sulfur is good for rosacea. It's a little drying though, which is like so, so is benzoyl peroxide. So try benzoyl peroxide first if you have any breakouts. Number one. Next up. Sulfur wash is fine. You don't look like you have a lot of like rosacea. I think the sulfur wash might dry you out, but try that out.

[Dear Media Employee 1]

Yeah.

[Dr. Sheila Farhan]

Hypochlorous acid spray. I'm going to write this all down for you.

[Dear Media Employee 1]

And what about witch hazel? Because everyone tells me witch hazel. Okay. Too dry.

[Dr. Sheila Farhan]

If you have like a gnarly one pimple that you want to kind of like Dry out. But it's an astringent that's probably going to irritate this because you're also, like, shaving it, right?

[Dear Media Employee 1]

Yeah. And that's the other thing, too. I'm like, should I be shaving? I think my biggest thing is I'm a plucker. I can't.

[Dr. Sheila Farhan]

Oh, yeah.

[Dear Media Employee 1]

I love being groomed. I'm like a monkey.

[Dr. Sheila Farhan]

Yes. You know what I mean?

[Dear Media Employee 1]

Like, you know, you see them in the forest. I make my husband do that and I'm like, whatever. But maybe that is also, like, irritating. Right.

[Dr. Sheila Farhan]

Don't irritate them. Lay off the exfoliators right now. You want to improve the skin barrier. You want to decrease that bacteria. Not that there's bacteria there, but it can just like that inflammation will cause those, like, ones that hurt. And then if those things don't work, like benzoyl peroxide, hypochlorous acid spray. Making sure you're hydrated, making sure you're not using too strong of actives to irritate the area. Your shaving down in that area, not up. I know that sounds really weird. Making sure you're using a good aftershave.

[Dear Media Employee 1]

With the grain.

[Dr. Sheila Farhan]

With the grain, Yep. And if that doesn't work, I like to give a little bit of, like, topical, like either azelaic acid or a little clindamycin. But usually we can do this without, like, putting you on oral medication.

[Dear Media Employee 1]

Yeah.

[Dr. Sheila Farhan]

Okay. So that is my. And I see that a lot, like, bumps in the beard area in men is. It's. It's super common.

[Dear Media Employee 1]

Yeah. I feel like, because I have curly hair as well.

[Dr. Sheila Farhan]

Oh, yeah. Curl.

[Dear Media Employee 1]

Curl back in and they grow like a curly hair.

[Dr. Sheila Farhan]

And I will say you're plucking them or messing with them, they'll scar and, you know, they'll scar and then they'll start, like, curling in and creating a foreign body reaction. And that's why you'll get, like, a recurrent cyst there.

[Dear Media Employee 1]

So I think that's maybe where I'm at. Like, I've tended to it too much.

[Dr. Sheila Farhan]

Yeah, yeah.

[Dear Media Employee 1]

And now it's just like, I can't get out of that phase.

[Dr. Sheila Farhan]

And then I can get out of it.

[Dear Media Employee 2]

Get out of it.

[Dear Media Employee 1]

Thank you.

[Dr. Sheila Farhan]

Yeah, yeah, yeah.

[Dear Media Employee 1]

It's been helpful.

[Dr. Sheila Farhan]

So that is perfect. You were asking about Botox. I think a little mini boat, like micro baby Botox.

[Dear Media Employee 1]

Yeah.

[Dr. Sheila Farhan]

Helps with those fine lines. Like, you want to, like, lift you, make you look awake. And that's, like, really good. We don't want to freeze you yeah,

[Dear Media Employee 1]

because I'm in that I need to get hot era. Like, my metabolism stopped working. My face has started to kind of show my stress and my. I mean, I'm not old, but, you know.

[Dr. Sheila Farhan]

How old are you?

[Dear Media Employee 1]

32. Turning 33.

[Dr. Sheila Farhan]

Oh, yeah.

[Dear Media Employee 1]

Which I'm like, young, but, like, you

[Dr. Sheila Farhan]

know, you're like, wait, I look.

[Dear Media Employee 1]

You see?

[Dr. Sheila Farhan]

I want to look that.

[Dear Media Employee 1]

Well, I think, like 10 years from now. What am I gonna. I. I did Claude. I said Claude. I don't chatgpt. Show me what I'm gonna look like if I keep project. I should never have done it.

[Dr. Sheila Farhan]

Oh, no, I'm not even gonna do that. I turn 40 next year.

[Dear Media Employee 1]

Wait, what? You're 40? You're like 25. I'm not even saying that to flatter you.

[Dr. Sheila Farhan]

Thanks. Thanks. I do. I do less is more like those things. Like, I have acne prone skin. I have the pimple right here. So I'm doing the same thing. I got the little clinmycin spray. I'll do my benzoyl peroxide hypochlorous acid spray. Keep it gentle. A lot of drugstore products are really good. So, yeah, you got to keep it really. And you got to not pick and touch.

[Dear Media Employee 1]

My biggest thing.

[Dr. Sheila Farhan]

I know.

[Dear Media Employee 1]

Okay, cool. I'll think of that when I'm.

[Dr. Sheila Farhan]

Keep me posted.

[Dear Media Employee 1]

I will do round two. Round two.

[Dr. Sheila Farhan]

All right, thanks.

[Podcast Host]

So I've been hearing so much about Zurf. I want to get your thoughts on that if you think it's worth it. I know it's still new to the scene, but curious.

[Dr. Sheila Farhan]

Great question, Zerf.

[Podcast Host]

Okay.

[Dr. Sheila Farhan]

People ask me this all the time, and you are like a little bit of a younger demographic, which is why, I think, why you're asking me. Also because it's non invasive, it doesn't have needles. You may be starting to see, like, some signs of sagging, maybe. And then the before and afters, immediate before and afters look so good. So Zurf is radio frequency. There's a lot of technologies out there that have radio frequency. Radio frequency is just like energy that it immediately contracts the skin, but then over time, it stimulates collagen.

[Podcast Host]

Right.

[Dr. Sheila Farhan]

So, you know, there's radio frequency microneedling, which is one of my favorites, but it has, you know, you have to numb the patient. There's a little bit more downtime. There's little micro needles that go into your skin. So people don't love that. But. But in my opinion, going down to where we really want to, like, fix and stimulate collagen, I like better Radio frequency with microneedling Morpheus or whatever secret. Those are really good. Two devices. With Zurf, it came out of South Korea. So it's been there for a little bit and it's been here since like October 2025. So barely like not even a year.

[Podcast Host]

So new.

[Dr. Sheila Farhan]

It's so new. But it's been used and it's not like new. Weird technology. We're not like, oh my God, it's going to cause cancer in like five years.

[Podcast Host]

Right, Right.

[Dr. Sheila Farhan]

The thing about Zurf, and this might be a hot take is I think people are posting there immediately. Posts after photo and you will see contraction. It will look amazing. And then I just literally had Erica Taylor here yesterday or like right before you. And she was like, I did it. And then everything came back down.

[Podcast Host]

Right.

[Dr. Sheila Farhan]

So then it's like, okay, so we know it's non invasive. We don't know how deep it's going. We know that it's not heating up and like meat melting fat. But is it heating up enough to actually do something? I think the verdict is still out. I don't know if it's worth the thousands of dollars people are spending. Spending. I think that it has really good marketing, but I guess we'll see. I think the data, I think everyone's like getting it now, like in the last like month or two. So then I think in like one or two more months we're gonna be seeing like people being like, oh, yeah, that, that lift that I saw right afterwards, it's like, it's now. I see that.

[Podcast Host]

Right.

[Dr. Sheila Farhan]

I don't know.

[Podcast Host]

Yeah.

[Dr. Sheila Farhan]

So I don't think it's worth your money right now. Especially you're young. Like for you, if you were like, I do want like a little bit of a lift. First of all, we got to make sure you have like retinol on board. Looks like you have a little bit of like sensitive skin rosacea. So retinols might be a little tricky for you to find. Medicaid has a retinal that's really gentle. You want to focus on skincare with peptides. Peptides help stimulate collagen as well. It's non irritating. Medicaid has one. Skinceuticals has one. It's like Botox in a bottle. Not really, but love that.

[Podcast Host]

Hear that everywhere.

[Dr. Sheila Farhan]

Yeah, I love that product. And then for you, because you're like in your 20s, right? Yeah. So microneedling is so good for like fine lines. You really don't have a lot of fine lines. But I think that that's going to still stimulate collagen and do something.

[Podcast Host]

Okay.

[Dr. Sheila Farhan]

We just be careful with your rosacea not to flare that. What else will stimulate collagen on a deeper. Like, what bothers you? Well, more of just like a texture. Okay.

[Podcast Host]

Kind of like resurfacing.

[Dr. Sheila Farhan]

Yeah.

[Podcast Host]

So I've been doing tretinoin.

[Dr. Sheila Farhan]

Yeah.

[Podcast Host]

But kind of balancing that because, like, you said, like, I have super sensitive skin. What about red light for stimulating collagen?

[Dr. Sheila Farhan]

Yeah, I love red light. Especially your age. Yeah. You just have to be so consistent with it. So red light, we know, like on a science. Oh, by the way, like, zurf doesn't really help with, like, resurfacing. Like, doesn't do anything for, like, texture. Acne scarring.

[Podcast Host]

It's like.

[Dr. Sheila Farhan]

It literally is like heat on the skin, which doesn't do anything on the outside and just tightens the skin. So for resurfacing. Yeah, like, texture, like old acne scarring, large pores, oiliness, like all that that you see, like micro needling. It's like a couple couple hundred dollars versus like a couple thousand dollars for some of these lasers. And I love that. Sometimes what I like to do is, like, rub, like, growth factors on top that glass skin. Love that red light. I'm a huge fan of. It does work. You just. It's not like a facelift result, obviously. You just have to be. It's like brushing your teeth. You just have to be, like, consistent with it and use it as long as it's like a brand that's like derma, you know, derma proof. So. So, like, Solo Wave is a really good one that is so affordable. It's a soft one. Omnilux is another soft one. Dr. Dennis Gross has a hard shell one. Shark has one as well. That's a hard shell one. That one is my favorite, the shark one, because it has, like, a cooling thing, too. It's good for rosacea. If your red light mask, like, you got one randomly on, like, TikTok shop and it's feeling hot or warm, that means it's pulling in infrared, and that's not good. You don't want it to feel warm, and it's going to worsen your melasma. Like, it feels like you're going into, like, a infrared sauna.

[Podcast Host]

Right.

[Dr. Sheila Farhan]

Wrong, Bad. Take it back, throw it away. But it should just feel pink and you may be a little flush because it stimulates collagen, increases circulation, decreases inflammation. And although it may worsen melasma a little bit in some people, I don't Think it should. I don't think it, like, worsens your rosacea.

[Podcast Host]

Okay. Amazing.

[Dr. Sheila Farhan]

Yeah. Thank you so much. Of course.

[Podcast Host]

So I have previous filler.

[Dr. Sheila Farhan]

Caught it.

[Podcast Host]

And I've gotten that filler dissolved.

[Dr. Sheila Farhan]

Okay.

[Podcast Host]

And I'm always so curious, what do you look for in a patient who has had previous filler? Are you more inclined? Like, how do you.

[Dr. Sheila Farhan]

Yeah.

[Podcast Host]

Is there something that you can't do? Is there anything that you look for in specific? And I was giving this kind of analogy of how tattoo artists look at previous work. Like, some people are inclined to be like, I don't want to even touch that.

[Dr. Sheila Farhan]

Yeah.

[Podcast Host]

I, um. Versus how do you build upon that?

[Dr. Sheila Farhan]

That's a really good question. So my. In my practice, I dissolve a lot of filler and I also will refill them depending on the location. Like, where did you have it dissolve? Under eye or lips or where. Got it. Yeah. So with lips, I usually am like, go for it. Like, if you have migration or you don't like the way your lips look, like, let's. Let's dissolve it.

[Podcast Host]

Yeah.

[Dr. Sheila Farhan]

A lot of the studies show, like, it's not going to actually, like deflate. Like, it's not going to dissolve your actual hyaluronic acid in your skin, like, with the way we do it. And I've done enough of dissolving to see that. Like, it just shrinks it. The reason why people don't want to, like, touch old filler, and it's really provider based. Like, I'm an advanced injector. Like, I want to be there for my people. I want to be there for people who went, you know, they didn't know. Like, you didn't know. Like, you just went, got your lips done. You're like, I don't really like it. Got it dissolved or some people will get it. They went to someone, maybe that wasn't really good and they got migration or they didn't tell them when to stop, or maybe they. And then they just did too much. So what I tell people is that we can totally dissolve it. I like to wait two months before redissolving. Not everyone will let me do that because they're like, I have tiny little baby lips. But the longer the better. Because that skin border, like, lip border can heal. And I will refill. But I will always tell them, like, it won't be as perfect as me injecting, like, virgin lips.

[Podcast Host]

Yeah.

[Dr. Sheila Farhan]

Because that crisp border has already been compromised because filler has already migrated. That, like, there's like kind of like a border there. So it's like, if it's been pushed through number one, if you dissolve it, you do want time to let that heal, like some people will. And I've done this before with a patient a long time ago where she came in from out of town and she had, like, some other stuff. So we dissolved her upper, you know, the migration there. But we did dissolve her lips, too. And we waited, like, two weeks, which is like the kind of like, yeah, what people do a lot. And then I went in there and it just wasn't, like, as crisp. They looked gorgeous. They still looked really good and better than what it was before. But it didn't have that, like, really nice, crisp border feel. Like if maybe we wait a little bit longer would have, like, healed more. But that's kind of the only thing that I tell people. The reason why some injectors are like, oh, I don't want to deal with, like, people have gotten filler, bad filler, dissolved filler is because it is harder. It's much harder to inject and get a good result with, like, not a perfect canvas. And not saying that we can't do it. Like, I'd rather someone get the filler dissolved and us do it than me be like, no, it's not going to look as good. So I don't want my work. You know, like, that's like an ego thing. But I think that I guess it's same with, like, tattoo artists where it's like, maybe like an ego thing, but. Or like an, like, like how good they're trained, you know? Like, I think that it does require a little bit more of an advanced technique to go in there. Especially for the under eyes.

[Podcast Host]

Yes.

[Dr. Sheila Farhan]

So for the under eyes, when someone comes in and their. Their under eyes are puffy, they're swollen, they're boggy because of bad under eye filler. And bad under eye filler can be from where the injector placed the filler. Like, was it too superficial? Was it too deep where it's obstructing your lymphatic flow, too much filler, and the wrong product. So usually you need to do very little bit. Like, some people would do, like, one whole syringe of filler in the under eye. I do, like, a quarter. So when someone comes in, though, I have a whole protocol for the under eye, which is we dissolve it. I do two sessions of that just in case, like, I. We feel like we need to dissolve a little bit more because it's not like a perfect science to, like, dissolve. And I'm Sure. Yeah. You have that with your lips. And then I'll go in and tighten the skin. Because if you do have a little bit of stretching, doesn't happen with the lips as much. Although I've seen it where people have gotten so much lip filler and I dissolve it and it's like deflated.

[Dear Media Employee 2]

And then.

[Dr. Sheila Farhan]

And then we kind of have to address that. But for the under eyes, you will see, like, creeping, usually crepey skin there because of the swelling and because they got the filler for a reason, which is to fill the area. So then when the filler went away, people are like, oh, my gosh, it looks so old now. So I have to tighten the skin. I'll tight it with radio frequency microneedling and a CO2 laser to tighten that skin. And then I'll go in and heal the skin with prf, which is like, I draw your blood, spin it, and it kind of regenerates and heals the under eye where we can improve that, like, lymphatic fluid flow again, so, like, things don't feel so swollen. And then, believe it or not, I will fill if we. If I feel like we need to. And some people are like, what? Like, I thought filler was the problem. And I'm like, no, filler was not the problem. It's just how it was filled was the problem. So same for the lippies. I go in, I dissolve them. Usually about two sessions. It's not as bad as what people think, like on the Internet. Yeah, right. Was it, like, so bad?

[Podcast Host]

It wasn't. And I've gotten them dissolved twice.

[Dr. Sheila Farhan]

Yeah.

[Podcast Host]

Just because we were wanting to go with a more like. What's the word I'm looking for, like, minimal approach. And then we ended up just doing the whole thing.

[Dr. Sheila Farhan]

Love.

[Podcast Host]

And it wasn't as painful as people think, but obviously, like, everybody's pain tolerance is different. Exactly.

[Dr. Sheila Farhan]

But I feel like on the Internet, people are like, oh, my goodness. And I will say, sometimes I will dissolve and sometimes I will, if not apply ice. The actual product does burn a little bit, so. And people get really swollen sometimes. But I think, like, just get it dissolved. Like, some people are just holding on to it and it's like, really, really, like, this is yours. Like, migrate a little bit, or was it like a shape you didn't like?

[Podcast Host]

It had us. I had a small migration on the sides because the corners of my lips tend to curl in a bit, and I wanted it to, like, pop out. And I just didn't work out that way.

[Dr. Sheila Farhan]

Yeah.

[Podcast Host]

So a follow up question for you is, when you do refill, is there a product that you are more inclined to use use for the refilling versus, like, I think my original one that I had was. Oh, I was. It was a Juvederm product.

[Dr. Sheila Farhan]

And I know people say, like, juvederm move. I know it is. Especially if it was like, Juvederm Ultra Ultra Plus. Those are really thick products, and they can migrate. I think that it really depends. So if I'll usually use one like, that's in the middle. So I don't think, like, all Juvederm products are bad.

[Dear Media Employee 2]

Right.

[Dr. Sheila Farhan]

Juvederm has a volbella product that I really like, and that's like, half structural. Like, Juvederm, Like Ultra Ultra plus is, like, very structural, very thick. And that's why people end up looking, like, too stiff in the lips. It migrated a lot because it was just like a product that, like, it was just too much and too much volume was placed. And then people used to inject really deep, like, into the muscle. And I inject so superficially to get that nice, nice lift. So I think that's a different thing. But I think it depends. If someone wants, like, a nice cris border, I'll use like, a volbella, which is like, half structural, half hydration. If we like the structure of this, the. The lips, but we need, like, hydration, I'll go, like, a little lighter, like, Refine. Galderma has a product called Kiss, which is a little bit more structural, which I like too. So I guess it kind of just depends. I don't feel like. Although we, like, say Move Derm, like, Ultra Ultra Plus. Those are strong. I feel like a lot of the issue is really, like, how it was injected too.

[Podcast Host]

Like, the technique.

[Dr. Sheila Farhan]

1,000%.

[Podcast Host]

Yeah.

[Dr. Sheila Farhan]

Yeah.

[Podcast Host]

Well, you've given me a lot to think about.

[Dr. Sheila Farhan]

Yeah, exactly.

[Podcast Host]

Maybe I should go back in for a little. A little touch.

[Dr. Sheila Farhan]

Yes.

[Podcast Host]

Yes.

[Dr. Sheila Farhan]

Happy to see ya.

[Podcast Host]

Yes. I know exactly who to go to.

[Dr. Sheila Farhan]

Yes. Thanks.

[Podcast Host]

Awesome. Thanks, guys.

[Dr. Sheila Farhan]

All right, Ms. Producer, look who's in the chair now.

[Dear Media Employee 2]

Yes, I know. Or in front of the camera this time. I have not started doing anything yet.

[Dr. Sheila Farhan]

Okay.

[Dear Media Employee 2]

And I'm starting to, you know, just start to prepare. I'm, like, turning 30 at the end of the year. Like, I've been using retinol for a year, and I use it every night now. So I'm using a 0.3. I use vitamin C in the morning, a basic Cerave moisturizer, and then I do use a beef tallow at Night, like a nice beef tallow that I really like.

[Dr. Sheila Farhan]

Actually, my skin looks good.

[Dear Media Employee 2]

Thank you. And yeah. So I'm just kind of wondering, like, what is the best, like, way to prepare myself for my 30s?

[Dr. Sheila Farhan]

Yes.

[Dear Media Employee 2]

And, you know, like, I want to keep it natural, and I don't want to, like, look like I have a stiff face. But, like, you know, just thinking about longevity.

[Dr. Sheila Farhan]

Yes.

[Dear Media Employee 2]

And yeah, my skin.

[Dr. Sheila Farhan]

Love. You're like the perfect patient where you're in your late 20s, approaching 30s. This is when you're starting to see the lines. All your friends have maybe had Botox, and you're like, am I missing out? Do I need to do this? How do I know I'm a good candidate? I don't want to look like some of my friends, but some of the other ones, I don't even know that they had it. So, like, what do I even do? So I always say, you've heard me say this a million times with patient. With clients or with the guests here.

[Dear Media Employee 2]

With the guests.

[Dr. Sheila Farhan]

With the guests is the way, you know, you're a good candidate for starting something like Botox, baby. Botox is if you start seeing those lines stuck there after making that facial expression. So you're like, okay, I went like this raise my eyebrows. But then, like, I brought them down and I still see them. Yeah, that is a good time to do it. So then they don't. So you can saw. So Botox does a few things. So Botox, well, it relaxes the muscle. So it's actually like a liquid that we inject, like, baby baby, little injections into the muscle. These set of muscles between the eyebrows, these ones here help the 11s. And then it also, because the muscle between the eyebrows get relaxed from Botox, the muscle up here, the frontalis muscle, actually raises up and overcompensates because this gets stronger because that one's relaxed, and that's how you get the nice lift. And that's what I do for my face. So sometimes it's not even like the wrinkles that some people are like. I just want to, like, look a little bit more lifted, you know, that's what I do.

[Dear Media Employee 2]

Yeah.

[Dr. Sheila Farhan]

For myself, for Botox.

[Dear Media Employee 2]

Almost like weightlifting for your face.

[Dr. Sheila Farhan]

You're, like, doing a different part. You like, you have, like, this tug of war. One muscle is relaxed, the other one is gonna overcompensate and pull up because it's just stronger because the other one can't. Can't.

[Dear Media Employee 2]

Yeah.

[Dr. Sheila Farhan]

So it's basically like going this way because this one's this Side is relaxed, and then the other side is, like, stronger. So it's like a tug of war. And that's how you get the nice brow lift. So. Because I cannot be mad right now, but I can be surprised price. So. And that's like my. My little, like, trick on. Because I want a lifted eyebrow.

[Dear Media Employee 2]

Yeah.

[Dr. Sheila Farhan]

For you, what I would do is baby talks.

[Dear Media Employee 2]

Okay.

[Dr. Sheila Farhan]

And, like, say you were like. But, like, I don't know if I want Botox. What else is there? Here are the things that you could do. Retinol is great. I think adding some more elegant skincare products like peptides. Peptides like neuropeptides, like the PTO helps static lines, those lines that are still there. Medicaid has a really good peptide that's like, a little bit more good for starting. It's a little bit more affordable than some of the other peptides there.

[Dear Media Employee 2]

Cool.

[Dr. Sheila Farhan]

Inherently, like, peptides are a little bit more expensive than, like, a retinol over the counter. Okay. But I think adding some of that, sometimes it is like a little dehydrated skin. Your skin looks really nice and hydrated, so I don't think it's that okay. A little bit of, like, exfoliation once a week can kind of help. Not those, like, not the muscles, you know, but it can help with, like, exfoliating some of that, like, dead skin that's, like, you know, that's maybe contributing to the dullness or anything like that. Microneedling is, like, the perfect treatment for your age. And it's so underrated. I know it sounds scary, but it's just vibration. It's basically little micro needles going in and out, and that creates, like, little controlled injury. And your body actually stimulates collagen and. And it is perfect for fine lines, these little fine lines here. So say if you didn't want to do Botox, we would do that. The thing is, we'll get to a certain point where we like it, and you won't have lines there, but then you're still making, like, facial expressions because you are a bit expressive. I would say, like, I am too, but I still have lines there that I have to be okay with. But, like, I want to soften them. So then that's where the Botox is really nice because you've done all this work, you've already treated those lines that were there. We're doing a little Botox to help prevent the soft. Like, basically the Botox goes in the muscle. It'll soften those lines that are there, and it prevents the Lines from getting worse. Okay. So it shouldn't feel heavy. I would say Botox, baby, Botox. About 20 units. I would do like a little bit between the forehead. Maybe a sprinkle on the forehead. Like between 6 to 8.

[Dear Media Employee 2]

Yeah.

[Dr. Sheila Farhan]

Like 20 to 24 is frozen in the forehead. So I do like a hat, a four, a third or a half of that in the forehead. And then sometimes I like to do the, the, the lateral eyebrows to help lift that too. To give like a lifted look.

[Dear Media Employee 1]

Yeah.

[Dr. Sheila Farhan]

So that's like my game plan for you. So. And then with Botox, you do it every. Like, it lasts about three to four months. Not saying that you need to do it every three to four months, but that's typically how long it lasts. Sometimes people do it like twice a year. Some people just want to come in a little bit more often when it completely wars wears off. And I will say one big myth is people are like, if I start Botox, do I have to continue for the rest of my life? And like, no, you don't, because you're not going to look that different.

[Dear Media Employee 2]

Right.

[Dr. Sheila Farhan]

You can just like, let it. Let ride it out if it's not for you. Although people usually just love it. Unless they get too many units and they feel heavy and restricted and claustrophobic. That's a bad thing.

[Podcast Host]

That makes sense.

[Dr. Sheila Farhan]

That means they did too many units. Okay. But yeah, less units, you get a nice lift, it looks a little bit more natural. The types of Botox brands like Xeomin tends to be a little bit more, like, softer.

[Dear Media Employee 2]

Oh, yeah. I was gonna ask you what you use.

[Dr. Sheila Farhan]

Yeah, I have them all. And I have Daxify in my forehead, which is like the strongest.

[Dear Media Employee 2]

Okay.

[Dr. Sheila Farhan]

And it lasts the longest. Cause I just don't have, like that much time to reinject myself. But Xeomin is a really popular one. It's like, purified. It's called Smart Talks. It's a little softer. It's a softer molecule. And I would say in my LA patients and my Tucson patients, that's like, especially for first timers. It's a really good one.

[Dear Media Employee 2]

Yeah.

[Dr. Sheila Farhan]

Yeah.

[Dear Media Employee 2]

Okay, cool. And it was funny. I actually got my A facial done for the first time in like two years a few weeks ago.

[Podcast Host]

Yeah.

[Dear Media Employee 2]

And like, my lines were gone and Because I never exfoliate because I didn't think I really had to because I was using retinol, but. But my lines were gone for a week, so I was like, okay, I guess I should be exfoliating. Do you have a recommendation for an exfoliator?

[Podcast Host]

Yeah.

[Dr. Sheila Farhan]

Everyone says, like, everyone's so scared of exfoliating, but I think it's so great. And all you need is, like, a gentle exfoliation. There's a few that I like, so when I'm looking for ingredients, I like to look for lactic acid and glycolic acid. Those are like. Salicylic acid is also one, but that's for, like, oily skin. So for you, you want to look for, like, lactic acid, glycolic acid, mandelic acid. Those also brighten the skin and help increase cell turnover and kind of, like slough off the dead skin. Paula's Choice has some really good, affordable ones. Skin Medica has some good, affordable ones. The pads are fine. You just have to be really careful not to be super aggressive.

[Dear Media Employee 2]

I use a glycolic, the ordinary, like the basic one. So is that an exfoliator? I do that once a week, but. But just. Okay. Okay. So I guess I am. Technically, I'm just, like, not getting, like, doing.

[Dr. Sheila Farhan]

It's just really gentle.

[Dear Media Employee 2]

Okay.

[Dr. Sheila Farhan]

So you could up it a little bit. Yeah, I think it's a few percent. I don't think. I don't think it's more than 5%, but.

[Dear Media Employee 2]

Okay.

[Dr. Sheila Farhan]

Glycolic is great.

[Dear Media Employee 2]

Okay, so how many times a week would that be? Like?

[Dr. Sheila Farhan]

I would say, can I mix it with retinol?

[Dear Media Employee 2]

Because I feel like I have. When I do my retinol, I don't

[Dr. Sheila Farhan]

do the other stuff. Yeah, you can. Especially if you can tolerate it. So the ordinary especially is very light. So that's a skin serum. So you would do that first and then you can put your retinol on top.

[Dear Media Employee 2]

Okay.

[Dr. Sheila Farhan]

Yeah. Because you're not doing prescription retinol, right?

[Dear Media Employee 2]

No, it's. I'm doing the first aid Beauty Love 1. That's 0.3. Because I have sensitive skin. I like, have been doing it with an oil. Like, I'll put an oil on first and then put the retinol on. But then I was talking to the facialist and she was like, you should. I was like, should I go up now?

[Dr. Sheila Farhan]

Yeah.

[Dear Media Employee 2]

She was like, you should just try without. Without. And that's what I've just started doing. And then I'll, like, go through that, I'm thinking. And then I'll go up to 0.5.

[Dr. Sheila Farhan]

Yeah, I think you'll be good. You're being, like, very good and careful. And the reason why no oil first is it's kind of creating, like, an occlusive barrier. So then your Retinoids not getting absorbed as much as we want it to. You can always oil afterwards.

[Dear Media Employee 2]

Okay.

[Dr. Sheila Farhan]

Yeah. Like sandwich. You're kind of doing like the sandwich method, which is like moisturize before, put your retinol and then moisturize after. I know first aid beauty has like a very gentle. So I think you can just like go for it and then one night maybe try them both together. Yeah, I think that's great. Ordinary is great. Yeah. So affordable clean stuff.

[Dear Media Employee 2]

Yeah. And it's just like. And it's exactly what it is.

[Dr. Sheila Farhan]

Like you get it. If you don't like it, fine.

[Dear Media Employee 2]

Exactly.

[Dr. Sheila Farhan]

Do you have one that's like orange or purple or something that people were a little reactive to? Like my sister, I think kept it on forever. But other than that, they have some good stuff. Okay. Yeah.

[Dear Media Employee 2]

Okay, great. Cool. Thank you so much. Appreciate it.

[Dr. Sheila Farhan]

Appreciate you. So as someone who recommends starting a retinoid, which is the gold standard for anti aging, it helps increase cell turnover, stimulates collagen. Not everyone can get on board with the retinol. It may cause irritation. They may be a little bit more have sensitive skin like with rosacea. So I always tell my patients, if you want to start a retinol, try a retinal. And Medicaid has a really good one that has almost like different stages. They can start really low and then go up from there. But retinal and tends to be a little bit more gentle. So it's not going to cause as much irritation or any irritation in someone who really wants to get on the retinoid game. I often see patients in my practice asking what they can do at home to treat fine lines and wrinkles. And I always love to recommend using Medicaid Liquid Peptides Advanced MP Face serum. This is literally the serum that delivers clinically proven wrinkle reduction thanks to GF mini protein which is great growth factor Medicates Liquid Peptides Advanced MP face serum is powered by the GF mini protein which mimics the function of natural growth factors but penetrates deep into the skin to visibly improve the appearance of skin structure over time. So if you didn't know, growth factors are naturally occurring proteins in the skin that support the overall skin health and can help promote younger, healthier looking skin. However, growth factors applied topically are way less likely to penetrate into deeper layers. And that's why finding a good product that does that is so important. I recommend Medicaid's Liquid Peptides Advanced NP serum for any of my patients looking for visible wrinkle reduction. I Also love their retinal. You can find these products online@Medicaid US that's M E D I K and the number 8 US use code dermaproof for 20% off your order. So as a dermatologist and skin skin cancer surgeon, you guys know that SPF and sun protection is my number one and I know it's really hard to find a sunscreen. It's so hard. Some of them are chalky, they leave a white cast, they break you out, they feel make you feel like super oily. LTMD is just one of those sunscreen brands where they literally have a product for everyone. If you have more dry skin, if you have rosacea, if you want a little bit more hydration, if you are working out. This is what I love about Eltamd L is not only the number one dermatologist recommended and trusted professional sunscreen brand, but dermatologists use Eltamd personally more than any other sunscreen brand and I can vouch for that. Eltamd sunscreens are formulated with ingredients to help protect and correct UV damage across skin types and skin concerns. If you struggle with dry or dehydrated skin, you need to try ELTAMD UV Daily Hydration Plus SPF 50. Available in untinted and tinted version. Based on a 12 week study on 32 participants, this product is clinically proven to provide 24 hour hydration and 100% saw improvement in hydration, plumping, fine lines and wrinkles. They really do it all in their formulations so people don't feel like they're actually wearing sunscreen that they don't like. And that's what I love because I'm like people need to wear sunscreen they actually will use and they like and ultimately is one of those products that I always recommend. And remember you need to wear sunscreen 365 days a year. Visit www.eltamd.com to shop and learn more. As a derm who focuses on cosmetics, it is so hard to find a good under eye cream. Of course I'm trying to fix the under eye area, but I get a lot of questions on what products I recommend. So for the under eye area people are asking me about dryness, for fine lines, puffiness, dark circles and with a lot of people even like losing weight or people we're just tired. All right, we need some help under the eyes. Developed with dermatologists, I love to recommend Rocks Revive and Glow Eye Bomb. This brightening eye cream is formulated with vitamin C and peptides. Clinically proven to Reduce puffiness and dark circles while brightening your under eye area. In just one week, 96% saw healthier looking eyes and 90% saw saw brighter eyes. And in four weeks, dark circles and puffiness are visibly reduced. The innovative cooling stick glides on invisibly with a unique touchless application for powerful results. It's available at Amazon for less than $27. Visit www. Rockskincare.com for more information. Okay, so first question from someone is I want to do the things. I want to get sculptra. I want to do radio frequency or softwave. But I heard that if you plan of facelift in the future, these things cause scar tissue. What do I do? So this is something that I talk to my patients a lot about because you will hear plastic surgeons say, oh, if you get certain procedure, you know, sculpture threads, radio frequency, these cause scar tissue. And then you'll hear other plastic surgeons say, no, these are fine. We do these in our office and we recommend these to patients. Like, no one can go from nothing straight to a facelift. So I say that it's all about the balance, right? So anything that you do to your skin will cause some type of inflammation. Right. Even coolsculpting. So I do a lot of like neck and double chin lipo. And sometimes a patient will forget to tell me that they did coolsculpting underneath, which is just freezing the area. It doesn't, it's not even hot. It's just freezing, freezing the area. Or they'll do Kybella. And when I'm going in there sucking out the fat with like a little, with a little tool, I'm feeling that resistance a little bit. It's not like gliding like butter. It has a little bit of like scar tissue there. So do I think that they're gonna be get like a really bad result now? No. Does it make my job a little bit harder while I'm doing it? Yes, but I don't think in that case it's compromising their result. It is adding a little bit more work on my end, but. And they may have a little bit more downtime and irritation after, afterwards. But I don't think it would make a big meaningful difference where I'm like, don't do coolsculpting. Don't do anything non surgical before you do something surgical. I think that non surgical things are there for a reason and that we should do them. Sculptra is a powder. We add water to it. So we're injecting literally liquid into the face to stimulate collagen and can give a little bit of like a tightening effect which I love and my patients love. And people are obsessed with this treatment. Yes, if you do maybe so many vials right before, you know, typically it lasts about 18 months, although it's also stimulating collagen. But say you did like so many vials and then like a few months later you went and had this like full deep plane facelift. There may be some, you know, not issues, but there may be a little bit maybe scar tissue there. You know, I don't think it's enough for the plastic surgeon to give you a worse result or anything like that. Like again, these non surgical things are there for a reason. So I don't think anyone now should be worrying about not doing anything for facelift. They're going to get like 20 years later. As far as radio frequency or ultrasound, anything like that. Again, we are contracting the skin. This is using heat and if done appropriately, we're not like targeting fat or anything like that. We're stimulating collagen on like contracting tissue on a deeper level. So could there be a little bit of inflammation there? Because that is like tightening and doing the thing maybe. But again, for me, I personally do all of these things, radio frequency microen to help tighten my skin injectables, PRF and sculptra. So these are things and I do plan to get a facelift in decades, like I will get one, but these things are maintaining me until I get to that point. Because people are also going to look really odd when they get a facelift and they haven't maintained doing any skin tightening lasers. Your skin quality doesn't look good because you're so nervous to even get any type of laser or, or micro needling or anything because you're like saving it for the facelift. I think that is like tech, like really. I think you're doing like a disservice to your skin and your facelift. I think by doing some of these non surgical things you're actually going to get a better result and a better facelift. Of course with anything people go crazy and have like 20 syringes of filler and they have threads and they've done, you know, face tight or any type of internal heat where it's like you have the probe inside the skin. Those types of things will cause issues that I think may impact a facelift. But the regular stuff, sculpture, radio frequency, ultrasound, injectables, mic, like a little bit of filler here and there, you're good. Like don't be scared Next question. What are your thoughts on the vibration plates? All right, so this is, like, a very trendy health and wellness longevity trend, I guess you could say trend. People have been doing really, in the last year. I think people really picked it up. I even bought one myself. So it's basically you get this, like, vibration play. You can get it from Amazon. I think it's like, a hundred bucks, something like that. And it vibrates like this. It goes up and back and forth like crazy. So. And I did a deep dive on all of this, and this may be a hot take, but I really looked at what the vibration plate does versus what a power plate does, which is completely different. So the vibration plate goes back and forth. It can help, like, help decrease swelling because it's getting the lymph flow. Will it help muscle tone? Maybe. Will it help bone density? I don't think so, because the way it's oscillating. And so people just love it because it's, like, their workout, their thing. I don't think there's anything wrong with it. I personally get so itchy when I'm on those. And, like, my, like, I feel like I'm, like, tearing my thighs apart because, like, tearing my thighs, like, up because I'm just, like, so itchy from the vibration. So if that happens to you, like, you don't need to do it. I have, like, really bougie, but I have a concierge medical doctor that. He's an md but he does a lot of, like, functional, integrative, like, full body stuff. And we had this, like, big thing because I have osteopenia. I have, like, weaker bones, just, I guess, genetically, I don't know. And so what I did a deep dive on. And what he recommended was a power plate, which is kind of like a vibration plate, but. And you see these at, like, chiropractor offices or physical therapy offices and, like, some workout places. And it is, like, a vibration, but you feel it in your core, like, like, to your core, like, your bones, your muscles. It can even make you feel, like, a little nauseous. So that's like twelve hundred dollars. So I got that, and I've been on that because I feel like that actually has studies to support, like, helps with muscle, helps improve muscle, helps improve, like, bone density and stuff like that. So if you're gonna be on it every day and you want. And you have, like, weak bones or you want to, like, strengthen your muscles, your bones, I would invest in, like, the power plate one. It's a lot. It Just feels a lot different. It's just like, feels like a vibration that you have to like, hold steady. You're not just like oscillating back and forth. So that's my hot take on that. If you're using it, just do a little bit more research on the vibration. And also if the vibration is not for you, like, don't use it. And lastly, I want to start a laser. Where do I even start? Okay, so laser is like the umbrella of this technology, of energy based devices, right? So I would say for like my patient who hasn't really done anything, say they're in their, like late 20s, 30s, 40s, and they're like, I heard everyone gets a laser, I want a laser. Where would I have them start? I would ask their concerns. And it's usually texture, pores, maybe a little pigment, like sun damage and lines, fine lines. We don't need to do any intense laser for those things. You could do a very light laser. So in my office, I have a very light CO2 that I can do that's kind of like a laser peel. So basically it exfoliates the top layer of the skin. I had a laser, and I'll show you guys some photos. I had a triple laser a couple weeks ago where we did a laser for my broken blood vessels around my nose. And I had a little bit, like on my cheeks and chin from like, I don't know, rosacea. Then we went in with an erbium, which is a more gentle, not gentle, but it's like better for darker skin types. But it's like basically a CO2 resurfacing laser for a little bit of the texture and pores that I had in my cheeks. So we did that full face and for like tightening around my eyes. And then I went in with. We actually went in with moxie. That helps. It's just pigment. And so I did this trio laser and. And I do a lot of these trio lasers for my patients. And I also add in radio frequency microneedling on the same day to really tighten as well. So it's all about laser stacking. What? I necessarily do that for a patient who's just starting off? No, but I would say that if you came to my office and say you're in like your 40s, you're complaining of like, under eye, maybe starting to get bags, you have crepey skin under your eyes. You just feel like things are dragging down. You have jowls, you have texture, you have pigment, you have deeper lines, you have fine lines. Then I Would do a laser stacking. I would do a little bit of skin tightening with radio frequency and then go in afterwards with a CO2 for my more mature patient. And then sometimes I'll add the pigment laser too. But for my more mature patients, I would actually even go in with micro coring on the same day, which is a non surgical way to remove sagging skin. Basically cores it out and then I do the laser. And so that is like a really advanced way to tackle your skin without Botox, filler, anything like that. Using things like lasers, so and energy based devices. So I love lasers. I say if you just start, they are a little bit more expensive. Lasers are, they're very big like machine, you know, they cost like a quarter to a half a million dollars sometimes for the practice. They're very expensive things. So treatments usually cost like if it's a light laser, sometimes they can cost like $800ish. You get more intense lasers, they can cost about a thousand to even like the more intense like a few thousand dollars for like a full treatment. But so if you're like just starting out and you have fine lines, texture like start with micro needling first. That is not a laser. It's a few hundred dollars at least. That's what I, you know what we charge our patients and that is just like the biggest bang for your buck. So don't feel like you get FOMO if you're not using a laser. There's also obviously like laser hair removal. IPL is a type of light based device, not technically laser, but everyone kind of thinks it is. And that gets rid of brown spots and broken blood vessels. So if you have rosacea and sun damage, that one's a really good one for you. But yeah, there's so many different types of energy based devices. And the two main skin tightening laser, they're not lasers, but energy based devices include radio frequency and ultrasound. So those are two technologies that actually don't do much on the top layer of the skin, but they go deep and tighten the skin by stimulating collagen and contracting that tissue. So I think we did pretty good. We touched on injectables. Lasers fill like filler migration, like some medical derm stuff. If there's anything that I missed, please send them over. You can go to at Dr. Sheila Derm on my Instagram. I'm happy to do another one of these or if I didn't get your question, I'll do like a little stories and answer the rest. So and also a quick note, we are taking the next two weeks off, which I know everyone's, like, out for the summer also. But don't worry, we're coming back August 19th.

[Podcast Host]

See you then.