298: Our Injector Answers ALL Your Questions 💉💋 Beauty & Aesthetics DEEP DIVE ft. Allison Lester PA

Summary

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Pop Apologists – Episode 298: "Our Injector Answers ALL Your Questions 💉💋 Beauty & Aesthetics DEEP DIVE ft. Allison Lester PA"

Release Date: October 15, 2025
Hosts: Kaitlyn Bristowe, Chandler Burr
Guest: Allison Lester, PA (Dermatology & Aesthetics, NYC)

Episode Overview

This episode is a deep, no-holds-barred Q&A about all things facial aesthetics with expert injector and PA Alison Lester. As Kaitlyn and Chandler admit up front, this isn’t for the “crunchy” crowd but for anyone curious about injectables, lasers, skincare, and a fresh, evidence-based perspective on beauty procedures. The sisters lean on Allison’s expertise to separate myth from fact, drill into the nuances of safe, elegant results, and address both concrete concerns (“Is filler in its villain era?”) and broader mindsets around looking hot and staying confident as we age.

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Key Topics & Insights

1. Introducing Allison and the Ethos of the Episode [03:34–07:42]

• Kaitlyn and Chandler introduce Allison Lester, their own injector, celebrating her bespoke, individualized approach versus generic “menu” treatments.
• The vibe: candid, light-hearted, honest about their own vanity and pursuit of looking “as hot as possible.”
• Quote:
  • Chandler: “This episode is all about trying to be as hot as possible, which some of us do want to be, sorry to say.” [05:03]
  • Allison: “I plan to just get hotter as I age.” [05:17]

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2. Botox: When to Start, How, and What Type? [07:51–14:30]

• Preventative Botox:
  • Allison: Only start injectables if you see lines at rest—no earlier. “You don’t need to be getting injectable treatments until there is some sort of indication for it.” [08:40]
  • Early skincare, sun protection, and chemical peels are better early strategies.
• Botox Can Remodel Skin:
  • “Botox... can remodel your skin… when my Botox wears off, I’m like, wow, I look younger than I did when I was in my early 20s.” – Allison [09:56]
• Botox Frequency/Atrophy Fears:
  • Muscles can atrophy if overtreated, but spacing treatments to every 14–16 weeks is safe. Don’t overtreat or consider only what's best for your muscles and skin.
  • Chandler: “So basically every four months is your recommendation.” [12:17]
• Types of Neurotoxins:
  • Botox, Dysport, Juveau, Daxify, Xeomin, Letybo—manufacturing differences mean not all products are interchangeable.
  • Allison trusts “Botox brand Botox” for her consistent results but emphasizes trusting your provider’s expertise. [14:00]

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3. Choosing Providers – Safety, Ethics & Taste [14:30–18:08]

• Red Flags and Credentials:
  • Only see PAs (like Allison), nurse practitioners, MDs, or RNs. Beware illegal/unlicensed “injectors” and non-medical settings.
  • “If the person you’re seeing is not one of those things, chances are they have no business injecting things into your face. And I would run away very quickly.” – Allison [16:20]
• Taste Matters:
  • Allison and hosts agree: choose a provider whose own results/aesthetic matches your goals.

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4. Botox Myths, "NoTox" Movement & Side Effects [20:57–22:57]

• Safety of Botox:
  • Biggest risk is only minor bruising or bleeding with FDA-regulated product. Cases of “botulism” have almost always involved illegal, black-market products.
  • “Botox is the most studied drug used in the aesthetic space…” – Allison [21:57]
• NoTox Movement:
  • Allison respects people opting out, but challenges blanket bashing. Key message: safe, informed choices = fine.

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5. Filler: Villain or Savior? [22:58–29:01]

• Filler Fears and Filler Era:
  • Filler “villain era” is social media’s eye for bad results, but subtle, well-done filler should be undetectable.
  • The real culprit often isn’t filler, but overuse or poor provider choices. “It’s the person behind the syringe that’s the problem, not the product itself.” [26:05]
• Compounding/Overfilling:
  • Bad “villain era” looks often come from repeat, overlapping treatments rather than single mistakes.
• Stick with One Ethical Provider:
  • Consistent care is key—providers keep records and can track changes, preventing filler blindness.

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6. Treating Specific Areas: Smile Lines, Smokers Lines, Under Eyes, Neck, and More [29:03–35:54]

• Smile Lines: Filler can help, but supporting skin quality (microneedling, lasers, retinols) is foundational. [30:12]
• Smoker’s Lines & Under Eye Circles:
  • Multi-modal approach: lasers, microneedling, Botox, little filler (Skinvive product), and in severe cases, surgery (blepharoplasty).
  • “I almost never put filler under the eye because there’s lots of issues with it, but normally it’s not the solution.” – Allison [34:11]
• Neck & Eyes: These areas “destined to fail”; early intervention (retinols, microneedling, PRP) delays aging.

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7. Skincare Philosophy: Minimal & Potent [38:38–43:15]

• Three Non-Negotiables:
  • Vitamin C (antioxidant)
  • Sunscreen
  • Chemical exfoliant (acids or retinoid/retinol)
  • Drugstore cleansers/moisturizers suffice for most.
• Quote:
  • “Nobody needs an 18-step skincare regimen. Nobody needs an 11-step skincare regimen. A highly effective skincare regimen… shouldn’t take you more than a minute and a half in the morning, maybe two minutes at night.” – Allison [39:02]
• Less Is More:
  • Overdoing products can irritate and worsen skin; paring back often brings improvement, even for pigment or melasma.

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8. Lasers, Microneedling, & Melasma [44:06–49:55]

• Best Tools for Collagen/Texture (esp. with melasma):
  • Microneedling, “Clear & Brilliant” and “Permea” lasers—low downtime, safe for pigment-prone skin.
• Cautions with Morpheus8:
  • Overhyped, best reserved for select use (acne scars, neck). Risk of facial fat loss if mishandled.

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9. Advanced Topics: Sculptra, Filler Migration, Dissolving Filler, Complications [49:56–55:58]

• Sculptra: Collagen stimulation, not quite Botox/filler—a useful long-term strategy, best reserved for appropriate facial zones.
• Filler Migration & Dissolving:
  • Migration is more about bad technique than the filler itself; dissolving filler is safe, but sometimes leaves the area more hollow due to stretched skin, not tissue loss. [73:13]
• Masseter Botox & Jowling:
  • Over-treating masseter can cause loss of facial volume/jowls; don’t treat unless medically necessary.

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10. Long-Term Mindset: Strategy, Dysmorphia, Consistency [66:49–69:28]

• Filler Blindness / Perception Drift:
  • People lose track of normals as they correct flaws. “One of the ways to stay looking natural is to keep photos of yourself… and continue seeing the same provider over time.” – Allison [109:27]
• Aesthetic Dysmorphia:
  • Both patients and some providers can gradually lose perspective on what looks normal or attractive. Experience of injector matters.

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11. Celebrity Work & Standards [110:27–112:02]

• Best Celeb Work:
  • Jennifer Lawrence, Anne Hathaway—discreet surgical work, gracefully done.
  • “If you look at some older photos of her compared to what she looks like now… she just looks very refreshed in a very, like, understated and undetectable way. And I think that is a surgical result.” – Allison (on J.Law) [116:26]
  • Cindy Crawford “chef’s kiss.”
• Worst Celeb Work:
  • Drake (overly sculpted abs for a non-fit body; looks odd, not chic).

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12. Miscellaneous Clinical Q&A

(Assorted answers, not exhaustive)

• PDO Threads: Allison does NOT recommend—too risky, results short-lived, better to save for “the real thing.” [99:27]
• Face Taping: No evidence it helps, possible skin irritation; not recommended. [92:23]
• Fat Transfer: “Depends on skill of your provider... can be lumpy/bumpy, must be willing to accept variable results.” [100:28]
• Ultrasound for Filler: Useful for complications; not yet essential for everyone, but may become standard someday. [78:35]
• LED Masks vs. Laser Masks: Both can help with skin tone or collagen but must avoid blue light if you have melasma/hyperpigmentation. [87:05–88:41]

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13. Provider Career Path, Training, and Networking [103:45–107:10]

• Allison’s Advice: Get into dermatology or high-volume med spa, network, learn at every opportunity, and do aesthetics full-time, not as a side gig.

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14. The Big Picture: Is It Anti-Feminist to Want to Be Hot? [102:01–103:06]

• Allison: “I think taking care of your appearance is pro-confidence. I wouldn’t say it’s anti-feminist.”
• Everyone agrees: pursuit of aesthetics is about self-care and confidence, not shame.

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Memorable Quotes

• "I plan to just get hotter as I age." – Allison Lester [05:17]
• "It’s the person behind the syringe that’s the problem, not the product itself." – Allison Lester [26:05]
• "Nobody needs an 18-step skincare regimen. Nobody needs an 11-step skincare regimen." – Allison Lester [39:02]
• "Overdone and overfilled...that's not the esthetic you’re looking for." – Allison Lester [15:22]
• "Tackle [smoker's lines] as soon as you start to see them. Once they're really severe...never going to look like nothing at all." – Allison Lester [31:22]
• "If you're seeing another provider, I don't know what they've put in your face. And a lot of patients don't know." – Allison Lester [28:03]
• "[Social media] makes it hard for normal people to feel beautiful because a lot of what we're looking at is not real." – Allison Lester [112:35]

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Timestamps for Key Segments

• Introduction & Episode Scope: 01:02–07:42
• Botox (When, How, Which Type): 08:01–14:30
• Provider Selection, Ethics, Taste: 14:30–18:08
• Botox Safety and “NoTox” Movement: 20:57–22:57
• Filler Era & Fears: 22:58–29:01
• Area-Specific Antiaging (Smile Lines, Under Eyes, Neck, etc.): 29:03–35:54
• Skincare Philosophy (Home Routine): 38:38–43:15
• Lasers & Melasma: 44:06–49:55
• Filler Migration & Complications, Dissolving Filler: 49:56–55:58
• Jowls, Masseter Botox: 55:02–61:05
• Filler Maintenance, Dysmorphia, Perception Drift: 66:49–69:28
• Celebrity Aesthetics Deep-Dive: 110:27–119:32
• Philosophy: Looking Hot and Feminism: 102:01–103:06
• Career Path in Aesthetics: 103:45–107:10

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Noteworthy Clinical Pearls

• Earliest Age for Botox: Wait for lines at rest, not before.
• Filler: When placed and managed well, should never be detectably “fake.”
• Skincare: Three core actives—vitamin C, sunscreen, chemical exfoliant. Everything else is add-on.
• Lasers: “Clear & Brilliant” for pores, mild pigment; watch out for heat-based options if you have melasma.
• PDO Threads: Not worth it.
• Fat Transfer: Skill-dependent, can be lumpy; not for the ultra-lean.
• Morpheus8: Useful but risky for facial fat loss if overused.

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Final Thoughts

This episode is indispensable for anyone who wants an unfiltered, expert-backed education on facial aesthetics. It balances deep-dive clinical advice with bigger-picture conversations about beauty, confidence, and making choices that feel right for you. Allison Lester’s guidance is clear: focus on restraint, quality providers, and consistent care. And, as both sisters agree, don’t be afraid to own your desire to look and feel great as you age.

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To book virtual consults with Allison Lester, PA:
Find her on Instagram @alisonlester_pa or call Shafer Clinic, NYC. $250 virtual consult, redeemable towards treatment if you’re local.

Transcript

[Kaitlyn Bristowe]

Fall is upon us and Macy's is kicking things off with their VIP fall fashion preview sale. We're talking an extra 30% off the best brands plus 15% off beauty. Honestly, you might not realize just how many of your favorites are at Macy's. Everything from Calvin Klein to Scotch and soda to Steve Madden. Even beauty staples like Lancome, YSL and Armani. So here's what I'm grabbing. I'm getting Ben a couple of button ups from Scotch and Soda because their fits are are perfect for guys. They have so many fun and playful options. I just know he's going to love them. And for me, I've been eyeing these Franco Sardo Mary Jane flats. They're chic, easy and I can definitely see myself wearing them non stop all over the city. And while I'm at it, since I'm on a roll, I'm also adding in some layers. Think sweaters and outerwear from French Connection and Karl Lagerfield. Macy's makes it so easy to grab all the staples I'll be living in this fall. The VIP Fall Fashion Preview runs September 25th through October 5th. Shop in store or online@macy's.com okay, I'm.

[Chandler Burr]

Going to tell you why you guys are going to love this episode. We sit down with the injector Chandler and I both go to in New York City, Alison Lester and we get into all the questions you are asking. And we don't just have a light overview brief episode with a rapid fire faq. No, no no, no. We dive deep. We get into all things Botox. The no tox movement. We we get into all things filler. We talk about filler migration. We talk about Sculptra. We talk about how to add volume in a really nice tasteful way. We talk about filler being in its villain era. We discuss all the different types of Botox. We discuss the risks of over treating, whether Botox can actually cause jowling. We get into safety and ethics regarding provider selection, credentials to look for, how to vet a provider and the dangers of unlicensed providers. We also get into why aesthetic taste and restraint really matters and what to look for when you are looking for someone in your area. And we chat all things skin care. We get into what essential products you need at home, the three essential products everyone needs, and why the 11 step routines are completely unnecessary. We get into the differences between exfoliating acids and retinoids. I mean on all these topics we go deep. This is a huge episode. It's super comprehensive. We discuss so many common skin concerns and treatments. Melasma under eye circles, neck aging, hyperpigmentation, hypopigmentation. We discuss lasers microneedling, clear and brilliant. You know, all the different lasers. IPL, MOXIE, BBL. We discuss CO2, microneedling, Morpheus 8. And then finally we wrap up discussing esthetic mindset and long term strategy. So why consistency matters. How to manage your expectations, Understanding filler blindness and aesthetic dysmorphia. This episode, I'm so proud of it. And I just think it's going to provide such a value to everyone because let's be real, I think most of us, we really want to look our best and we thank God for the aesthetics industry that, you know, STEM is really stepping up to the plate and helping us in that endeavor. And with that, let's get to the episode with Allison, which I hope is just such a valuable resource for everyone. Love you guys. Well, well, well. I'm so excited because today we are joined by Alison Lester, dermatology, Pennsylvania in New York City, and truly dear friend of the pod beauty consultant to the pod.

[Alison Lester]

You're too, too kind. I'm so excited to be here with you today. We've had a lot of fun in the office. We have. We've been looking forward to this chat. We have a lot to cover.

[Chandler Burr]

It's been a long time coming. Not to quote, you know, our favorite. Our favorite girly. But one thing I want to share with everyone. So I have a friend who is very beautiful and looks much, I think, much younger than her chronological age. Okay. She always sh. I think she always shocks people with her age. And one time, she revealed to me her secret. And her secret was Alison Luster.

[Alison Lester]

Oh, stop.

[Chandler Burr]

No, I'm serious.

[Alison Lester]

Okay, okay, wait. I know who you're talking about.

[Chandler Burr]

You know exactly what I'm talking about. People are always floored when she says that she's her age. She looks at least 10 years younger.

[Alison Lester]

She truly does.

[Chandler Burr]

She truly does. And so this is a good friend. She doesn't gatekeep. And she said, you need to go to Alison. And I think I. I did tell you at our. At our appointment yesterday, I was like, I do think you made me better. Made me better looking. So you're the most important person in my life.

[Alison Lester]

I think that's a little dramatic. But yes, I thoroughly enjoy playing a small role and helping people feel their best in their own skin. It's not like we had to work very hard. I mean, come on.

[Chandler Burr]

I think it's understating matters personally but no, I mean, this is an episode for the vain girly. So for all of the girlies who like to just be one with nature, let it take its course. Accept Mother Mother Nature's edicts.

[Alison Lester]

Good for them.

[Kaitlyn Bristowe]

Yeah.

[Alison Lester]

God bless. Not I.

[Chandler Burr]

God bless Not. Not Allison, not me. And not everyone else who's continuing to listen. This episode is all about trying to be as hot as possible, which some of us do want to be, sorry to say.

[Alison Lester]

Hot. I'm. I plan to just get hotter as I eat.

[Chandler Burr]

Yeah, exactly.

[Alison Lester]

That's the goal. Like hotter, hotter, hotter. Until like maybe 50.

[Chandler Burr]

Okay.

[Alison Lester]

And then I'm just never going to look older than that ever. That's my goal.

[Kaitlyn Bristowe]

Okay.

[Chandler Burr]

So thank you so much. That's a beautiful goal. I'm so excited you're here because I feel like you have such an expertise and one of the great things about going to your office and working with you is it's not this kind of like, off the shelf solution where there's like a set menu and you get a few things and that's it. Like, there are a lot of these, like, big chains where you go and you can get Botox or a laser or whatever where when you work with you, you. You really can give a very bespoke treatment plan to all of your clients and do like, very small amounts of certain lasers, more amounts of others. And you look at, you look at your client's skincare and basically you just provide a really comprehensive service. So I want to bring your expertise to our listeners so they can also, you know, benefit from everything you have to share.

[Alison Lester]

Welcome.

[Chandler Burr]

Okay. And also, also everyone, this, the intro sounds in any way scattered. And if I sound psychotic, it's because we are 20 minutes late starting today because it is pouring rain in New York City. Chandler just walked in and so she is going to be joining us. She happens to be in a mini skirt and flip flops.

[Alison Lester]

She looks fabulous. So.

[Kaitlyn Bristowe]

Yeah, the fashion. I just. More jeans in another episode. So anyway, perfect day for a thunderstorm, right? I might green or something on my feet because of all the puddles I stepped.

[Chandler Burr]

I mean, it is questionable for sure. Pouring rain and you look. You're about to go out to a club in Cancun.

[Alison Lester]

Well, all she needs. Yeah.

[Kaitlyn Bristowe]

Amazing. Everything. Thank you.

[Alison Lester]

Thank you. Okay.

[Kaitlyn Bristowe]

Wow. What a journey. So happy to be here. Hello to both of you. Welcome.

[Alison Lester]

We're so happy that you're joining us.

[Kaitlyn Bristowe]

Thank you. I'm so happy to be here.

[Chandler Burr]

Um, I was just sharing with everyone that this is an episode for the Vain girlies.

[Kaitlyn Bristowe]

Yes.

[Chandler Burr]

We just are trying to learn how to be as hot as possible. And Allison is gonna, you know, hold our hand and lead us down the path.

[Kaitlyn Bristowe]

This is not a crunchy episode. This is not for, you know, the people who are just trying to, I don't know, just lean into the wrinkles.

[Alison Lester]

Which, like, that's fine for them. I respect everybody's decision, but my decision is to do everything in my power to feel and look my best and as I continue to be alive on this beautiful Earth.

[Kaitlyn Bristowe]

Yes, absolutely. Okay, we got so many questions for you, like, inundated about Botox, fillers, lasers, treatments, everything.

[Alison Lester]

There's some good ones in there.

[Kaitlyn Bristowe]

There are some good ones. I mean, we could. We're even maybe going to get into celebrities and what they've had done. So anyway, maybe we just start with injectables.

[Alison Lester]

Sure.

[Kaitlyn Bristowe]

There.

[Alison Lester]

Love them. Yes. What do you want to talk about?

[Kaitlyn Bristowe]

I think a lot of people asked, should we wait? Should, you know, should this person wait for the first line, or should they be doing it, like, in a preventative way?

[Alison Lester]

It's a really good question. That's a common thing a lot of people ask me when they come into my office. I would say my demographic skews a little younger. I definitely see a lot of patients who are early to mid-20s and some who are in their 50s, 60s, and beyond. But a lot of them are younger, and it's common. They come to my office, should I be doing preventative Botox? My friends are doing it. I wanna make sure that I don't get wrinkles. And I actually have a pretty strong opinion on this.

[Kaitlyn Bristowe]

Okay.

[Alison Lester]

I don't think you need to be getting injectable treatments until there is some sort of indication for it. So until there is a fine line on your face at rest, meaning you're not moving your face and you're seeing a little wrinkle at the side of your eyes or in between your eyebrows. That's an appropriate time to start Botox.

[Kaitlyn Bristowe]

Right.

[Alison Lester]

Until then, you're protecting your skin from the sun. Good skin care regimen at home. Maybe some, like, chemical peels or something like that. I'm sorry, I keep hitting your microphone. Yeah. So maybe some chemical peels. Wearing sunscreen, Good skin care regimen at home. That's the proper place to start before you start really seeing fine lines and wrinkles on your face.

[Kaitlyn Bristowe]

Right. No, I completely agree. And I'll just say quickly from my own experience. I didn't start doing Botox until I noticed that I had a one Wrinkle on the very tippy top of my forehead. And when I did Botox, it went away. So it wasn't like, oh, the damage was done and it was too late.

[Alison Lester]

To like, no, absolutely not. And I think that's one thing a lot of people don't really understand about Botox, is that it can remodel your skin. I'm sure you notice now when you can Botox completely wears off. You don't see that line anymore, right?

[Kaitlyn Bristowe]

Yes. Or I do see it or. No, the original one.

[Alison Lester]

Yes, the original one.

[Kaitlyn Bristowe]

Right. Well, when my Botox wears off, though, there are lines.

[Alison Lester]

Okay. But maybe not quite as severe as before.

[Kaitlyn Bristowe]

Definitely. Definitely not as severe.

[Alison Lester]

I see photos myself when I was probably 23 years old and I had resting lines on my forehead. Thank God I didn't know about Botox then because that would have been a little too aggressive and I couldn't afford it. But now when my Botox wears off, I'm like, wow, I look younger than I did when I was in my early 20s. And that's pretty powerful.

[Kaitlyn Bristowe]

I mean, the other thing I think that people don't realize is that nothing gives me glassier skin than Botox.

[Alison Lester]

Yes. Botox, it has multiple different effects. It's kind of a wonder drug, for real. But the change in your skin quality, it's just beautiful. I actually really like that glow. Some people don't like that shine or glow that they get from Botox. I think it's amazing. I love it too.

[Chandler Burr]

Trans addicted? No, I love it as well. I saw someone on Instagram say that if you get Botox every three months, your muscles, because they never basically get to work, they will start atrophying and basically, like, bad things will happen. Can you address this?

[Alison Lester]

Sure. So that's not entirely false. I would say there's some truth to that statement. Does it mean that we shouldn't be doing Botox more than once a year? Not necessarily. I think if you're over treating the muscle so you're fully paralyzing it, there's no motion at all. You're not letting it go at least 12 to 14 weeks between treatments, and you're repetitively getting the treatments over and over again, you could theoretically thin out the muscle to a degree that it could make you look more skeletal or aged, versus if you kind of wait the proper amount of time, at least 12 to 14 weeks between treatments, maybe longer, let some of the muscle activity come back. I think it's pretty safe. Some people prefer to maybe only do it twice a Year. But if you're letting your full muscular activity get back to baseline, you're kind of losing some of the preventative effect of the Botox. When it's there and it's relaxing the muscle, it's preventing these etched in lines in the skin. And if you're letting the muscle contract at full force, you're getting that tension again. You can break collagen from the repetitive motion. So. Oh, my gosh. I think if you're combining your treatments with other things like laser resurfacing and proper treatments at home to build collagen in your skin, maybe you can stretch it a little longer. I. I personally do mine like clockwork every 14 to 16 weeks.

[Chandler Burr]

You do? Okay, so basically every four months is your recommendation. Okay. There's something so gruesome about the wrinkles crunching your collagen. Is that what you just said?

[Alison Lester]

Yeah. Your muscles, assets. Think of it. It's almost like bending a paperclip back and forth and back and forth, and eventually it's gonna break in the middle. Right. It's kind of what's happening to your little collagen fibers in your skin. When your muscles contracting, contracting, contracting, eventually they give up and it breaks and we start to see little lines.

[Chandler Burr]

Yeah. Okay. Wow. Well, new fear unlocked.

[Kaitlyn Bristowe]

Absolutely. I think this is just like a, like kind of a rapid fire type question, but give us like a quick overview of like Botox Dysport. The other one. Juvenile.

[Chandler Burr]

Am I saying that?

[Alison Lester]

Juveau. Juveau, yes. So those are three of the neurotoxins that are on the market. There's other ones. There's also Daxify, Xeomin, and Latibo, which is a newer product.

[Kaitlyn Bristowe]

Yeah.

[Alison Lester]

They're not all created equally, so I'd like to say it's almost like a brand name. Pepsi versus Coca Cola. Band aid versus adhesive bandage. Not necessarily true. They all come from the same exact bacteria. Botox comes from a bacteria, and it's an inactivated toxin. There's differences in the manufacturing processes behind each of these products. The molecule size is different, so that dictates how it spreads in the skin, how active it is, and how efficacious it can be. I personally use exclusively Botox brand Botox in my practice. I do carry some of the other brands. I reserve them for specific cases if a patient really doesn't respond well to Botox brand or they prefer another product. But I find Botox brand Botox to be the most consistent and predictable tool in my hands.

[Kaitlyn Bristowe]

Okay.

[Alison Lester]

Other providers might have a preference for another one. But I think what that should tell you when you're going to see someone for one of these treatments is you trust them to make the proper recommendation for you. You don't go in asking for something specific, as you wouldn't go to your cardiologist asking for a specific blood pressure medication. It's their job to diagnose your symptoms and give you the proper treatment. So they're gonna have the tool that they're most comfortable with, and you should give them free reign to practice their expertise.

[Kaitlyn Bristowe]

Yeah, absolutely.

[Chandler Burr]

I think one of the things that is kind of scary as you're trying to figure out what to do, is knowing what provider to trust.

[Alison Lester]

Right. It's hard. Right. There's a lot of nonsense out there, but there's a lot of really great providers, too, for sure.

[Chandler Burr]

And I think. I mean, not to be awkward, but I think you're so stunning, and I think you look amazing. And I actually do think that is a very, like, a good kind of thing to look at. Like, does. Has this person overfilled their face? Do they look unnatural? Like.

[Kaitlyn Bristowe]

Well, yeah, you're, like, trusting somebody else to perfect your face. And so it's like you want to trust their vision for what. What's a perfect face or whatever, you.

[Chandler Burr]

Know, share their taste level.

[Kaitlyn Bristowe]

Yes, exactly. The same thing with, like, I think a hair stylist or a colorist. Yeah, for sure.

[Alison Lester]

Even, like a personal trainer. Do you, like, really want to hire a trainer who's not fit and you're trying to get fit, right? Probably not.

[Chandler Burr]

Right.

[Alison Lester]

But when it comes to esthetics, yes. You might, you know, take pause if someone looks overdone and overfilled, and that's not the esthetic you're looking for. So I would definitely say find someone who's perfect. Personal appearance matches something that's in line with the aesthetic that you're looking for. Personal referral. You see someone in your life who looks great, like, you want to know who they're going to. Knowing the credentials of the provider that you're seeing is super important. There's a lot of people illegally providing these procedures.

[Kaitlyn Bristowe]

Oh, wow.

[Alison Lester]

There's been a couple people in New York who've been all over the news, been arrested for getting illegal injectables from China. And they're estheticians. They don't even legally have licensure to be able to perform these procedures. So you want to know, is the person laying hands on you a physician? Are they a PA like myself? Are they a nurse practitioner? Or are They a nurse. Dentists can also inject Botox. I'm not sure I would want a dentist doing like my filler and things like that. But you never know.

[Kaitlyn Bristowe]

Yeah.

[Alison Lester]

If the person you're seeing is not one of those things, chances are they have no business injecting things into your face. And I would run away very quickly.

[Chandler Burr]

Yeah.

[Alison Lester]

I think other good signs to look for are more professional settings. The plastic surgery or dermatology office, a provider who is actively engaged in their academic community. So are they clinical trainers or speakers for companies that manufacture the products that we're using? Do you see them sharing online that they're going to conferences locally, nationally, internationally and staying on top of their game? Those are the things you want to look for. For.

[Kaitlyn Bristowe]

Wow.

[Chandler Burr]

And I mean, how, how would you even know, though, if they're like going to conferences and stuff like that? That, that almost seems like, I don't.

[Alison Lester]

Know, like a weird thing to ask you. Sit down. You're like, so tell me the last conference, the last four conferences you've been to.

[Kaitlyn Bristowe]

Name them.

[Alison Lester]

Yeah. Right.

[Kaitlyn Bristowe]

But I mean, I don't know, I think, I think we live in a social world.

[Alison Lester]

Like, I share these things. I do it. It's like all over my social media. I'll be at a training tomorrow. It's going to be all over my, my stuff. You see that? I'm there, I'm learning.

[Kaitlyn Bristowe]

I. And I think, I think the point about professional settings important, you know, like, are you getting this from like the back room in a nail salon or something? You know, like, I just think you don't always want to seek out the cheapest option when it comes to this type of thing because it really can backfire on you beyond belief.

[Chandler Burr]

Right.

[Alison Lester]

It's going to come back to the cost probably three, four fold.

[Chandler Burr]

Yeah.

[Alison Lester]

You definitely want to be in a professional setting. You want to make sure it's not inappropriate to ask what the side effects or potential complications are of the procedure you're having and ask the person, do you have what you need in your office?

[Kaitlyn Bristowe]

Yeah.

[Alison Lester]

To help me if, if that happens to me. And they should be able to tell you what those things are that they should have and they should have them in their office.

[Kaitlyn Bristowe]

This is so bad. I've never asked about potential side effects. Any treatment teacher I've ever done, I've just been like, let's go, sign me up.

[Alison Lester]

Can you do it right now?

[Kaitlyn Bristowe]

No, but it's true. You, you need to advocate for yourself.

[Chandler Burr]

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[Kaitlyn Bristowe]

They also have a ton of flavors.

[Chandler Burr]

We love the chocolate and vanilla.

[Kaitlyn Bristowe]

Those are like our go to's but.

[Chandler Burr]

They have over what, 20 flavors probably. And they're all delicious. I'm obsessed with the mint chocolate cookie one. It tastes like a thin mint smoothie. Like a gorgeous thin mint delicious shake.

[Kaitlyn Bristowe]

Yeah, I believe that. I mean I've been using all my.

[Chandler Burr]

Clean simple protein powders in my Ninja creamy and it's like I'm making delicious.

[Kaitlyn Bristowe]

Ice cream every night.

[Chandler Burr]

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[Alison Lester]

So I don't know what a botulism reaction is. Is it possible to contract botulism, the illness that comes from the bacteria Clostridium botulinum? That's where the toxin is coming from. There have been documented cases of it. It's normally come from illegal injectables. So the way that things are manufactured and monitored by the fda, the chance of that is teeny, teeny, teeny tiny, so remote that I would even argue a lot of providers don't even know that it's a possibility. It's not something that I would be concerned about. I put it in my face all the time. I wouldn't if I was truly concerned that that was a possibility. That being said, any procedure we do, there are associated potential risks or complications. Botox is the most studied drug used in the aesthetic space and specifically Botox brand cosmetics has over Botox brand Botox. That cosmetic product has almost 3,000 published peer reviewed studies in the literature. It's very established that it's safe and effective for both therapeutic and cosmetic purposes. The most common side effects would be very transient or temporary things like bleeding, bruising or slight discomfort during the injection.

[Chandler Burr]

Okay, well that is great to hear because I definitely can get my for you page can be a scary place sometimes.

[Alison Lester]

Right? But this whole like no talks thing, I think part of what that is is there's always going to be a group of people that first of all wants to go against the norm. Right. But also people who want to kind of not conform to certain beauty standards or say, hey, there's other ways and it's okay to not choose to do these things that, that I don't have a problem with, but I don't really agree with bashing other people's decisions, especially when they're doing something that is, is safe.

[Chandler Burr]

Right, Right.

[Kaitlyn Bristowe]

Yeah.

[Alison Lester]

Right.

[Kaitlyn Bristowe]

I want to get into fillers.

[Alison Lester]

Please, let's do it.

[Kaitlyn Bristowe]

I, I am scared of filler.

[Alison Lester]

Okay.

[Kaitlyn Bristowe]

I think because I, I think that I see so many Real housewives where filler has just gone so wrong. And I, I feel like. Is filler in its villain era like, or are we just like some of us just not like seeing how good it can be and how subtle it really can be.

[Alison Lester]

People are not seeing how good it can be because when it's done well, you can't tell which. I believe it's truly undetectable when it's been done elegantly and people have sophisticated work and that's where a lot of this nonsense comes from, is that it's very easy to spot. Bad Botox, bad filler, bad plastic surgery. It's really obvious, and it's unfortunate when people have these things done, and I don't know if they think they look good or they just don't know that they could look better if they had some of these things reversed and redone. But no, filler is not the villain, really. There is no substitute for it. There is nothing that can provide volume replacement in a safe, effective, precise way that filler can. The only thing that even comes close is facial fat grafting. And that has its whole host of issues that filler does not have. And it's much more invasive. You have liposuction to harvest the fat from somewhere on your body.

[Kaitlyn Bristowe]

They inject it into your face, then they do.

[Alison Lester]

Yes. And, you know, it can be beautiful, can be a really great option for a lot of people, but it can be lumpy and bumpy. It's not easily reversible the way that fillers are. It would have to be surgically removed if it wasn't esthetically pleasing. So that's the only thing that can even almost do what filler does, but it doesn't even come close. And filler, really, when it's done conservatively and done in the hands of an experienced and ethical provider, it looks beautiful, and it's not something to be feared. There, I think, was a lot of information on social media within the past three to five years that was maybe new information to the general public about some of the potential consequences or complications associated with fillers, but none of that is new information to your providers. I think for some providers, it may be changed the way that they go about doing their filler treatments, meaning that they're not refilling people on a schedule. Like every four to six months, you come and you get refilled. Because the clinical trials that we have for this product say that it lasts for 12 months. Well, if that study ended 12 months into the study, how do we know if it lasts longer or not? What we're finding is it lasts far longer than we've ever believed it did. And I would argue that's a good thing. If it's in a place where it's doing what we want it to do and it's creating a positive, like, nice aesthetic outcome, I would love for it to last forever. That sounds great.

[Kaitlyn Bristowe]

That's such a breakthrough for me because I think I. I didn't realize, like, so much of the issue with, like, people with bad filler. It's just. It's like compounding. Like, they're just getting it way too often and it's not going anywhere and they. Versus, like, one bad injection of it. I guess, like, that's kind of what I thought was happening.

[Alison Lester]

Yeah.

[Chandler Burr]

Okay.

[Kaitlyn Bristowe]

So it's really. It's. The issue is with, like, the. The too consistent of, like, repetition with it, for sure.

[Alison Lester]

And I would say it's the person behind the syringe that's the problem, not the product itself. The filler is not the problem. Yeah. Okay.

[Kaitlyn Bristowe]

Yeah.

[Chandler Burr]

They potentially want to give you that extra filler because it makes the money. Right.

[Alison Lester]

Right.

[Chandler Burr]

Wow.

[Alison Lester]

I would say an unethical provider.

[Chandler Burr]

Yeah.

[Alison Lester]

That's their take. I tell people no all day, and that's one of my talk tracks. I say I get paid when I put this stuff in your face. So, you know, there's. There's a benefit for me to say yes to you, but I'm not going to say yes to something that it's going to make you look silly or it's just not an appropriate thing to do.

[Chandler Burr]

Yeah.

[Alison Lester]

And one of my favorite things that I say all the time, too, is just because we can doesn't mean we should. Right. There should be some thought put into these things. Yes, we have something that can reverse filler, but we need to also understand if we've overfilled somebody's tissue that once we dissolve it, they're not going to go back to normal. They might need some other procedures to get to a place where things are aesthetically pleasing and it's an acceptable outcome. So really, there should be some thought put into what we're doing to our faces, and it should be an open conversation with your provider. And if they tell you no, don't get mad. You should be very thankful for them saying, hey, I don't think that's the right thing to do or not yet. Like, let's wait a year or two.

[Chandler Burr]

I mean, go ahead. Well, I also think that that is why it's just so important to find someone really good and stick with that person. They know your history.

[Kaitlyn Bristowe]

I.

[Chandler Burr]

One of the things that really impressed me when we were first, you know, meeting was you were telling me how you have photos of all of your patients from the start so you. You can always see, like, where you began so you don't kind of lose perspective essentially on how much has been done to this person. And I. I feel like if you're going to random med spa, random doctor that has a, you know, a promo going. I think it too many. Too many cooks in the kitchen spoils the broth.

[Alison Lester]

I totally agree. I totally agree. And I think you're much more likely, when you're hopping around to different providers like that, ending up kind of in the hands of someone that maybe doesn't align with what your aesthetic goals are long term. And things can start to look a little funny. Like, if I'm the only one who's been treating you, I know where I've placed your filler. If there starts to be a problem, I know how to go after it. I can use ultrasound to find it and dissolve it, things like that. If you're seeing another provider, I don't know what they've put in your face. And a lot of patients don't know. It happens every day. They come to my office. Well, I had this injected here. I'm like, was it Sculptra? Was it filler? Was it Radius? Oh, I don't know. They don't know. People don't think to ask. So I think it's important to stick with one, one person who's an ethical, responsible provider. Going to not be afraid to tell you no when something's not appropriate and lead you down a path to success.

[Chandler Burr]

I absolutely agree.

[Kaitlyn Bristowe]

Right.

[Chandler Burr]

Someone wants to know about if filler can help a smile line.

[Alison Lester]

Yes, filler can help with smile lines.

[Chandler Burr]

Okay.

[Alison Lester]

It's really depends on the person's individual anatomy, how I would use filler to tackle their smile lines. Sometimes really what they need is some volume enhancement in their temple or cheek area, and it will correct the problem. But some of these really superficial, little like, almost like a crease on the surface of the skin versus a deeper fold. I do use little micro droplets of filler and lines like that. I actually use a product called Skin Vive. It's a skin booster. It's really meant to be injected in a grid like fashion, for hydration of the skin. But it works beautifully to kind of airbrush little fine lines like smile lines. It's really great for lines around the lip, so you can use things like that. But oftentimes, really, it's a sign of loss of collagen and elasticity in the skin. It's a skin quality issue. And things like microneedling, laser resurfacing, and using retinols at home are the best way to tackle that.

[Chandler Burr]

Really.

[Alison Lester]

Okay. But I do use small amounts of fillers for those lines sometimes too.

[Chandler Burr]

Speaking of, like, those smoker lines, can you use that as well?

[Alison Lester]

There you can. I often, depending on how severe they are, I often will have my patients do a series of either laser resurfacing treatments like a fractionated CO2 if they're pretty severe, or if they're only mild to moderate microneedling treatments in conjunction with Botox for the muscle that's creating the, you know, the puckering of the mouth to relax it. And once we've done that and kind of help the integrity of the skin, I'll. I'll go in and kind of airbrush with filler some little fine lines because.

[Chandler Burr]

I've always, I've always assumed those were pretty much like unless you get some crazy fat transfer to your upper lip. Like those are inevitable someday. But is that not, is that not the case?

[Alison Lester]

There really is not necessarily. You definitely want to tackle them as soon as you see them. Okay. I use small amounts of Botox currently to kind of prevent ones on my own face because I started to see little fine lines there probably five years ago.

[Chandler Burr]

We gotta add that to my list then.

[Alison Lester]

She's creating a shopping. Yes, this is bad.

[Chandler Burr]

Okay, well that, that is great to know and it's great. Or. Sorry, I feel like I. Maybe I interrupted you. I think.

[Alison Lester]

No, I think I'm done. Wait, what else do I have to say about. Oh, focus lines. Yeah, they're very hard to treat, so tackle them as soon as you start to see them. Once they're really severe, we can make great improvements with non invasive things like lasers and injectables, fat transfers, but it's never going to look like nothing at all. So you want to tackle them.

[Chandler Burr]

Start early.

[Alison Lester]

Okay.

[Kaitlyn Bristowe]

Are there any other places like that where you're like, start early. Neck, you know, like our neck, under eye.

[Alison Lester]

Neck and under eyes areas where the skin is pretty much destined to fail. The eyes, number one area. It's like there's no hope. It's just, it's sad. It's the thinnest skin in the body. It's subject to constant motion and it doesn't have the same protective characteristics as some of the other areas of the face, like a thicker, deeper layer of the skin, hair and all of these other things. So you want to be even in your early 20s using retinol based eye creams as you start to see the changes in the skin there. Normally we start to see them in our late 20s to early 30s, things like microneedling, PRP injections, stuff like that.

[Kaitlyn Bristowe]

That's on my list.

[Alison Lester]

Definitely tackle the eyes immediately.

[Kaitlyn Bristowe]

I want to, I want to ask you A little bit more about under eyes and dark circles, because this is my number one problem area. And a lot of people also asked about it. I promise this isn't just like a, you know, a consultation for me, but for the people like me who have had dark circles since birth, where, like, where do we start? What should we be doing? I'm afraid of, like, no under eye filler. Obviously, like, that can be really scary.

[Alison Lester]

Sure.

[Kaitlyn Bristowe]

But do we just skip straight to the bleph?

[Alison Lester]

Not necessarily. So first of all, dark circles can be caused by various different factors, and sometimes it's a combination of all of these factors, and sometimes it's just one thing. So either it's from an actual herniation of the fat pad underneath the eye. That's more of like a baggy or puffy look. That's truly an anatomical issue that has to be fixed surgically. You cannot change anatomy to that degree with an injectable. No lotion potion cream is going to do anything to move a fat pad back under around anywhere else you want to put it.

[Kaitlyn Bristowe]

Okay.

[Alison Lester]

Dark circles can also be caused from pigmentation of the actual skin. So I do this thing called a pen pinch test. When I see people in the office where I'll pinch their skin up and I'm looking at two things I'm looking to see. When I pinch the skin, does it turn normal color? Is it still brown or dark? And then when I pinch it and let go, does it snap right back or does it stay tinted up? If the skin is loose, it can be creating some puffiness because more fluid can accumulate there. So maybe something to tighten the skin like CO2 laser resurfacing, that can help with pigment as well. If it's purely just darkening of the skin. Pico lasers, skin brightening, eye creams, retinols, those kind of things can help with the pigment of the skin. Chemical peels as well. Sometimes the appearance of a hollow under the eye is actually not hollowness under the eye. What you're starting to see is the bony structure and the ligaments around the eye because you're seeing some migration of facial tissue in the cheek and volume loss in the temple and cheek area. And really we need to target the cheek and the temple. And the whole under eye looks really nice and smooth and restored. I almost never put filler under the eye because there's lots of issues with it, but normally it's not the solution. There's something else going on. But definitely, I would say if you have a true anatomical issue where there's A fat pad, bulging. I would just save your money, get surgery. It's gonna be a more complete, an impressive solution and it's going to be much longer lasting.

[Kaitlyn Bristowe]

Yeah, I currently don't use any type of under eye cream because I just thought they were all kind of a hoax.

[Alison Lester]

But I think some people would argue they're just expensive moisturizers. But I think if you're using a retinol on the rest of your face, you do want to bring it up to the under eye.

[Kaitlyn Bristowe]

I currently don't.

[Alison Lester]

Maybe not every night because it could be a little irritating. Or if you're going to do it every night, put your eye cream on first and then bring some retinol under the eye. But there are eye creams with retinol and skin brightening compounds that are specifically formulated to be gentle enough to use around the eye.

[Kaitlyn Bristowe]

Okay, I'm gonna need that.

[Alison Lester]

I am a fan of eye creams. I think they're necessary. Okay.

[Chandler Burr]

If there is one thing that I post about and get so many responses, Chandler, it's early bird CBD gummies. Whenever I share them on our stories, invariably multiple people will respond and say, you thank. Thank you for introducing to me. These are life changing. Whatever magical concoction they have going on in these gummies is a secret elixir that truly, it puts me back to sleep. If I can't sleep, it helps me enjoy a meal a little more. It makes shows funnier. It makes conversation a little funnier. Have an early bird CBD before going to a party with people you don't really want to talk to. Highly recommend. Highly, highly recommend. I always tell people, if you're new to early bird cbd, start with a half of a gummy before you, you know, are about to turn in and just see how you feel. Also, I always take half and I swear a single bottle will last me four or five months. So long. Yeah, so long. It's a great value.

[Kaitlyn Bristowe]

And if you're skeptical, okay, you can.

[Chandler Burr]

Get one of the travel size packs that comes with, I believe, like three to four gummies. Okay. For literally 11. With our code, you guys, you can get a cocktail east, west, south of the Mississippi for that price. You guys go to oibcbd.com use code pop apologist for 20% off your order and we'll see you in the DMS.

[Alison Lester]

See you there.

[Kaitlyn Bristowe]

Okay.

[Chandler Burr]

Do you ever eat? Yes. Eat on your couch. Okay. We're not supposed to, but sometimes Kagan and I, we do everyone and have a little spill. Even though you use soap and water to get it out. And then a few days later, you just look and see in the sunlight all those stains. Enter the green Mitt kit from Clean Safe Products, your new sanity saver. It makes your fabrics look brand new in five minutes or less. Spray the solution, wipe, rinse the mitt and repeat. That's it. It can be used on carpets, couches, even delicate wool rugs. It works without bleach, harsh chemicals or sticky residue. The green Mitt kit is non toxic fragrance free and made with just three ingredients. One bottle of concentrate makes up 16 full size bottles so it legit lasts forever. Try it risk free. Clean Safe products offers a 30 day money back guarantee. No questions asked. Go to cleansafeproducts.com pop now to get 15 off the green mitt kit. That's clean safeproducts.com pop for 15 off the world's easiest soft surface cleaning solution. One of my favorite parts about working with you is your approach to skin care because I think that there are, there's just so speaking of eye creams, you know, moving on from the under.

[Kaitlyn Bristowe]

Eyes, I suppose, I mean I've got more things to talk about with my face, but alas, we can move on.

[Chandler Burr]

I feel like you have such a no nonsense approach to skincare and it is just a wild west out there with $1300 creams you can buy. And it's 18 steps Kim Kardashian's 11 steps skincare line. It's just there's always something new that's going to solve your problems and I think that a lot of it is snake oil. And so I'm curious or I would love if you could share your skincare philosophy with our audience.

[Alison Lester]

Absolutely. So Nobody needs an 18 step skincare regimen. Nobody needs an 11 step skincare regimen. A highly effective skincare regimen. We're talking like aging prevention and just for the overall health and cosmetic appearance of your skin really shouldn't take you more than a minute and a half in the morning, maybe two minutes at night. Okay. I think aside from a very basic cleanser and moisturizer which can just be Cerave, cetaphil, La Roche Posay, something drugstore brand, not fancy. Aside from those two things, there's really only three essential things you need in your skincare regimen and that is an antioxidant, I prefer vitamin C, a sunscreen and then a chemical exfoliant. So chemical exfoliants, there's two categories. There's exfoliating acids, alpha beta hydroxy acids, or retinol retinoids. What those do is they build collagen in your skin with continued use, and they help prevent pigmentation in the skin. The retinols. Retinoids are a little bit better at collagen building versus the acids. The acids are a little bit better at surface brightening compared to the retinols and retinoids. They're generally a little bit easier to tolerate. I think people get really hung up with trying to use a retinol retinoid and they're getting irritated and they think they're going to die this slow, painful death because they can't use it. I'm like, no, just use the exfoliating acids instead. You're still going to be in a great place when it comes to adding in other things aside from those essentials, really. I think it's only necessary if you have some sort of dermatologic disorder like rosacea or acne or a pigmentary disorder where we can add in some other things to help suppress pigment production for things like melasma or, you know, maybe have some congenital hyperpigmentation, which is darker areas of skin around the eyes or other areas of the face. Otherwise, it's totally unnecessary. You're just putting more opportunities for irritation on your skin.

[Chandler Burr]

Okay.

[Kaitlyn Bristowe]

That is, like, so enlightening. I feel like I've been consuming information about skin care for, you know, my entire existence, and I. I did not know that vitamin C was. Was an antioxidant. Like, I've. You definitely used in my routine a vitamin C and an antioxidant serum, too, at the same time. Like, just.

[Chandler Burr]

I don't know, it's just.

[Kaitlyn Bristowe]

It's very. It's fascinating hearing it like, all, like, outlined like that. And it's true and nonsense.

[Chandler Burr]

The idea that less can be more here.

[Kaitlyn Bristowe]

Yeah.

[Alison Lester]

Oh, for sure. I think there was a time when my skin wasn't looking so great. It was when I first started my career and, like, entered this space in New York City and I was just doing all the things. My skin was really not happy. It wasn't looking good. I have melasma. It was flaring like crazy, and I was doing all the things. And when I just stopped and kind of scaled it back, I saw a major transformation. Really?

[Kaitlyn Bristowe]

Yeah.

[Chandler Burr]

That is huge, for sure. I also think one of the things that I love is that you didn't always have such a perceived pristine. Like, you didn't always look so pristine. Like, you did suffer from melasma. You would never know looking at you. But you did have pigment issues and you actually have like a before and after. It's kind of like a personal trainer. I don't want to honestly get trained by someone who's genetically ripped. Like I want to. I want to get trained by someone who knows how to actually change their body and I want to work with someone who knows how to change their skin. So.

[Alison Lester]

Right. And no, my skin is not perfect. I still struggle with acne when I go on vacation and things like that. My pigment will come back out. And I think that's, that's a common thing. Someone will sit in my exam chair in my room. They're like, well, you don't need any of this stuff. Your skin's perfect. I'm like, my skin is not perfect and I didn't used to look like this. Right. I do a lot of things to upkeep my appearance. But it's now in a very manageable schedule where it's digestible. For me maybe three, four times a year am I doing something to my skin other than my daily skincare regimen. And really that's all most people need.

[Chandler Burr]

Yeah. I think that when we were chatting because I was in your office a couple days ago, you were saying like really what you need to be doing is your skincare. But then you know it to get to where you want to be. It's going to be like all of these behaviors or all of these. A few treatments in skincare compounded over probably a couple years.

[Alison Lester]

The consistency is key. It's major. Major. Especially. I don't know, you've probably talked about this before your skincare journey.

[Chandler Burr]

Yeah.

[Alison Lester]

But you have melasma which is a pigment condition and it's very tricky to treat. It will never be cured. Like it's something you'll have and managing it. People want to see this. Like people want instant gratification. Right. And that's just not what you're going to get with melasma. When you want to treat it effectively. People ask about all these lasers for it. Lasers are very tricky. With melasma there's really only two. I will use pico and clear and brilliant Permea. But you can use things that really make it go away instantly. It comes back with a vengeance almost every single time really. So I think the lower and slower you go consistent with your skincare regimen. That's the key for fading it and then keeping it under control long term.

[Chandler Burr]

Interesting. What about for people? Because I'm not the. This is my under eye moment. Chandler. Not the only one who Suffers from melasma and pigment issues. I have a question about like resurfacing. So for us that want like resurfacing lasers, but a lot of them are not safe for our skin because they can make us flare our melasma. Are we just like out of luck over here?

[Alison Lester]

No, you're not. There are options. There's options. I understand why you might feel that.

[Kaitlyn Bristowe]

Way, but destined to fail.

[Alison Lester]

Traditional microneedling is a wonderful tool. Yes. And I would start it before you really see terrible texture issues on your skin. The data, clinical data that we have for micro needling in the skin shows that it can increase collagen elastin production up to 400%. That's insane. Yeah. The fact that I don't microneedle my own skin is actually ridiculous. I'm going to start that this week. Yeah. But that the clear and brilliant permea, there's different, like wavelengths of the clear and brilliant laser. I think it's the most slept on treatment ever because it's very minimal downtime. And really with a series of four treatments initially based about a month apart, and then doing it even like twice a year, just once, it will do a lot for the skin texture and collagen building.

[Chandler Burr]

How often can we microneedle as melasma girlies?

[Alison Lester]

I would say a safe kind of regimen would be to do it maybe once a quarter.

[Chandler Burr]

Quarter.

[Kaitlyn Bristowe]

Okay.

[Chandler Burr]

Not once a month.

[Alison Lester]

Not too much. And I even kind of off label, I do some things with micro needling specifically for melasma. With Botox. With Botox, yes. So when you're microneedling the skin, you're putting something on it so that the, the device is gliding against the skin so it's not tearing and causing too much damage. And I will actually use it to deliver products into the skin, Skin brighteners like vitamin C and tranexamic acid. But I also use very dilute Botox. So there's some research that's being done injecting actually very little micro doses of Botox all through areas of melasma because there's a neurological component to the pigment production. And I've seen some pretty amazing results with that as well.

[Chandler Burr]

See, you're just, you're not going to get this, you're not going to get this level of care.

[Alison Lester]

Like, you're probably not at a mad spot.

[Kaitlyn Bristowe]

No, no, no. I like the, the first 20 minutes of our appointment where we're just like talking about like the plan, the outlook, and I'm asking you about procedures that I'M curious about is just, it's so valuable. In fact, next time I'm gonna like record the whole thing so I can remember everything.

[Alison Lester]

Well, I find if you do that, you're welcome to record it.

[Kaitlyn Bristowe]

We're gonna go live and something our.

[Chandler Burr]

Audience needs to know is that for listeners who don't live in New York and can't come into your office, they can get gain access to your expertise. Right?

[Alison Lester]

Absolutely. I provide virtual consultations. We can do them through zoom or facetime, whatever you prefer. Prefer they're 30 minute consultations. So I normally ask people to show up with their skincare products, whatever they're currently using.

[Kaitlyn Bristowe]

Yeah.

[Alison Lester]

And if it's nothing, that's fine. We'll start from scratch. But I will tailor skincare regimens or recommend kind of a treatment schedule and they can find a provider local to them.

[Chandler Burr]

Amazing.

[Kaitlyn Bristowe]

I think like just in a general sense, what, what would you say like are which lasers? I know you said you love clear and brilliant. I think it's like a little slept on. People don't realize what, like, what are your favorite lasers in general for people who are just totally, you know, like novices when it comes to that.

[Alison Lester]

So lasers are powerful, powerful tools for transforming the skin. And they really, they can do three things. They can treat red discolorations, they can treat brown discolorations, or they can purposefully destroy soft tissue to get it to regenerate in a nice uniform fashion. So that's how we can treat acne scars, surgical scars, resurface wrinkles and things like that. For most people, I think some sort of combination of an IPL or BBL laser that targets red and brown discolorations and very gentle resurfacing with something like clear and brilliant or moxie. That is most of what younger people need. If you have acne scars or more aggressive wrinkles, that's when we pull in the big guns, like CO2.

[Kaitlyn Bristowe]

Okay.

[Alison Lester]

Yeah.

[Kaitlyn Bristowe]

So it's really like the moxie. And then what was the other one you said?

[Alison Lester]

Clear and brilliant.

[Kaitlyn Bristowe]

Clear and brilliant for more of a like a glow and to like help with any type of like red or brown pigmentation that you don't want the pigmentation.

[Alison Lester]

I prefer to target with something like IPL or BPL.

[Chandler Burr]

What about Morpheus 8?

[Alison Lester]

So that's a little controversial. I think it's a little overhyped. Morpheus 8 is a microneedling radio frequency treatment that's probably the newest type of energy based device within the dermatology, plastic surgery aesthetics landscape. Within recent years and I mostly reserve it for acne scars or treating the skin on the neck.

[Chandler Burr]

Okay.

[Alison Lester]

I think it is overly done in a very aggressive manner, and it can cause fat loss in the face. It can also dehydrate the layer of your skin that all of your muscles are attached to, called the SMAs. So I think a lot of times it can do more harm than good, especially in the hands of someone who doesn't really understand what they're trying to target it.

[Kaitlyn Bristowe]

Okay.

[Alison Lester]

Target with it.

[Kaitlyn Bristowe]

Right.

[Alison Lester]

So I don't think it's bad. Again, it's one of those things that it's appropriate, and it can be a wonderful tool in the hands of someone who really knows what they're doing with it. But I find that I use it less and less. But I'm blessed to have probably 40 to 60 devices in my office. We have everything under the sun. So I normally have something when I see someone, I'm like, oh, no, this is going to be the perfect thing for you.

[Chandler Burr]

Right.

[Alison Lester]

I just find that I'm using it less and less.

[Kaitlyn Bristowe]

Okay.

[Chandler Burr]

What about Sculptra? Is Sculptra still. I know Sculptra is kind of irreversible, Right.

[Kaitlyn Bristowe]

Sculpture is like prp, right?

[Alison Lester]

No, it's not like PRP in the sense that it's something that's coming from your own body. But it. I would put it in the camp of, I guess, a skin quality product. Yeah. It's a regenerative collagen build therapy. Yes. So the purpose of it is to stimulate a response that gets your body to lay down new collagen in the skin. And what it's doing is it's creating a thicker, more fibrotic tissue in the area that it's put in. One of the reasons it's controversial is because people are talking about it making surgery impossible or more challenging. And, yes, it can make dissecting certain areas of the face a little more technically challenging for a surgeon. But there's not a facial plastic surgeon in the world who is not operating on people every single day who have had lasers, Botox, filler, and Sculptra in their face. They know how to deal with it, getting it.

[Kaitlyn Bristowe]

What is Sculptra? Is it Sculptra?

[Alison Lester]

It is essentially, if you've ever had stitches that dissolve or absorb, it's like dissolvable stitches in a liquid form. So it's plla. Poly lactic acid. Poly lactic acid. And when it's injected into the skin, you kind of have to massage it. So it stays nice and smooth and it brings blood flow to the area and it causes a very fluid inflammatory response so that your body brings in these things called fibroblasts, which lay down new collagen in the skin. So when we look at it, when we actually cut the skin open, it actually looks like these little balls are almost like thumbtacks that kind of get spread out through the area. So I don't like to use it in areas that are very mobile, like around the mouth or this part of the cheek because again, it's creating a stiff tissue but around the frame of the face where things are pretty stationary and we like these anchoring points. I think it's a really wonderful option.

[Chandler Burr]

I really think the future of medicine and taking care of ourselves really, wellness is going to be Tracking our metrics. Okay? And that is where I'm so excited to introduce you all to Function Health. If you're feeling like you're running on empty, juggling a million things and you can't figure out why your body feels off off, you need to utilize a platform like Function Health where it can give you the data that most people never get and insights you can actually act on. Inside Function. You can test over a hundred biomarkers, from hormones to toxins to markers of heart health, inflammation and stress. You can even track MRI and chest CT scans in one place over time. Top health leaders like Dr. Mark Hyman, Dr. Andrew Huberman and Dr. Jeremy London are all behind Function Health and how it can empower individuals to really track their health metrics over time. One of the most eye opening markers for me were my cortisol levels, the stress hormone. Seeing how stress was actually affecting my body made burnout feel measurable and manageable for the first time. Learn more and join using our link function is a near 360 view to see what's happening in your body and our first 1000 listeners get a hundred dollar credit toward their membership. Visit www.functionhealth.com popapologist or use gift code popapologist100@signup to own your health. This episode of Popapologist is brought to you by Progressive Insurance. You chose to hit play on this podcast today. Smart Choice Progressive loves to help people make smart choices. That's why they offer a tool called Auto Quote Explorer that allows you to compare your Progressive car insurance quote with rates from other companies so you save time on the research and can enjoy savings when you choose the best rate for you. Give it a try after this [e-mail] Progressive Casualty Insurance Company and affiliates not available in all states or situations. Prices vary based on how you buy. And we are back with the one and only, the esteemed Alison Luster. Alison, thank you so much for continuing the episode here in Williamsburg. We have departed the Midtown Studio.

[Alison Lester]

RIP Midtown studio. Exactly. I'm thrilled to be back. We had so much to talk about still, you guys.

[Chandler Burr]

So I'm sure we mentioned it at the top of the episode. There was a torrential downpour. We couldn't start the session basically until 30 minutes into it because everyone was running late, or me and Chandler actually running late.

[Alison Lester]

I was right on time.

[Chandler Burr]

Yeah, Allison was on time. And long story short, we just didn't have enough time to get to everyone's questions at all. And Allison has so generously agreed to finish out the episode here at the home studio. So thank you so much, truly.

[Alison Lester]

You're very welcome. Let's get to it. I'm excited for round two.

[Chandler Burr]

Let's get into it. Okay, so let's just go through a few of the Botox questions that we didn't get to the fun. First of which is, does Botox secretly create jowls if you do it wrong.

[Alison Lester]

That's a great question. It actually can wait.

[Chandler Burr]

I'm so sorry.

[Alison Lester]

What?

[Chandler Burr]

Cuz jowling is a big thing in my family. It's coming for me at some point. Luckily, I'm so far I'm good, but I am terrified now.

[Alison Lester]

So not the areas that most people are kind of accustomed to treating in the upper face.

[Chandler Burr]

Okay.

[Alison Lester]

Treating there does not cause jowls. What can cause jowls is specifically treating this very large muscle here at the back of your jaw. It's called the masseter muscle.

[Chandler Burr]

Okay.

[Alison Lester]

And people treat it esthetically to slim that part of the face, so makes the cheekbones look more prominent and this part of the face look more lean. But people also very commonly treat it for teeth grinding or TMJ pain.

[Chandler Burr]

Okay.

[Alison Lester]

And the reason it can cause jowls is because it's a gigantic muscle. It kind of starts all the way up at your cheekbone. It covers this whole area, and it's very large when we treat it with Botox. And it can't contract anymore. Kind of like if you stop working out at the gym. The muscle shrinks.

[Chandler Burr]

Yeah.

[Alison Lester]

So the muscle and fat and bones are kind of like the stuffing of our envelope of skin. And if you take out some of the stuffing, it has excess. So there's no longer this space occupying volume here. The facial tissue can kind of re drape and shift forward and create some jowling.

[Chandler Burr]

So, okay, yeah, I want to slim their face or want to help their, like, TMJ situation. They need to be wary of this.

[Alison Lester]

Very wary of it. And not everybody would experience that kind of phenomenon. Okay. I purposely do not treat my masseters for grinding and clenching anymore, because I get jowly when I treat mine. And we're like, about beauty over function at this point. No, that's crazy. At some point, like, I. I do need to treat them, but there's other things we can do. Sometimes I need to treat other muscles in the neck, so. So it's not pulling down on that little gel fat pad or I put a little bit of filler and the chin or along the jawline to kind of counteract some of some of that volume loss here from treating the masseter.

[Chandler Burr]

Okay. So when someone has jowling, because this is something I've considered for the future, is the. There is treatment before you go to the facelift.

[Alison Lester]

Sometimes. Yes. Truly, a facelift is most appropriate when you see that gel fat pad kind of below the border of the actual bone here, the mandible.

[Chandler Burr]

But isn't that a jowl? Like, is there anything that before then that happens?

[Alison Lester]

Well, so there's actually a fat pad here called the jowl fat pad. And a little bit of early jowling is when we start to actually see the outline of that fat pad. Like, we see a little indent in front of it and maybe an indent behind it. And the jawline, instead of being a nice straight line, starts to look like a little wave or a W shape.

[Chandler Burr]

If you start to see it on me, you're not allowed to tell me because, by the way, Allison told me that I have hypopigmentation across my arms and chest, which I did not know. I thought I just had little white dots whenever I was cold. And I thought they're maybe even charming. But then I learned they were irreversible. Sun damage. I'm so sorry. So I have to set some firm boundaries. So this is a problem I want.

[Alison Lester]

To discover on myself when it occurs. There's things that are just part of my very normal talk track that I don't realize. Like, really, patients take to heart. A good friend of mine, her friend came to see me, and we were talking about aging. I'm like, we can kind of lump people into two categories about what they experience with facial aging. There's singers and there's saggers. So some people, they really hollow out. They. They lose all of Their volume. And some people not so much, really. Things just start to move and shift and sag. And I was like, yeah, there's sinkers and they're saggers and you're a sinker. Oh. He has taken it, like, with him along with him every single day. I'll never live it down.

[Chandler Burr]

No, that's like, for sure. That's part of his identity now. He'll never. He'll never not know that he's a singer. Except he didn't know that before he entered the office. So funny.

[Alison Lester]

It's funny. Yeah.

[Chandler Burr]

No, I mean, I think knowledge is power. And the hypopigmentation thing, we're moving away from the jowls, everyone. The hyperpigmentation thing is. I'm glad you told me about it because it is relatively minor at this point. And now I'm just way more aware of putting sunscreen on my arms and chest even when I'm home. Like, you know, there's UV that's comes in through the window.

[Alison Lester]

Does. I feel like a lot of people really don't understand that. They think I'm crazy when I tell them they need sunscreen when it's cloudy and rainy outside, or even if they're just sitting by a window. Right.

[Chandler Burr]

Well. And I never lay in the sun, ever. I always am in the shade. And if I'm outside, I have sunscreen on. But you were like, no, this is sun damage. Just from normal everyday life. Walking outside or being at your house inside.

[Alison Lester]

It's true.

[Chandler Burr]

And so it's important to know I actually got long sleeve pajamas with a high neck because I'm just like. I'm just going, my default at home be a long sleeve. Right.

[Alison Lester]

Like, do we start buying UPF clothing for indoors? Oh, gosh.

[Chandler Burr]

We have to make sure the fabric is upf.

[Alison Lester]

Yeah.

[Chandler Burr]

For sake. I just. Okay.

[Alison Lester]

I mean, that's just above and beyond, like extra protection.

[Chandler Burr]

Yeah.

[Alison Lester]

But yes, I think genuinely they could wear a what? The T shirt you have on. I think fabrics, it's really only like UPF, like 8 or something like that. It's incredibly low, which was shocking to me because I think we've all experienced some point in our life where we were outdoors and clothing and everything that's not exposed was burn and the rest is not. Well, those sneaky little rays, the UVA rays, not the UVB that caused the sunburn, they can penetrate through our clothing, and that's what's coming through our windows as well.

[Chandler Burr]

Okay, well, stay safe out there.

[Alison Lester]

Godspeed.

[Chandler Burr]

I could wear Like a wetsuit around my house, maybe that. With a very thick material that could maybe do the trick.

[Alison Lester]

I'm sure Kagan would love that especially.

[Chandler Burr]

It'd be great in Puerto Rico, where it's hot.

[Alison Lester]

So hot.

[Chandler Burr]

Right. That's gonna be perfect. Okay, so basically, when you do have minor jowling, you can do a little bit of fil first.

[Alison Lester]

Yes. And that can be enough to negate any negative effect on the appearance of the jowl if you're treating the masseter muscle with Botox and.

[Chandler Burr]

Okay, but what if you're not treating the masseter muscle with Botox and you just have a little early jowling?

[Alison Lester]

Oh, yeah. So either treating the. The platysma, this neck muscle that kind of attaches to the gel fat pad there is enough to kind of just stop the pull down there and it will correct it. Or a little bit of filler right here. This area is called the pre jowl sulcus, or right along kind of the.

[Chandler Burr]

That can buy some time.

[Alison Lester]

Yeah.

[Chandler Burr]

And can we start. This is a consultation now, everyone. Can we start this on my neck for prevention?

[Alison Lester]

I don't really do it for prevention. If we're not seeing, like, bands that are popping out when you're talking and moving around, or when I have you purposefully contract your muscles there, you're not seeing a lot of, like, movement here from the corner of the mouth across that gel fat pad. I don't really think it's necessary. Necessary. You have a really nice, crisp jawline, people, where it's, like, not very defined. I do it kind of preventatively. It's not preventative. It's purposeful to contour the jawline, but you don't have any jowling that we would need to address with that kind of treatment.

[Chandler Burr]

I'm grateful you said that because I wasn't gonna ask because I didn't want the bad news. So thank you. I. I thank goodness. I have other issues, everyone, which, thankfully, Allison has addressed very well, so we appreciate that. Um, okay, so let's see here. I think that. I think that sums up basically all of the. All of the Botox questions. Like someone asks, is everyone secretly banking on dissolving everything at 70? Like, what's the long game? But I think that more.

[Alison Lester]

That's for filler. You don't dissolve Botox. Once you've injected it, it's going to do what it's going to do. It typically is active for about 10 to 12 weeks, and then it goes away. It's temporary. Yeah, that's a filler, filler thing, dissolving.

[Chandler Burr]

And so when it comes to filler though, do we all just need to dissolve everything at 70 or when we before the facelift?

[Alison Lester]

Not necessarily. So some surgeons have a pretty strong preference and they might have imaging done of your face and have you dissolve fillers in certain areas prior to surgery. Some even manually remove filler during the surgery while you're in the operating room. Yeah. But for the most part, I do not put any new filler or other bio stimulatory products like Sculptra or Radiesse into anyone's face for two whole years prior to surgery. So when I'm first meeting a patient and I think they're an appropriate candidate for a facelift or even like eyelid surgery, like a lower upper blepharoplasty, I will always ask them, are you surgery averse? Are you maybe considering having facial plastic surgery in the next five years or so? And we have that conversation. I'll tell them, here are the things I can do non surgically to make a nice improvement.

[Chandler Burr]

Right.

[Alison Lester]

But if you're considering surgery in the next five years or so, I would suggest we don't do that. Maybe we stick to Botox, lasers and skin care and really work on your skin quality, keep your skin in a good place so your surgical outcome is going to look really nice.

[Chandler Burr]

Right.

[Alison Lester]

But if someone's not really in a timeline where that's going to happen sometime soon. I use fillers very regularly and not always are they removed before surgery? I kind of leave that up to the surgeons. Okay.

[Chandler Burr]

And when you have, let's say you have a patient for many years and filler, even done in the best hands, it can migrate. Can you see it when it's migrating? Or like, do you ever use ultrasound to kind of figure out if maybe there's parts that we now need to dissolve or what's like the, what's like the maintenance of the, of this stuff.

[Alison Lester]

So I think migration is a concept that's very poorly understood. I think filler can really spread and it's normally spreading kind of when it wasn't placed correctly to begin with.

[Kaitlyn Bristowe]

Okay.

[Alison Lester]

And it's very easy to place filler in the, in the wrong kind of layer of the tissue.

[Chandler Burr]

Okay.

[Alison Lester]

It's really hard to tell sometimes what layer of tissue you're in. And even the most advanced expert, expert injectors can be placing something within your muscle when they think it's actually on your bone or in the fat. So what we see when we use ultrasound Is oftentimes when we're finding filler that we thought was on the bone, it's not at all. It will end up in the muscle or somewhere else. So the muscles in the face are moving. The product wants to follow the path of least resistance. Certainly just the biodynamics. The facial expression, over time can kind of push and move things around. So what the most important thing is, is not like going searching for it. It's just having a trained eye looking. And if we start to see some fullness in an area that maybe filler wasn't intentionally placed or shouldn't really be there, it needs to be taken out to have a good outcome. Very commonly I see this in the under eye area and around the lips. So I see lip filler end up all out here all the time. And people come in and, you know, I want more filler in my lips. Like, you just can't see them anymore. And I have to tell them, you know, adding more filler to your lips is not going to do what you think it's going to do. It's actually just going to weigh them down more and curl them under. And if we just remove the filler that's moved outside of the lips, normally immediately their lips look fuller because there's not all of this shadowing and fullness around the mouth, distorting the volume. So it can be kind of a necessary evil when you're having filler treatments to have to dissolve it at some point in time. I don't think dissolving filler should necessarily be seen as a negative thing. I think you should kind of accept it as a possibility of you might have to take it out at some point in time and maybe refill to maintain a really nice result.

[Chandler Burr]

Right. Okay. I mean, that. That makes total sense. I'm curious. I feel like you have such a keen eye and you also don't have any filler blindness. Like, you know how I think some people.

[Alison Lester]

You mean for my own face or look?

[Chandler Burr]

Obviously you look impeccable. And all of your patients, all your before and afters, everyone looks so natural, everyone looks amazing. And then you honestly come into contact or you see injectors who clearly have some filler blindness, where I think that they. There are at least a different aesthetic, maybe.

[Alison Lester]

Sure.

[Chandler Burr]

I'm curious, like, what you would chalk that up to? Do you think that. I guess, is it probably a taste thing?

[Alison Lester]

Some of it can be taste. As far as when you see, you know, people who provide these kind of procedures looking a little funny or looking Overdone. Maybe that's an aesthetic that they find attractive or appealing. But some of it is true dysmorphia. So body dysmorphia, where you show them a mirror and they genuinely do not see what you're seeing when you look at them. And there's a whole kind of spectrum of this. I see it in patients all the time. They'll come in, you know, I've even had a patient say, you know, I like, I touched my nose like this and it stayed like that. Or when I push my cheek up, like, now it's too full there. And I'm like, that's not possible. Those things don't actually happen. But you can't convince that person that that's not real.

[Chandler Burr]

Yeah.

[Alison Lester]

So truly, some of it can be a disorder. Some of it just poor taste or maybe poor understanding of what the normal human anatomy looks like. So I think my eye for aesthetics has evolved a lot over the course of about 10 years, I think when I look at faces now, even when I look at other people's work or work that was done on my own face, like, 10 years ago.

[Chandler Burr]

Yeah.

[Alison Lester]

I don't really like what it looked like 10 years ago, but I'm like, oh, at that time, I didn't realize that I didn't have enough of a transition between my lower eyelid and cheek. Or I was too full here or there. And now I know how to see those things. So some of it just comes with experience as well.

[Chandler Burr]

For sure. It's like a visual vocabulary. I'm sure you develop and refine as you're looking at so many people constantly.

[Alison Lester]

Yeah. And I think you get. When you're seeing a lot of faces over and over again, especially faces that have never been touched, and you kind of can appreciate what normal changes look like that are associated with aging and certain normal anatomic variants, it's more obvious to you what has been created by.

[Chandler Burr]

Interesting.

[Alison Lester]

Some sort of intervention. Yeah. Versus what's. What's natural and normal.

[Chandler Burr]

Every fall, we're dying to rotate our closets. We pull out the sweaters, the boots, the coats, but somehow we forget our homes. They're still stuck in summer. And, yeah, I'm guilty too, everyone. But honestly, our spaces deserve a fall refresh as well. And Macy's is making it ridiculously easy with their fall fashion guide for your wardrobe and your home. I just love changing up my space. I love changing it up, you know, based on my mood, based on the vibe, or based on the season. And I feel like sometimes you know, like, bedding, pillows, it can all get a little stale. They have great, like, pillows and, like, down comforter inserts. Like, the stuff that you need to really spend a pretty penny on because it's, like, stuff you're using all the time.

[Kaitlyn Bristowe]

I mean, think about how much, you.

[Chandler Burr]

Know how many hours you spend sleeping.

[Kaitlyn Bristowe]

On your pillow, using your duvet.

[Chandler Burr]

Absolutely. Also, kitchen utensils, pots and pans. Sometimes I'm just, like, looking at these things and I'm thinking, how long have I had them? It's time for a new, cute cookware set. I was telling Kagan I want to get one. And the perfect place to shop for all your new home needs for fall if you're looking for a revamp is Macy's. You gu. They have incredible sales in so many good brands. They have Calvin Klein. They have Charter Club Hotel Collection, Mackenzie Childs. Like, all of the appliances that you want by all the chic brands are available at Macy's. They absolutely are. I think a really nice way to just introduce some hominess. If you have a room that's feeling a little bit bland is with some nice, like, heirloom layers focusing on textures, vintage prints, checks, stripes, items that just add elements of interest. Macy's has you covered in this arena, everyone. They have Charter Club, Ugg Art studio brands that really can facilitate this exact endeavor. I mean, they've also got the status symbols, like, you know, a smeg or a kitchenaid. Le Creuset.

[Alison Lester]

Yeah, absolutely.

[Chandler Burr]

I love a little Le Creuset flex. And Macy's can get you that flex at an incredible deal.

[Kaitlyn Bristowe]

Oh, I completely agree.

[Chandler Burr]

I mean, is there anything chic than.

[Kaitlyn Bristowe]

Being like, oh, I'll just, just.

[Chandler Burr]

I'll just pull out my Le Creuset. I'll just pull out these. This. This sturdy cookware. How it looks on an Instagram story.

[Kaitlyn Bristowe]

Perfection.

[Chandler Burr]

Perfection. Also, I know that, like, chic country is really the thing this fall, so people love a good houndstooth jacket. They love a plaid. Well, introducing those elements into your home as well can just make you feel like you're in a Cotswolds cottage.

[Kaitlyn Bristowe]

Simply stunning.

[Chandler Burr]

I mean, also, you might be hosting some holiday parties. You might want some new stemware. Okay, it's time to, you know, get rid of those. Let's. Let's just face it. Those ugly wine glasses. And let's get some, like, massive, chic thin stemware.

[Alison Lester]

Okay.

[Chandler Burr]

And they have chic brands for that. Oak, Villeroy and Bach Godinger. I mean, there's just so much good stuff at Macy's and I feel like people don't realize that it's actually not as expensive as you'd think. No, it's almost always at some type of discount. Major steal. Yeah. You guys, if you're looking to refresh your wardrobe or your home for the fall, you need to go to macy's. Shop@macy's.com or in store. For your fall wardrobe or home dreams, shop@macy's.com or in store. It's so interesting, and I'm curious of another filler question. When you dissolve filler, is there any chance that natural facial tissue will also be dissolved?

[Alison Lester]

So there is no evidence to support that whatsoever. It's actually a kind of a hot debate within the medical community because you'll find online people sharing their experience having dissolving procedures, and you cannot convince them that it did not destroy their natural tissue.

[Chandler Burr]

Right. Okay.

[Alison Lester]

But the way that we use it and the way that it's been studied, there's no evidence of that.

[Chandler Burr]

Okay.

[Alison Lester]

Okay. I'm a very firm believer and believing patients I don't like to gaslight patients I have seen funny things happen.

[Chandler Burr]

Okay.

[Alison Lester]

And patients I've seen that I've had to dissolve their filler. And I'm like, yeah, I think it is more hollow here than it was before. But is that a product of the dissolver itself, or is it really that the tissue had been stretched to a certain degree by the filler product that was there? And then once we get rid of it, you're not really returning to baseline, you know, so it can look more hollow than it did before, but depending how long the product's been there, there's also aging that's happening.

[Chandler Burr]

Yeah.

[Alison Lester]

Things are changing. So we don't. I think we don't really know. Some people are going to come after me for saying that. They're going to be like, no, it absolutely 100% does not destroy normal tissue. But I think there's far too many, like, anecdotal experience experiences of people talking about the things that, you know, have gone wrong for them, that I am of the camp of believing them.

[Chandler Burr]

This is just such a nuanced answer because you were like, there's no evidence. But people do say that they experience this.

[Alison Lester]

Right. And what. What that means for me, it's not that dissolving is bad. It's literally our only emergency tool.

[Chandler Burr]

Right.

[Alison Lester]

When it comes to things that can go poorly with filler, especially something very acute, like, of the moment, like blood flow is being blocked some way, it is our only emergency tool and we have to be able to use it. Yeah. And sometimes the potential risk that maybe something will look a little more hollow or a little more deflated is preferable to the distraction or distortion of what's going on with filler that. That needs to be removed.

[Chandler Burr]

Right.

[Alison Lester]

It's kind of the only option.

[Chandler Burr]

Well, and I mean, not that. Not that a surgical like procedure should be the solution. And I'm sure it's not a perfect fit always, but you know, there is fat transfer if, you know, if you feel like you've been over hollowed by dissolving filler or something like that, for sure.

[Alison Lester]

And sometimes that's. If people have a large amount of filler that's creating something that's visually distracting and I need to remove it. That is a conversation I have. I had that with a patient last week.

[Chandler Burr]

Oh, really?

[Alison Lester]

She was new. She has been seeing someone in the city for many, many years. Very well respected physician. I don't think this physician did anything wrong.

[Chandler Burr]

Yeah.

[Alison Lester]

I think it's just she has some filler in places where it's distorting her face shape a little bit and it needs to be removed. But just feeling her tissue and seeing her age and the quality of her skin, I have to tell her we actually don't know what you're going to look like when we get rid of this. When we break it down, you need to expect that we're probably going to have to do some procedures to stimulate some collagen in the skin to get it to tighten back up. We might need to refill you in certain areas or especially around your under eyes. Once I remove all this, the correct answer might be surgery. And is that something you're okay with?

[Chandler Burr]

Right.

[Alison Lester]

And sometimes they're not. It's a big emotional decision and I won't do it if, you know, they seem really uncertain. But yeah, it's just the reality of the situation for sure.

[Chandler Burr]

Okay. So speaking of filler in places that are kind of dangerous and you need to use hyaluronidase, the dissolver. Do you do liquid rhinoplasties?

[Alison Lester]

Do you? What?

[Chandler Burr]

Do you have any thoughts on those? And also under eye filler.

[Alison Lester]

Sure. So let's start with the liquid rhinoplasties. So I don't do a whole lot of them. I will in very special circumstances do it. And that normally is if someone is happy with the shape of the tip of their nose. Things are reasonably nice and straight, but maybe there's a very defined hump right here. A dorsal nasal hump. A Little bit of filler right above it or right below it is enough to straighten it out. Aside from that, I think.

[Chandler Burr]

How dangerous is that, though?

[Alison Lester]

Very dangerous.

[Chandler Burr]

It's still very dangerous.

[Alison Lester]

Yeah.

[Chandler Burr]

So are you scared when you're doing it?

[Alison Lester]

Not scared, but there's certain things that I do. I do have ultrasound. You know, I can look for blood vessels if I need to, that sort of thing. Always staying directly midline, injecting very slowly. I always aspirate, like draw back to make sure I'm not in a blood vessel. That's not necessarily foolproof, though. Okay. So that's one of the reasons why I kind of stray away from doing it. In general, there's only a certain amount of filler product that the tissue here can accommodate, where even if you're not directly injecting filler into a blood vessel, it can stretch, you know, the skin or disrupt the blood supply to the cartilage there enough that there's an issue with the tissue being able to get blood supply and survive. So it's dangerous. Normally I think it makes people's noses look larger for sure. And I don't think it's a great option. So it's something I really stray away from. And again, that is like the instance that I just described, this teeny little hump here. And they could use a little right above and below. It's like the only time that I will do it and I do it very slowly with very small amounts of filler.

[Chandler Burr]

Okay, another filler question. Should we only trust injectors with ultrasound or is that just med spa gatekeeping?

[Alison Lester]

So I don't think you should only trust providers with ultrasound. Right now there is no recommendation for doing ultrasound guided filler injections or, you know, for neurotoxin, you know, your Botox to support all of that. Really not necessary. It is most useful in the event of complications or when dissolving filler. So purposely finding the filler because you want to see on an image the needle going into it and know that you're treating the actual filler to dissolve it so you're not affecting the surrounding tissue with the dissolving medication or if there seems to be a disruption in blood supply or something, maybe some filler got into a little vein or an artery, looking for the blood supply and then injecting, dissolving medication and seeing if the blood supply comes back. So most useful for complications. I don't think it should be a requirement that you find an injector that's using ultrasound to do your fillers it's nice to ask them if they have it in the event of a complication. But I think what you will find is you're, they're probably going to say no. I think it's becoming more common that people are getting trained on using ultrasound and my hope is that within the next five to 10 years it will be more commonplace in every injector's office.

[Chandler Burr]

But most people don't have it.

[Alison Lester]

No. And for many, many years, I mean, mean we've, we've functioned without it. I think it is a useful tool. I just think it's, it's not something that's going to be the standard of care for quite some time. But for complications it certainly is a nice thing to have in the toolbox.

[Kaitlyn Bristowe]

Okay, great.

[Chandler Burr]

Can we talk about smokers lines for a second? Is this something that everyone is going to get at some point? Do, do, do you only get them if you smoke or you're a straw enthusiast? Speak to us.

[Alison Lester]

So not everyone who smokes gets them and not everyone who gets them is a smoker. Wow. But you can certainly get them if you're a very diligent straw user. It's more common, certainly more common in females than it is in males. It is incredibly challenging to treat smoker's lines. They can be very stubborn. So it requires a multifactorial approach usually. So normally it requires lasers, some sort of an injectable like a filler or maybe PRP or something to regenerate new collagen in the area. And also Botox. So Botox to help stop the muscular contraction, the puckering movement is that the lip can be helpful, essentially a lip flip. But you know, it can be done a little differently to prevent those lines or try to treat them. Usually I use little droplets of filler if they're very mild. A specific filler that's really meant for skin hydration. It's called Skin Vive. It's a Juvederm product. I love to use that for the, the lines around the lips. That is an off label use of that product. But it works beautifully for the smokers lines. If they're very, very mild. I'll use that in conjunction with Botox if they're a little deeper. I normally like to do laser resurfacing first and my go to for that would be be a fractional CO2 laser. So a real laser, not like a gentle resurfacing, you need to really damage the tissue.

[Chandler Burr]

But that's the fractional CO2 that's the one with like the 10 day recovery, right?

[Alison Lester]

Well, the fractionated version, really within five days, people are in makeup and they're looking pretty good. They're not fully healed at that point in time. They're probably still a little pink and blotchy, or if I go really, really deep, closer to seven days, that they feel like they're. They're on the men's. But the old school CO2, where we treat 100% of the surface area for sure, like two weeks to a month that people were really healing from it.

[Chandler Burr]

But that's the fully ablative one.

[Alison Lester]

That's the fully ablative. So the fractional CO2, it's ablative as well. But if you think of like a little square, that's like the stamp of the laser. The fully ablative treats 100% of that fractionated. I'm normally treating somewhere between 30 to 50% of that surface area. So there's little circular columns within that footprint that get treated by the laser. And the skin between them is left unharmed. And it helps to heal a lot more quickly and also prevent any kind of distinct transition in the color of the skin. So the treated skin could look lighter than the other skin when you treat it at 100% surface area, especially in someone who has darker pigmented skin.

[Chandler Burr]

Okay, I'm curious, if you have melasma and you are not a candidate for CO2, can you still do CO2 and then just work on the melasma after if you just feel like you have.

[Alison Lester]

Bad texture issues, potentially. So I, I would put someone in that category on a very specific skincare regimen prior to lasers to suppress the pigment production and depending on other factors, maybe even some oral medication as well. Okay. And then we would kind of see, I have treated patients with CO2 who have melasma and I have not seen it flare. Oh, great. But I don't think you can, you know, blanket that to everyone and say, that's going to be the experience of everyone. With melasma, certainly the heat involved can be enough to cause it to flare.

[Chandler Burr]

Right. But if you do get it and you do flare, you can just afterwards work on the melasma. But you've improved your text texture.

[Alison Lester]

This is true. It's not fun to have to treat it afterwards. Anyone who has melasma knows inevitably there's times where it flares and you have to get it back under control.

[Kaitlyn Bristowe]

Right.

[Alison Lester]

It would be a similar situation.

[Chandler Burr]

Okay, that makes sense. So now that we're on the topic of lasers, let's get into a few more Questions? Someone says best laser for pores the size of moon craters.

[Alison Lester]

Oh, moon craters. I think it's probably a little bit of an exaggeration, but, you know, your opinion's valid. I'm not trying to say that you don't have large pores. Maybe you do. I think my favorite treatment for enlarged pores that makes the most improvement is actually clear and brilliant.

[Chandler Burr]

Really?

[Alison Lester]

Or moxie is another version of it. There's another one called ultra. So these are non ablative fractionated lasers. I think they do a better job than fraction axle, actually. Or even some of our more aggressive laser resurfacing. Really? I don't have a great, like, I don't have a great rationalization for why. Yeah, I'm really not sure. That's just what I observe when I treat people. So I like to make sure that if you're complaining of enlarged pores, you're using something that's kind of knocking down the oil production. Our pores are an elastic structure, so if you're creating a lot of excess oil, they're going to expand to fill with oil. But if you're using a lot of, say, salicylic acid to help break down that oil, if the pores aren't full, they will snap back close. So definitely want to be on a proper topical regimen. And then I really like to use clear and brilliant in my practice.

[Chandler Burr]

Okay.

[Alison Lester]

Enlarged pores.

[Chandler Burr]

Didn't you say that fraxel made your melasma worse?

[Alison Lester]

It did. This is true. Yes. Yes.

[Chandler Burr]

That is so crazy, because now you're like, melasma free.

[Alison Lester]

For the most part. Yes, I am.

[Chandler Burr]

And because I was thinking of doing a fraxel just to like, rip a lot of this shit off, but you basically have said it's like, not the solution.

[Alison Lester]

Not always. So again, I don't think I can always compare my experience to someone else's. It's a very individual thing. But I am not the only person that I have seen melasma flare in after a fractal axel treatment. It can be the degree of the heat generated by the laser and how deep it's penetrating into the skin. So the clear and brilliant, also moxie and ultra laser, these things, they, they don't penetrate quite as deep. I treat with more moderate settings on that laser for someone with melasma. And historically I have not seen that flare. I have 100% seen melasma flare with fraxel treatments.

[Chandler Burr]

Crazy. Okay.

[Alison Lester]

Even though there's like a very defined, like, protocol for treating melasma with Fraxel, I have not had great success with that.

[Chandler Burr]

Okay.

[Alison Lester]

But, you know, maybe that's a me thing. I'm not sure.

[Chandler Burr]

Okay, well, that's. It's good to know. Someone wants to know about LED masks versus laser masks. I didn't know there were laser masks. I.

[Alison Lester]

You know, I didn't either. And you shared some of these with me before we did this episode. Episode in the studio. And so I looked it up, and yes, there is a laser mask. So the concept is the same. It's kind of using a certain wavelength of light that's absorbed by the skin that can calm inflammation and boost collagen production. So it can make the skin look brighter and help combat some aging changes of the skin. The biggest difference is. Well, first of all, let me just say, like, yes, I think these things actually do work.

[Chandler Burr]

Oh, you do?

[Alison Lester]

Okay. So I don't think they're 100% necessary, but if you have, you know, some discretionary income to spend on these kinds of things. Yeah, I think it's a worthy purchase.

[Chandler Burr]

Okay.

[Alison Lester]

I wouldn't purchase it if you're not going to use it at least, like, three to five times a week. I would recommend using it every single day if you're going to be doing it. And the biggest difference between the LED version and the laser version is really, like, how concentrated the light is. So the laser can be more of, like, a very uniform, direct penetrating light. It could theoretically be a little bit more effective than an LED light. But have seen the LED light masks. They actually do work.

[Chandler Burr]

Okay, what about if you suffer from hyperpigmentation? Should you use them still or. No.

[Alison Lester]

So hyperpigmentation in general, I think it's fine if you have melasma, I would trial it, make sure it's not making things darker. But you want to make sure that you are not getting an LED mask that also has blue light.

[Chandler Burr]

Okay.

[Alison Lester]

So there are masks that combine different wavelengths of light and the. The lower wavelengths. So the ones that are in, like, the 500s or even low 600s, they can stimulate the production of the pigment in your skin. So you want to make sure that you have the ones that are, like, in the high 700s or low 1000 is, like the number of the wavelength of the light. Those are going to be safer for people who have melasma or hyperpigmentation. The heat component would be the concern with those. For the melasma, I would maybe test it for a week or two, and if you even think at all that you're getting a little Darker, I would stop using it.

[Chandler Burr]

Okay, what about, what if you suffer from redness? Is this going to help with redness? Like if you have rosacea or any of those issues?

[Alison Lester]

So it could potentially help with redness from rosacea because rosacea is an inflammatory disorder and it can kind of calm some inflammation, disrupt some inflammatory pathways. So it would seem like something that's putting heat on the skin can make your redness worse, but it can potentially make it better. It's certainly not a cure all. If you have true rosacea, you're much better. Getting an in office laser treatment, some prescription topical medications.

[Chandler Burr]

Okay, great. Okay, that's good to know. Can CO2 lasers compromise your later facelift? Is it sabotage for later surgery?

[Alison Lester]

Not necessarily.

[Chandler Burr]

I think if it's potentially, yeah, that's an easy answer.

[Alison Lester]

I think what you can see when these ablative lasers are done too aggressively, also microneedling radio frequency, is that it can cause some changes to fat tissue in the skin or even some potential scar tissue that's just a little harder to work with.

[Chandler Burr]

Okay.

[Alison Lester]

But if it's done pretty conservatively and it's not too aggressive, the better your skin quality, the better your facelift or surgical outcome is going to look. Right. So if you're thinking of having surgery in the future, I wouldn't say like, you know, swear off getting any sort of laser procedures. Just make sure, sure you're going to a reputable provider, preferably at a dermatology or plastic surgery office, and who knows your surgical plan? Yes. And, and make sure that you know they've been doing it for a long time and even ask, say, hey, I'm, I'm planning on having surgery in the future. Is that going to change how you would treat me? And if so, why? Make sure you're informed about what's happening with your procedure.

[Chandler Burr]

Okay. Someone wants to know if you can only do one treatment per year in your 30s, what is the, the most valuable product? Is that probably so patient dependent or is it Botox?

[Alison Lester]

I don't know. I guess it would be under like what lens you're asking that question. Is it for anti aging? Is it just for overall?

[Chandler Burr]

I think so. I think for anti aging.

[Alison Lester]

Anti aging, I would say, I would say Botox. Even if it's just once a year, I would go with Botox because if you're, you're using the right things at home, I think a very consistent skincare regimen can do more for you sometimes than lasers or chemical peels. If you're doing the right things at Home. Nothing can replace Botox. There's nothing that even comes close to that kind of effect. There's all sorts of things that are marketed as, like, Botox in a bottle and face taping and all these things. I'm sorry, none of them are weakening muscle contraction. They're not really going to prevent those kinds of lines from forming.

[Chandler Burr]

Do you have any thoughts on face tape? On if it's worth the hassle and discomfort?

[Alison Lester]

I don't have a strong opinion on it. I don't want to totally trash it.

[Chandler Burr]

Okay.

[Alison Lester]

But I don't think it's doing anything, probably.

[Chandler Burr]

Yeah.

[Alison Lester]

I certainly would test the adhesive somewhere on your skin to make sure you're not allergic to it before putting it all over your face. Otherwise, you can have some very interesting red rashes on your face for a week or two. I don't. I don't see how it could be helping a whole lot, but, yeah, in general, I don't think it's harmful.

[Chandler Burr]

Okay. It's a very diplomatic answer. I had an allergic reaction to some silicone tape that Allison actually very helpfully prescribed me the correct medication. The first doctor. I went to a doctor for help with it, and he actually incorrectly diagnosed me and prescribed something that was making it worse. And then I was talking with Allison, and she sent me on the right path. And within a day after. After using what you prescribed, it had majorly calmed down. But anyway, it is no joke when you have a reaction to these silicone tapes. Like, it is scary.

[Alison Lester]

Adhesive irritation is a really big problem, and it's becoming very common. Oh, really? I can't use most band aids. There's a certain type of medical tape I can use. I had something removed on my neck last week, and I literally have, like, a makeshift band aid. I have to cut out a little piece of gauze and put it over the spot with ointment and then cut tape and put it on because I'm allergic to, like, every other adhesive that's on normal bandages. It's a real problem, and it's. It's not very uncommon.

[Chandler Burr]

You don't want. You're not all over your face.

[Alison Lester]

No. It's so uncomfortable.

[Chandler Burr]

Okay, this next question is a very good one because this is going to be controversial, everyone, but I. I was on a skincare program that's very popular right now and touted. And anyway, it has a vitamin C as part of it, and I sent you my full regimen, and you said to me, your vitamin C is not good enough. And you. This person wants to know if the SkinCeutical CE Ferulic is worth selling their kidney for or if cetaphil just will be fine enough. And we actually already had this conversation in person so I would for you to explain why people need to go with the skinceuticals.

[Alison Lester]

Sure. So the skinceutical C for like is kind of like the holy grail of vitamin Cs. Are there others that can measure up to it? Yes, but all vitamin Cs are not created equal. There are a few different formulations or of like the molecular structure of vitamin C that are used in topical skincare products and two of them are a little more efficacious than some of the other ones that are more commonly found. So really what you should be looking for is L ascorbic acid as the form of vitamin C that's in your product or tetrahexadecyl asorbate. Say that five times fast. So those tend to be the two most effective vitamin C, that's the ascorbic acid form. It's most stable in an oil base. Those products tend to not be so great for people that have acne and they can be a little bit more irritating. But there are versions that are in like a water based skinceuticals makes another really phenomenal vitamin C that's oil free. It's called silymarin CF and it also has some salicylic acid in it. So it helps to treat acne and it has some pigment fighting capabilities.

[Chandler Burr]

Amazing.

[Alison Lester]

So I would look for something that has L ascorbic acid or the tetrahexadecyl asorbate, the jamborini. It's some sort of like lipolyzed one. And yeah, they make all these claims that it makes it absorb better and all of these things. I disagree with that. Don't come at me like if you like your J and your skin's looking great, use it by all means. I just think if you know for you we're trying to treat your pigment. If I'm going to look at everything you're using, I think you could use something better.

[Chandler Burr]

Yeah, completely. Someone wants to know about vitamin C that doesn't make your face burn off. My vitamin C never makes my face burn.

[Alison Lester]

That's more common than you think that some people can't really tolerate vitamin Cs and normally it's the L ascorbic acid version.

[Chandler Burr]

Okay.

[Alison Lester]

That they have a hard time with. So I would say if you have experienced that using a vitamin C, look for One that has the tetrahexadecyl asorbate instead. That is a very efficacious form of the vitamin C. Can be a little less irritating and easier to tolerate than the L ascorbic acid.

[Chandler Burr]

I have a question on dosing. So it says like four or five drops. This is getting very specific, but it says like four or five drops. But I feel like when I, by the time I put the four or five drops in my palms, it's like absorbed already. And when I get it to my face, it's so little gets on there, I kind of feel like I have to do like 10 to 15 to really kind of get it on.

[Alison Lester]

I think you just answered your own question. You're wasting it by putting on your hands.

[Chandler Burr]

Am I supposed to be going like this?

[Alison Lester]

So drop it on your face instead? Yeah. If you're putting a serum onto your hands and then rubbing it around, most of it's absorbing into your hands. So you do just the.

[Chandler Burr]

This little number.

[Alison Lester]

You tilt your head back and you drop like in each quadrant of your face. So like three to four drops and then spread it around.

[Chandler Burr]

I thought that was a performative influencer thing. I didn't realize it was actually supposed to be applying skin care.

[Alison Lester]

That's how I would suggest you apply your skincare.

[Chandler Burr]

Okay.

[Alison Lester]

Unless you have all the resources in the world and you're going to have like the smoothest, brightest hand, you can afford to waste your $200 vitamin C in your pocket. No, no, drop it right on onto your face.

[Chandler Burr]

Okay. Okay.

[Kaitlyn Bristowe]

Wow.

[Chandler Burr]

I'm learning a lot and I'm so grateful for this. So thank you. So someone wants to know they've been off retinols for nine months for pregnancy. What's their re entry plan?

[Alison Lester]

Postpartum. Sure. So as soon as you're no longer breastfeeding. We also can't use retinoids during breastfeeding. You want to gradually reintroduce those kind of active ingredients into your skin care regimen. So I kind of like the rule of thumb of, you know, week one, one night a week for your retinoid. Week two, two nights, week three, three nights. And gradually increasing the frequency to the point that you can use it seven nights out of the week. Retinoids really are supposed to be used on a nightly basis. So if you can't tolerate it more than two or three nights a week, there's some other tips and tricks to kind of cut down on some of the irritation. The sandwich method. So you can put moisturizer on before the retinoid and then more moisturizer on top of it. You can use a barrier cream like Aquaphor or some sort of healing ointment around the areas where their skin folds because there's normally more absorption in those areas and those are the areas that tend to get irritated. So that's just going to kind of block some of the absorption of the retinoid into those areas, but low and slow. So start with just one night a week and slowly work your way up until you can tolerate it every, every day.

[Kaitlyn Bristowe]

Okay.

[Chandler Burr]

And can you, if you want to be more in the habit, can you just use like a fourth of the pee amount every night?

[Alison Lester]

Usually that does not do enough to kind of stop the irritation. It's better to slowly introduce it for sure. Okay.

[Chandler Burr]

Someone wants to know about PDO threads. Do you do them? Are you a fan?

[Alison Lester]

No, no and no. I do not do them. In my opinion, there's the risk to depend benefit ratio does not check out. So far more risk than benefit, pros and cons just does not check out in my mind. So threads, they're far more invasive than any sort of injection. They can cause a whole host of issues that injections do not cause.

[Chandler Burr]

Yeah.

[Alison Lester]

And we find them all the time during surgery. So I think any true result people see from them, it tends to be really short lived. It's a big expense, an invasive procedure, lots of potential complications for such a short lived benefit. It just doesn't make sense in my mind.

[Chandler Burr]

And they're so expensive too.

[Alison Lester]

They're very expensive. I think just save your money, do the real thing when the time is right. It just doesn't make sense in my mind. So I don't offer them. No.

[Chandler Burr]

Someone wants to know, is a fat transfer a chic longevity play or overhyped and lumpy in the end?

[Alison Lester]

I think it all depends on the skill of your provider. So fat transfer, there can be lumps and bumps. There can be issues with the fat not surviving once it's been taken from somewhere else on your body and injected. Maybe it doesn't create a new blood supply and live. So there's always a risk that it's not entirely smooth or that it doesn't quite take. If there's lumps and bumps, they do kind of have to be removed surgically. There's no way to just dissolve a lump of fat. So I think if you're going to do it, I would make sure you're going to someone that does a whole lot of fat grafting. And you need to have fat to take in the first place. If you're very lean and there's really no acceptable area on your body to harvest the fat, you're not a candidate for the fat transfer.

[Chandler Burr]

How much fat do you need for a fat transfer? Like, is it. I thought, like, if you're going to do a fat transfer like under eyes, isn't it such a tiny amount?

[Alison Lester]

It's a pretty tiny amount for that area versus doing say someone's full face. Or in the instance where people are getting breast surgery and they need some fat to kind of disguise the outline of an implant or something. Certainly the under eyes is going to be far less volume than that. I am not a plastic surgeon.

[Chandler Burr]

Right.

[Alison Lester]

I don't perform fat transfer, so I can't tell you the certain amount. Like, oh, you only need 50ccs. I actually don't know. I'm not sure. Okay.

[Chandler Burr]

I like these philosophical questions, everyone. So I want to know if wanting to look hot unapologetically is anti feminist or just pro confidence. I think it's just being honest with yourself.

[Alison Lester]

Are we talking about this because. Yeah, I would love your thoughts. Is. Wait, so is wanting to be unapologetically hot anti feminist?

[Chandler Burr]

Yes. Or is it just pro confidence?

[Alison Lester]

I would say that it's pro confidence. Is vanity, like shunned by feminists. I was not aware of that. I think when I think of feminism, I more think about rights maybe not conforming to certain gender norms or societal constructs of like what women should do in the workplace or at home. I don't. I guess you could maybe say part of like that whole feminist thing is like discarding the idea of needing to be like put together and looking good. But I would say it's part of self care and feeling good about yourself. I don't think feminists think going to the gym is anti feminism.

[Chandler Burr]

Right.

[Alison Lester]

So I think taking care of your appearance is pro confidence. I wouldn't say it's anti feminist.

[Chandler Burr]

Yeah. And I mean, let's be like, we all know the difference between when we run to the grocery store just, just like in a. And don't, you know, look our best. And when we've like really put effort into our appearance, we have a great outfit on, we've done our hair and makeup and we feel very different. It's a very different psychological experience. And I just think that to. To deny that reality is trying to gaslight yourself, which is a task I wish on no one. So that's my speech.

[Alison Lester]

Agree.

[Chandler Burr]

Okay, so this is a question that more gets into your Career trajectory. But someone says, as one physician assistant to another, how did you break into aesthetics?

[Alison Lester]

That's a great question. I think this is an industry a lot of people are attracted to. Yeah, I think it has a false misconception of being easy. It's certainly not. It is a true specialty. There's a huge learning curve. There's a lot to know, especially if you want to be really great at it. I dedicate a lot of time on an annual basis to continuing education. I travel to conferences. I take extra training courses. I'm still constantly learning. I think if you are not currently in a specialty, that could easily translate into aesthetics. Like you're not already in medical dermatology or some sort of reconstructive plastic surgery. The best option is to network. Go to aesthetic conferences in your area. Each, like, major city and every state has a society for dermatology physician assistants or plastic surgery physician assistants. Join those professional organizations, start meeting people, but also be willing to start somewhere. So part of my play when I kind of came into this industry was I started in dermatology. That's what I wanted to do. Medical dermatology, dermatology. It wasn't my goal to practice aesthetics. It just kind of happened. But when I started my job in New York City and I was in this Durham office, I realized what a huge demand there was for it. And that first job was not ideal. And you need to be willing to have a. Not an ideal job off the bat. And where I went from there, I was, you know, really, I wanted to be in a very professional environment. I wanted to be in a dermatology office. Office. But I left that first job and went to a med spa somewhere that had very high volume, where I was seeing 20, 40 patients every single day. And I was injecting people all day long. And that came with resources for training because it was a huge account. We were getting a lot of support from the manufacturers of the products and the aspect of training. And I learned a lot. And I knew I would position myself very well. I'd kind of be golden to any practice because they want you to come in and be able to take care this cash business and. And run with it. And that's what exactly what happened for me. So I spent about a year and a half working in a med spa. And I learned a lot. It was crucial to my development. And then I transitioned kind of back into a dermatology practice that was mostly cosmetic, maybe only 20% medical.

[Chandler Burr]

Okay.

[Alison Lester]

So networking. I would try to get in at a med Spa. Some, some places even have offer like a fellowship or training program within their business where you might work at a reduced salary for a little while, but they're going to train you and that's invaluable.

[Chandler Burr]

Yeah, absolutely.

[Alison Lester]

My other biggest kind of pointer on that one would be to make it your full time job. It's not a side hustle. So it's not a side hustle. You're going to learn a lot and you need to be able to reinforce what you're learning. You take a training and then it's not another month until you're putting a needle in someone's face. You're going to be so intimidated. And that is not. It doesn't inspire confidence.

[Chandler Burr]

Yes.

[Alison Lester]

If you're coming up to a patient with needles in their face and you're.

[Chandler Burr]

Like your hands are shaking.

[Alison Lester]

I don't know. Yeah. You want to be really confident in what you're doing and that comes from repetition. So I would suggest jumping ship and do it as a full time job.

[Chandler Burr]

Yeah. Okay. That's great advice. Let's get into this. But I will say it might be hard to answer these questions because people want to know about like how to get that gold standard refreshed but not fake look. People want specifically Kylie Jenner's early lip fill lip filler era.

[Alison Lester]

They don't want to look like that is what they're. They do. They do, I guess. No, that was bad. That was bad.

[Chandler Burr]

This is interesting because they say who's whose work sets the gold standard and how do I get it for refresh but not fake. For example, Blake Lively's nose, which I would think would be good. But then they say Kylie Jenner's lip early lip filler era, Nicole Kidman's current look. I mean, how do you, how do you avoid the Nicole Kidman phenomenon?

[Alison Lester]

So. Right. It's all very subjective and personal. Right. I can genuinely say I haven't seen Nicole Kidman in the last like couple of months. I'm not sure what she's looking like.

[Chandler Burr]

Yeah.

[Alison Lester]

Now. But there were certainly some times in the past few years where I saw her in films or in TV series. And I was kind of cringing inside because I'm like, you know, she's such a gorgeous woman and of course she's getting cosmetic work done in the line of work that she's in. And I think it was a little overdone at times. And it always makes me wonder, is it something that she was pushing for some standard and there was a doctor that took her someplace that really wasn't the best or was it in poor taste on, on the physician's part? I don't really know.

[Chandler Burr]

I'm. I mean, I get Botox and I think pretty regularly. I get Botox every four to five months. I mean, recently I got it, I think like on the, at the 12 week mark on the dot, which is not ideal. I'm gonna wait longer next time. But I think that like, I look at Nicole Kidman and I'm like, I do not want to look like crazy like that someday. I mean, how, how much Botox is, are we getting here?

[Alison Lester]

That's not necessarily all Botox. Okay. I think there's some areas of her face that were overfilled. There might be some questionable surgery going on there too. Who knows? But really, if you're sticking with Botox and you're sticking with the same provider over time, it's part of their job to keep you in line. There's this concept called perception drift. Have you heard of this?

[Chandler Burr]

I think so.

[Alison Lester]

Okay. So essentially we start off at baseline. Never had any sort of intervention in the form of injection or surgery. That's what you look like, but you're really focused on like this line at the side of your eyes. You start getting Botox and the line's no longer there. Well, you start to find something else to focus on in the mirror that bothers you. And people tend to get laser focused in on little problem areas versus looking at the big picture. So I think one of the ways to stay looking natural is to keep photos of yourself. Go back and look at old pictures and kind of remind yourself where you started and where you are now and continue seeing the same provider over time so they can kind of keep you on a path to looking nice and normal and natural and also be very honest with you. I think sometimes people end up overfilled or looking a little funny because they're trying to adjust, achieve something that's not achievable with non invasive work.

[Chandler Burr]

Right.

[Alison Lester]

So I think a lot of it is, is the provider's fault. But when it comes to celebrities and people with a lot of resources and probably some sort of power and recognition, I think it could be very easy to persuade someone to kind of go against their ethics. If they end up in a provider's office and they're asking for something that the provider doesn't necessarily think is the best idea, I could see how they might cave and agree to do it well.

[Chandler Burr]

And I'm sure you can always find someone to say yes.

[Alison Lester]

Or in people who are motivated by money.

[Chandler Burr]

Right.

[Alison Lester]

And they'll do just about anything.

[Kaitlyn Bristowe]

Right.

[Chandler Burr]

I have a question about Jennifer Aniston.

[Alison Lester]

Okay.

[Chandler Burr]

Do you have any idea, like, kind of what's going on there? It's a horrible question.

[Alison Lester]

She was definitely overfilled at one point in time, but I think she's had some of this work corrected. Okay. And she looks much more natural now.

[Kaitlyn Bristowe]

Okay.

[Alison Lester]

Before that kind of, like, filler debacle where all of a sudden she was looking a little funny.

[Chandler Burr]

Yeah.

[Alison Lester]

I think she'd been doing a beautiful job with her injections and whatever else she was doing. I think she's done a great job at aging in a very graceful way where she's obviously having some interventions, but it's very tastefully done.

[Chandler Burr]

Yeah.

[Alison Lester]

I think Cindy Crawford is, like, chef's.

[Chandler Burr]

Kiss, the gold standard.

[Alison Lester]

She has very openly said, like, she credits her plastic surgeon. It's like. Like, yes. Like, nobody looks that way without having some sort of intervention. And hers has been done very tastefully. She looks absolutely gorgeous. Okay.

[Chandler Burr]

You know who also looks amazing is Monica Lewinsky.

[Alison Lester]

Wait, I haven't seen Monica Lewinsky.

[Chandler Burr]

I think she looks better than all of them.

[Alison Lester]

Okay. I'm gonna look her up when I get home.

[Chandler Burr]

I do think having. I think she's always kind of been a little bit fuller figured, and I think that probably plays a role. Like, I think she.

[Alison Lester]

Your facial volume. Yeah, sure.

[Chandler Burr]

She looks really good and very natural. So someone wants to know.

[Alison Lester]

I mean, these are.

[Chandler Burr]

This question is so funny. Do Nebo babies. I think Kylie Jenner, Bella Dean, and Kendall Jenner make it harder for the average person to feel normal, beautiful. I mean, I think if you're spending all your time on Instagram, as a lot of us are, yes, the answer is yes.

[Alison Lester]

I think social media makes it hard for normal people to feel beautiful because a lot of what we're looking at is not real. I see this in my office on a weekly basis. I have. Sometimes it's helpful if someone shows me a photo of themselves and then how they face tune it, because I can say, oh, this is what you're seeing that you don't love. And here's realistically what I could do. But there's a big difference between that and, like, totally changing your face and face tune and saying, well, why don't I look like this? And I have to say, because that's not real.

[Kaitlyn Bristowe]

Right.

[Alison Lester]

And these people will show me all these photos of people that they're striving to look like, and they're very Obviously filtered and tuned and nipped and tucked. And it's, it's an unrealistic, unachievable goal to be, or, you know, like pedestal to be reaching for. It's not achievable. And it's one of the really nasty things about social media, for sure.

[Chandler Burr]

I mean, we shouldn't be comparing ourselves, period, to a celebrity. But if you're comparing yourself to a celebrity, please don't have it be a photo they're posting on Instagram. Maybe check out a photo of them on Getty Images and that might actually be a better, you know, reference point for what they actually look like. The other thing I, I personally think is like, there's so many, if you're in this like, aesthetics algorithm that I certainly am. There are a lot of plastic surgeons doing reels and you get served all this content that talks about all these like, micro issues and speaking to the girlies listening, sorry if this is a little heteronormative, but no guy is in tune to all of these like micro changes or this, this perfect harmonization that you might think you need because you follow certain, you know, aesthetics accounts. And I think that it's just way, it's just like way, way overdone, basically.

[Alison Lester]

So I think it is too. And I think, you know, I like that there's doctors, there's providers on Instagram now sharing factual information things. I think it's great. I think it can spread really positive, wonderful information to a lot of people. But I think we can also be part of the problem. Right? Maybe you never even knew that a nasal labial fold was a thing until you saw someone post about it. Or like, why is it, is the term deep plane facelift or deep plain neck lift part of people's normal vocabulary now? Like, they shouldn't even know what that is.

[Kaitlyn Bristowe]

Right.

[Alison Lester]

Until they need one and genuinely need one. And a surgeon sits down and explains why there's different approaches in which they would choose for them. It's kind of crazy that we're being exposed to all of this stuff.

[Chandler Burr]

Yeah, I think it's totally unnatural to be constantly kind of thinking about these things as well. Like, we just, we really have never been so hyper fixated on our appearance until we had the selfie camera, until we had Instagram stories and all that zoom call.

[Alison Lester]

My goodness.

[Chandler Burr]

Yeah, like we, I think our parents generation really kind of was blessed to not be burdened by so much of this social media stuff that unfortunately, I think we all feel like we can get a little bit down from so I think it's normal, but we deem to give ourselves, like a sanity check.

[Alison Lester]

Reality check. Yeah, it's really important. Exactly.

[Chandler Burr]

Okay, so to finish this out, someone wants to know this very profound question or the answer to this very profound question. They said if you had to name one celebrity, who's the poster child for who's done it Right. And who's. And who should have left it alone, who would that be?

[Alison Lester]

My goodness. Okay, so I'm convinced that Jennifer Lawrence has had some surgical intervention.

[Chandler Burr]

Okay.

[Alison Lester]

And I think it's absolutely beautiful.

[Chandler Burr]

Like, what kind of surgical intervention?

[Alison Lester]

I think she had a brow lift and upper blepharoplasty and maybe a very subtle facelift. Whoa. This is all speculation. I cannot confirm that anyone that I speak about has had the procedures that I'm. I'm gonna say for sure. But if you look at some older photos of her compared to what she looks like now. Yeah, she just looks very refreshed in a very, like, understated and undetectable way. And I think that is a surgical result. I do not think. Interesting. Non invasive. I do think, obviously she's getting skincare and Botox and things like that, but I think it's. It's really, really phenomenal. She looks great.

[Chandler Burr]

I mean, you would know, like, you're looking at faces all day. You know what injectables can.

[Alison Lester]

Can and cannot do. Yeah.

[Chandler Burr]

So if anyone would know, it's you. So that is a hot take.

[Alison Lester]

Love to hear it. I think she looks phenomenal.

[Chandler Burr]

I will say I do have some insider knowledge on a certain celebrity that I cannot disclose. But all I can say is that facelifts are happening younger and younger.

[Alison Lester]

And younger. Yes. And there's. If you're kind of like, did she, didn't she. She probably did.

[Chandler Burr]

She probably did.

[Alison Lester]

She probably did. Right. There's. There's some really nice, elegant work that I've been seeing in the. In the celebrity community. So there's lots of people I could shout out, but I feel like Jennifer Lawrence is one that people maybe are not so in tune to, but I noticed that kind of thing. Well, so we're up. I don't think this is, like, totally, like, not being talked about, but in Hathaway. Okay. For sure. That is surgery, my friends. That is not face tape. That's not a diet. That's not weight loss. Like, there is eyelid skin moving off of the face. There is elevation of the eyebrows. I think she had maybe a minimal access or endoscopic brow lift facelift and some eyelid surgery as well. She looks phenomenal.

[Chandler Burr]

Yeah, she does look great.

[Alison Lester]

I can probably guess which surgeon did it, because it looks a little characteristic of some of his.

[Chandler Burr]

Do you think it was Levine?

[Alison Lester]

No, I do not.

[Chandler Burr]

Oh, really? Can you say who I think it was?

[Alison Lester]

Dr. Cow. That would be my. My guess.

[Chandler Burr]

In Beverly Hills. The ponytail lift guy.

[Alison Lester]

Ye.

[Chandler Burr]

I know way too much about this.

[Alison Lester]

Right, right. It seems a little characteristic to some of his work. So that would be my guess. All speculation. Yeah, but she looks phenomenal. I think people who like no shouldn't have done it. Drake, those abs. Have you seen them?

[Chandler Burr]

Oh, I have not seen this.

[Alison Lester]

Okay, so Drake got, like, lipo sculpted abs, but the rest of his body is just not fit. It's like. Sir. Okay, hold on. Okay, that's. So let's explain to the people how abs happen. It's not from doing crunches all day long. Like, you need to be below a certain body fat percentage to have visible abs.

[Kaitlyn Bristowe]

Right.

[Alison Lester]

And when you're that low body fat, like, you're gonna see your deltoids, your biceps. So.

[Chandler Burr]

Right.

[Alison Lester]

Yeah. He's just got, like, these sculpted abs, and then the rest.

[Chandler Burr]

Oh, but it doesn't match, because abdominal lipopla or lipoplasty liposuction is the hardest that I've, you know, read about, so.

[Alison Lester]

I haven't seen it up close in pictures. It looks precious, but, you know. Yeah, I think better not, you know?

[Chandler Burr]

Okay. Better term, not. That's a good answer. That's a safe answer. Going with a guy. Okay, Allison, thank you so much, you guys. Allison is such a wealth of knowledge. So let's just repeat for people or share with people how they can work with you, what the process is. So you're in New York City. You're on the Upper east side of the Shaffer Clinic.

[Alison Lester]

For locals, more like Midtown. 44th and 5th Av. It's near Bryant Park. So that's where my office is in Midtown. I always start with a consultation for my patients. It can be done in person the same day as your first treatment. Or I do offer virtual consultations, so you can either find me on Instagram. My handles. Very creative. Alison Lester. Underscore PA There's a link in my bio for booking. You can request that it's a virtual consult, or you can call my office to book an appointment as well.

[Chandler Burr]

Okay. And if someone is not living in New York and they want to do a virtual consult, how much does that cost? What's the process?

[Alison Lester]

Sure. So you would book the consult the same exact way as someone who's local. And my consult fee is $250. Okay. If you're coming into my office for a procedure, that consult fee is deducted from any procedure that you would have.

[Chandler Burr]

Okay.

[Alison Lester]

If it's just straight up, we're doing a consult, you're gathering information, or I'm putting together a treatment plan or skincare regimen for you, the consult fee is $250.

[Chandler Burr]

Okay, great. Okay, Allison, thank you so much. You're the best.

[Alison Lester]

It was a pleasure to be here again. It was so much fun.

[Chandler Burr]

So nice of you, truly. You guys, thank you for listening. We'll be back on Friday with an episode for our global elites and then next Wednesday. Love you guys. Bye.

[Kaitlyn Bristowe]

This thing on I'm Caitlin Bristow, host of off the Vine Podcast, where I get real, maybe a little too real sometimes, with my friends and celeb guests from Bachelor franchise and beyond. I'm talking guests like Jonathan Van Ness.

[Chandler Burr]

Na na na na na na na na na na na na na.

[Kaitlyn Bristowe]

Nikki Glaser, Wells Adams, Elise Myers.

[Alison Lester]

Just like in this, like, business jacket. Like, I would love some tacos.

[Kaitlyn Bristowe]

Heidi d', Amelio, Big Brother's Taylor Hale. I have to bring it up because it happened and we're going to get through it. What I do and so many more. So come hang out with us, hear ridiculous confessions and get a little vulnerable. But because you know what? We're all just floating on this weird little planet together. Follow rate and review off the Vine Podcast wherever you listen to your podcast.

[Alison Lester]

This October, Fear is free on Pluto TV with horror movie collections from Paranormal Activity, the Ring, you will die in seven Days, Scream, and From Dusk till Dawn. This is my kind of place. And don't miss the man made nightmares in Mary Shelley's Frankenstein or the world ending chaos in 28 days later. Something in the Blood, all the scares, all for free. Pluto TV Stream now pay Never fall is upon us.

[Kaitlyn Bristowe]

And Macy's is kicking things off with their VIP fall fashion preview sale. We're talking an extra 30% off the best brands, plus 15% off beauty. Honestly, you might not realize just how many of your favorites are at Macy's. Everything from Calvin Klein to scotch and soda to Steve Madden. Even beauty staples like Lancome, YSL and Armani. So here's what I'm grabbing. I'm getting Ben a couple of button ups from Scotch and Soda because their fits are perfect for guys. They have so many fun and playful options. I just know he's going to love them. And for me, I've been eyeing these Franco Sardo Mary Jane flasks hats. They're chic, easy, and I can definitely see myself wearing them non stop all over the city. And while I'm at it, since I'm on a roll, I'm also adding in some layers. Think sweaters and outerwear from French Connection and Karl Lagerfield. Macy's makes it so easy to grab all the staples I'll be living in this fall. The VIP Fall Fashion Preview runs September 25th through October 5th. Shop in store or online@macy's.com.