Host (4:00)

You mentioned there's like no downtime for this, right.

Dr. Allenby (4:03)

Who's the best candidate? You know, it's always going to be a young person because they're the best candidate for everything. You know, if you have a lot of loose hanging skin, the sculpture works great. But sometimes the thread will kind of give a little gathered look and that's not good. Anywhere from 35 to 75 is probably okay. But once you start getting older, it becomes a little bit not such a great procedure. So you know that you kind of have to say, okay, you don't want totally wiped out skin. You know, you want somebody who has a little bit of collagen left, a little bit of spring left to their tissue that actually is going to have enough thickness that if the thread grabs the tissue, it's not going to gather up. The candidate is fairly important. But really a wide range of people do very well with these. When you're having the procedure, you know, we've learned to make it much more comfortable. Back in the day when it first started was a little more uncomfortable when you're putting. Before you put them in. We use a lot of lidocaine mixed with the Sculptra. We do it in the path where we're going to put the thread and it really makes it much more comfortable because as you can think you have something that has a little bit of a sharp little barbs on it. They do. You can feel it a little bit. It can be kind of uncomfortable and pull a little funny. So that would be kind of. The negative is they can be a little bit uncomfortable, but kind of learn to put a lot of lidocaine in. We use a lot of nitrous oxide, which is laughing gas in the office to really help people who are very pain intolerant. And I think if you can get through some of the discomfort piece of it. And that's probably the worst part about it, truly. It is a 10 minute procedure.

Host (5:34)

Wow. I mean it sounds like a great option though if you're looking for something that's like faster and you know, you don't have that downtime. Right. So.

Dr. Allenby (5:41)

Right. And you rarely bruise from this. You can, you know, you can bruise with anything, but it's. You don't normally see a bruise. You're just seeing the lift. And that is kind of like the winter, winter chicken dinner situation.

Host (5:52)

Now you mentioned the collagen that, you know, you naturally have more collagen production than after getting these treatments, right?

Dr. Allenby (5:59)

Yeah. I mean that's the nature of both products. Internal sutures, when they're closing a wound, when they're in wound healing state, they are meant to cause fibrosis, which is really collagen build, you know, so you're getting some collagen building in the area. Okay. What is Sculptra sculpture is poly lactic acid. And the way it came about, it was actually suture material that was pulverized into a powder. We Put bacteriothytic water and lidocaine in it, and that's what we injected. And, you know, it had its moment of learning curve like everything else. And we've come to the proper dilution so people don't have negative things. In the past, it was bumps and things, and it was because it was not diluted enough to kind of spread in an area. So it really is kind of a suture material that we're putting in there to create this collagen build. But we're spreading it over a zone, and then you have a suture that is more of a, you know, a solid piece that's going to be growing collagen. And so they're really both very similar product lines, and they both are meant to build collagen. And you're using them to kind of be stays, kind of like little bumpers in the area to hold what you're trying to get up. If you're using as a lifter. If I'm using it to recondition the tissue, I'm using it more like in a blanket form. So it'll grow collagen and kind of pull wrinkles out or maybe acne scars. It kind of effaces or pulls out a wrinkle or an indent of the tissue.

Host (7:23)

It's very interesting, though. I mean, I guess there's multiple uses, depending on what you're looking for.

Dr. Allenby (7:27)

You know, I mean, we use it in the rear. I build up rear ends with this. I mean, I put it in thighs. You can use it in so many ways. It's really a cool product.

Host (7:37)

So what is the maintenance then involved after you get the sculpture or threads?

Dr. Allenby (7:41)

Sculpture, you know, because back in the day, we had some bumps, and that's why we ended up putting more fluid into the bottle. So you put the fluid in, and the fluid looks amazing. Like, you look. I get a facelift because that fluid filled in the space, and it's kind of putting a preview of what's going to happen later. The fluid absorbs, it, builds collagen. While usually the first couple days, during the after phase, you're going to massage the area, and you just massage it so you don't get bumps. I mean, if you're using just Sculptra, like, as a product to fill or to create lift, usually we say you need a vial of your age, decade. So if you're 50 years old, you really need five vials to get you there. But really we kind of do two, and we just see how you do. We give You a couple months between it. Give your body some time to grow collagen. And if you really grow in and you look fine, you don't need to do more. But if you are empty, it's like, maybe you're a slow grower, maybe you're not a robust grower grower. But everybody grows collagen. So everybody really responds to this.

Host (8:41)

The kind of results that we can expect. I mean, it's going to be good because it works pretty much for everybody.

Dr. Allenby (8:45)

Pretty much, yeah. I mean, I. I think I can count on one hand and I probably do close to 1200 a year of vials of Sculptra.

Host (8:54)

Oh, wow.

Dr. Allenby (8:55)

In my whole career on one hand, people that didn't respond well with it.

Host (8:59)

Wow.

Dr. Allenby (9:00)

And it's been around since 2004, so that's a huge track record.

Host (9:04)

See, I like that. I like the treatments that, you know, they've been proven, you know, multiple for many, many years.

Dr. Allenby (9:10)

Like, I mean, honestly, they've been proven here because, like, we're one of the bigger users in the country with this. We're pretty inventive and things. Well, we're chasing age ourselves. You know, we all want to look good in here. It's not just me. It definitely is something that it can be used so safely and it's just so minimal with any risk of side effects. You know, it's very liquidy because it's really more liquid or water going in with the product. The product is so minuscule that even if you got a little on a vessel, you're not going to hurt anybody. It just goes through the system and washes away. You know, unlike a hyaluronic acid, you get that in a vessel. You can occlude a vessel and you might have a problem because you're not getting good blood flow to the area.

Host (9:51)

I mean, I think that it's. For me, when I look at fillers, you said this in the beginning for me, fillers, I. The more and more I look at people who are getting them done, I'm noticing it's just a lot of like, question marks. You know, if you're not going to the right practitioner, it becomes like a very much a gray area. And I think it's. It's better to do something tried and true.

Dr. Allenby (10:08)

Just did a social media piece on it. You know, you. You go to a surgeon for surgery, you should really be coming to a dermatologist or dermatology practice for your fillers, because that's really our ballpark. You know, that's what we're proficient in. I'm not proficient in surgery and I don't want to do them. Skincare, fillers, devices, those are all things you should be coming to the dermatology practice for.

Host (10:29)

Absolutely. I couldn't agree more and I hope people take that advice. I want to talk to Amanda now about the Ellacor.

Amanda (10:35)

Hi there.

Host (10:36)

Hi, Amanda. I want to ask you about Ellacor. Tell us about Ellacor. What is it and what should we know in terms of background?

Amanda (10:43)

Ellacor is one of the newer devices on the market. We've had it for almost. It'll almost be two years now. It's a little bit different than the lasers or micro needling with radio frequency because there's no heat, there's no energy with this device. It's little needles and they've got a hollow core. So what it's doing is it's leaving little punches to excise or take out the tissue. So really, anybody who's battling with excess tissue, instead of undergoing any surgeries to remove this, this is an option that you can go and do without undergoing surgery.

Host (11:20)

I know that, you know, in the past, people used to directly go to surgery for that, any excess tissue removal. Who is the ideal candidate then for that kind of treatment?

Amanda (11:29)

It kind of falls into that same age range of you've got to have good skin quality, you've got to have some sort of balance and collagen to your tissue to actually respond to these devices. So I'd say anybody between the ages of like 30 to 75 with that excess tissue, any of even that pre jowling where they are starting to have a little bit of the hang or wrinkling by the mouth, you know, that's often an area that people do not like to see. Or even the upper eyes. We're treating the off label to get rid of some of that excess tissue and hang so that people don't have to go that surgical route, seeing great results. It's one of my favorite devices.

Host (12:07)

How many treatments does it usually take? If you're trying to get a couple of areas, you know that they want that excess tissue. I mean, do you have to come back and forth like you come in once and then you have to come back again? Or how does that work?

Amanda (12:20)

This one, you know, it takes a little bit of time for your skin to heal from this. You have to set out a minimum of four to five days of downtime where you're a little messy looking, you know. And we have products that help to get you through that healing and expedite that if you have any certain events or anything. But it's something that you do want to plan for a little bit. You go through that healing phase, you know, you have some swelling, some redness, maybe a little bit of pinpoint bleeding to the areas that we treat that improves usually by day four or five and maybe just a couple little residual swelling and some redness to the area. Then we usually want to wait about 90 days to see the peak results of it and then space it out by doing it. A second treatment. I'd say minimum 90 days, usually sometimes even six months apart. Dr. Allenby, we did her two treatments. We did one in February and I think the second one in August. So it was a good four or five months apart that I did our treatments. And she responded well to.

Host (13:24)

That's very interesting. So in terms of like maintenance between treatments or even if you say you got one treatment, what is the maintenance that's involved?

Amanda (13:31)

It's the same with it. You're investing into these procedures. If you're investing into sculpture threads, you're investing into CO2 laser or you're investing into ella core. These are all things that you want to keep your investment going. So you want to back it with good medical skin grade products. And you also may want to do like a peel or a laser treatment in between to keep that collagen stimulated and growing. You're removing up to 2-3 cm of tissue. So when you think of it in that aspect, you know, compare that to what you can achieve with a lift without undergoing surgery.

Host (14:10)

This is really fascinating actually, because whenever I think of excess tissue removal, I think of like back in the day, you know, when people used to lose a ton of weight and then they would go through those excessive surgeries to try to get that, you know, like the excess skin off. And it was a big deal in terms of results. I mean, what are realistically, what can people expect?

Amanda (14:28)

That's what I do love about this device. One of the big things like Dr. A was mentioning on social media, everybody is going the more natural route. You know, they don't want this fake look. They don't want this tacked back look that you get when you undergo surgery. You can get good results of a lift of treating that excess skin or wrinkles around the mouth, around the eyes, you know, the excess hanging, get that tighter and lifted without that tack back fake look.

Host (14:58)

I know right now, I mean for this past year, Ozempic has been such a buzz, right? I mean, everyone's been talking about it and I'm wondering, people who've been on Ozempic, they've experienced obviously the weight loss, but then any sagging skin or whatnot, would they be good candidates for something like this?

Amanda (15:13)

Absolutely, yeah. As you, you know, you have fat and you have bone structure that helps hold up skin. As you lose some of that fat, you have that excess skin laxity. So that is a huge area and seeing really good results for those patients.

Host (15:27)

Thank you so much, Amanda. I love learning.

Amanda (15:30)

Thank you.

Host (15:31)

Hi, Danny, how are you?

Danny (15:32)

I'm good. How are you?

Host (15:33)

I'm good. I would love to understand cool peels and CO2 from you, Danny, if you could explain to us what is cool peel and the CO2 techniques that are utilized in your clinic.

Danny (15:42)

Cool peel is the specific CO2 device that we have here in office. CO2 has been around for years and years and years. This is newer technology that allows us to safely treat a broader range of skin types and also achieve better results with less downtime. CO2 lasers and cool peels are highly customizable, so we can go as light or as intense as a patient wants, depending on their skin goals and willingness for downtime. Really good for skin resurfacing, collagen stimulation, getting rid of unwanted pigment, whether it's from acne, scarring, post inflammatory hyperpigmentation, sunspots, it's really great at treating that. It's also really good at achieving a lifting and tightening of the tissue depending on the intensity of the laser as well.

Host (16:29)

Who are the ideal candidates for this?

Danny (16:32)

I think the better question who's not an ideal candidate? I would say anyone with skin that has again, concerns for any type of unwanted pigment, textural concerns, or wanting lifting, tightening, or just an overall collagen stimulating anti aging treatment are really great candidates for a cool peel or a deeper CO2 laser. There are some considerations that we like to discuss in consultations with the highest risk being for pigment for darker skin types.

Host (17:01)

Okay, great. Yeah, I was going to actually ask you about that. If you have melanin rich skin, you want to definitely do a, you know, a deeper dive into understanding how this.

Danny (17:09)

Works for the skin type, the more you have for the pigment. So up to a certain degree we can pretreat these darker skin types with a melanin suppressant, usually some sort of hydroquinone. We would follow post treatment with those products. Well, to decrease your risk for hyperpigmentation.

Host (17:25)

What's the downtime like for, for treatment?

Danny (17:27)

That really depends on the type of laser that you're getting. So our lighter lasers which we call the cool peel. They're more superficial. You're going to have about a day of swelling with some pink skin for maybe one to two days with potentially some residual for dry, flaky skin just from cellular turnover and healing. Then for our deeper lasers, we usually say it's about two to three days of, as Dr. Allenby would say, not wanting to go to Publix. You're going to have some more intense swelling, you're going to have some more intense redness, and then your skin's just going to look icky for about those two to three days. We see a big turnaround in the swelling and ickiness of the skin on day three. That's really when you can cover things with makeup, go back out in public and just continue your daily living activities.

Host (18:14)

Oh, so it's not too bad.

Danny (18:15)

Gone are the days that we're wiping out people with downtime for seven to 10 days.

Host (18:19)

A lot of us just don't have that time anymore. But. So in terms of, like, side effects, are there any side effects we should be aware of?

Danny (18:25)

I would say the biggest ones are, of course, the redness and swelling. Big one, again, is hyperpigmentation. Depending on the tone of the skin. Ones to consider are potentially, if you're acne prone, you might potentially have some purging. If you are prone to cold sores, you might have some of those surface. So we like to pre treat with Valtrex. It's generally a very safe treatment, well tolerated by all of our patients.

Host (18:48)

There are certain maintenance that you recommend right after getting the peel done or, I mean, how does that work?

Danny (18:54)

Yes. So we like to tell our patients that your maintenance and aftercare for your laser actually starts before your treatment. So really prepping the skin with something that's really hydrating. We love using Plated Intense because it's full of growth factors and exosomes just to prep the skin for in office procedures. And we recommend proceeding to use this after the treatment because it helps expedite your healing process, it enhances your treatment results, and it helps with extra collagen stimulation because that's what those growth factors and exosomes are really great at. We have tons of tools in office for recovery as well. Something else we really love is that CO2 after kit by elastin. It comes with a gentle cleanser, sunscreen, moisturizer and elastin nectar, just to keep the skin super moisturized while you're healing.

Host (19:38)

I love elastin. It's like one of my favorite. Yeah. They're amazing. So in terms of the results, what can we realistically expect?

Danny (19:46)

That's a good question. So, again, this is dependent on the type of laser you're getting are like lasers. You can expect an immediate improvement in texture, complexion, and pigment pretty soon after you heal. Our deeper lasers that require more downtime, again, you'll have a pretty immediate improvement in texture, pigment, and complexion. But the tightening of the tissue really takes about six to eight weeks to begin to see, because it takes our body's time to stimulate collagen with it taking up to three months to fully see the benefits of that lifting and tightening from that one laser.

Host (20:19)

Wow. That's pretty solid, though. I think when you're investing in anything that has to do with aesthetics, I mean, you have to go for things that are going to last for a little bit. So I think that's important to understand. If you're tuning in, you're looking to get something new done. Definitely. Again, like Dr. Allen was saying, like, you want to go to an actually trained dermatologist practice.

Danny (20:38)

It's also really incredible because these types of lasers are. There's studies that show that they have proven reduction of future skin cancers.

Host (20:46)

That's huge. I didn't know that.

Dr. Allenby (20:48)

Yeah.

Host (20:48)

That's really cool.

Danny (20:49)

It's a great treatment. We like to incorporate into pretty much everyone's annual treatment plans.

Host (20:53)

Well, thank you so much, Danny. That was really educational. I enjoyed learning about that. No problem.

Danny (20:58)

It was good talking with you.

Host (20:59)

Yeah, likewise. Thank you guys so much.