The Trillium Show with Dr. Jason Hall

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Think fat in your neck is something to get rid of? Think again. In this episode of The Trillium Show, Dr. Jason Hall explains why a little fat in the right places is essential for youthful, elegant facial contours—and why destroying it with trendy non-surgical treatments like Kybella, CoolSculpting, or radiofrequency tightening can actually make future surgery more difficult and less effective.

He breaks down the science behind neck contouring, the long-term risks of fat-dissolving treatments, and what you should know before booking any “quick fix” procedure. Whether you’re considering facial rejuvenation now or years from now, this conversation will help you make smarter, safer choices for lasting beauty.

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Thinking about plastic surgery? Don’t pick a surgeon until you’ve heard this. In this solo episode of The Trillium Show, board-certified plastic surgeon Dr. Jason Hall pulls back the curtain on the cosmetic industry’s marketing hype to give you an honest, practical roadmap for selecting the right surgeon for you.

You’ll learn:

How to tell if a “cosmetic surgeon” is actually trained in surgery
Why hospital privileges matter more than flashy social media
What to watch for in before-and-after photos and online reviews
How pricing, personality, and complications factor into your decision

Dr. Hall even shares a free downloadable checklist you can take to consultations to help you make a confident, informed choice.

Get the download here: https://drjasonhall.mykajabi.com/surgeonchecklist

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We’ve all heard about the dramatic weight-loss results from drugs like Ozempic®, Wegovy®, semaglutide, and tirzepatide, but what aren’t you hearing about? In this episode of The Trillium Show, board-certified plastic surgeon Dr. Jason Hall explains the under-the-radar effects these GLP-1 medications can have on your face and skin, including accelerated volume loss, thinning, and changes to your skin’s ability to rejuvenate itself.

Dr. Hall breaks down:

Why these drugs can dramatically change your skin quality
What treatments (fat transfer, fillers, lasers, etc.) may help combat this and their limitations
How to protect your muscle mass and skin health if you’re taking or considering GLP-1s

If you’re curious about the real impact of GLP-1 medications on aging skin, this episode is a must-listen.

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This week on The Trillium Show, we’re back with Part 2 of the Q&A series! Once again, I’m taking on your biggest questions about plastic surgery. From recovery to results (and even some of the myths you’ve always wondered about), nothing was off-limits.

These have been some of my favorite episodes to record, and I hope you enjoy listening as much as I enjoyed answering. If this format is something you want more of, let me know! Your feedback will help me decide if Q&A episodes become a regular part of the show.

And if you missed Part 1, be sure to go back and check it out for even more answers to your most-asked questions!

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This week on The Trillium Show, we’re doing something a little different — and I’m pretty excited about it. Instead of picking the topics myself, I opened the floor to you: my listeners, followers, and patients.

In this 2 part, Q&A style episode, I’m answering all of your burning questions about the ins-and-outs of plastic surgery. No topic was off-limits, and I had a blast recording this one.

If you enjoy this format, let me know! I’d love to make these Q&A episodes a regular thing, but I want your feedback. So tune in, see if your question made the cut, and don’t forget to send me your thoughts for next time.

Be sure to tune in next week for more answers in part 2!

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I'm Dr. Jason Hall, board-certified plastic surgeon and author of The Art of Aging. Today, I'm busting the top 5 myths surrounding Botox and dermal fillers. Whether you’re curious about wrinkle prevention, worried about looking “fake,” or wondering if injectables are safe, this episode gives you real, no-fluff answers straight from the source.

You’ll learn:

What Botox actually treats and what it doesn’t
The truth about filler longevity (hint: it’s not what the ads say)
Why looking fake has more to do with your injector than the product
When to start facial rejuvenation (it’s not about age, it’s about anatomy)
What you should know about safety and complications

If you’ve ever considered non-surgical facial treatments or want to understand what’s happening behind the scenes in med spas and aesthetic clinics, this is your episode.

Grab my book → The Art of Aging on Amazon

Have a question or show idea?

DM me on Instagram @drjasonhall or email info@drjasonhall.com

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Women over 45 are the #1 demographic for cosmetic procedures—but what are they actually choosing, and why?

I'm board-certified plastic surgeon Dr. Jason Hall, and in this solo episode I'm going to break down the top trends driving aesthetic decisions in 2025 for women over 45. From non-surgical facial rejuvenation and the rise of body contouring (thanks, Ozempic) to deep plane facelifts and hormone optimization, I'll cut through the fluff to give you the real story: what works, what’s hype, and what’s next.

You’ll learn:

Why injectables, lasers, and RF microneedling remain go-to treatments
What GLP-1 medications like Ozempic are doing to demand for tummy tucks and body lifts
How deep plane facelifts are changing the facelift game
Why hormone optimization is the new frontier in looking and feeling younger

This isn’t your average anti-aging talk. It’s smart, straightforward insight from someone who knows the industry inside and out, and who’s not afraid to say what others won’t.

Grab The Art of Aging on Amazon
Questions or show ideas? DM @drjasonhall or email info@drjasonhall.com
Subscribe to The Trillium Show for more real talk on plastic surgery and aesthetics

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Thinking about opening a med spa? You’ve seen the rise: new med spas popping up on every corner, flashy marketing, and $500 treatments, but is the business really as profitable as it looks?

I'm your host Dr. Jason Hall and in this episode of The Trillium Show, I'm pulling back the curtain on the economics of the med spa industry. From startup costs and overhead to hidden expenses and private equity myths, he walks you through the real numbers, hard lessons, and what it actually takes to build a med spa that lasts.

You’ll learn:

What the average med spa really earns (and what’s just hype)
How long it typically takes to turn a profit—and why
The biggest mistakes people make with devices, overhead, and debt
Why controlling your costs and prioritizing patient care is non-negotiable
What private equity is looking for, and whether it's worth chasing

If you’re a physician, injector, or entrepreneur eyeing the med spa world, this is your reality check, and your playbook.

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Are non-surgical facelifts worth the hype—or just a waste of money? I'm your host, Dr. Jason Hall, and in this solo episode I break down the truth about the most popular non-surgical facial rejuvenation treatments. We'll cover lasers, radiofrequency microneedling, fillers and thread lifts, and why so many of these options fall short, especially if you're expecting facelift-level results.

You’ll learn:
- Why “non-surgical facelift” is often a misleading label
- The four true causes of facial aging, and why no single treatment solves them all
- What lasers, RF, and fillers actually do (and what they definitely don’t)
- Why thread lifts are basically “cosmetic sugar highs”
- How to approach diagnosis before you invest in any treatment

Whether you're considering aesthetic treatments or just want to understand what works and what’s marketing fluff, this episode will give you the clarity you need to make smart, informed decisions.

Grab a copy of my book The Art of Aging for an even deeper dive.

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Vaccines are often hailed as one of the greatest medical achievements of the 20th century, but what if that story is missing some key chapters?

I’m Dr. Jason Hall, and in this episode of The Trillium Show, I sit down with Roman Bystrianyk, co-author of Dissolving Illusions, for a conversation that made me question everything I was taught in medical school about disease, immunity, and the history of vaccines.

Roman’s research takes us beyond the standard “one germ, one drug” model and into terrain theory, which suggests that a healthy internal environment, not just microbial exposure, determines whether we get sick. We dig into historical data showing massive declines in infectious diseases like measles, scarlet fever, and whooping cough long before vaccines were introduced, thanks to improvements in sanitation, nutrition, and public health.

We also talk about:

Why terrain theory might matter more today than ever
How modern medicine’s financial incentives shape what we’re taught
Why critical thinking is your most powerful tool in any doctor’s office
The potential downsides of overrelying on vaccines as a cure-all
And how you can take real ownership of your health and immune system

This isn’t a call to ignore science, it’s an invitation to ask better questions and take a deeper look at what health really means.

Grab Dissolving Illusions or visit dissolvingillusions.com
Check out Roman’s Substack for more independent research
DM me @drjasonhall or leave a comment if this episode challenged your thinking

If you’ve ever wondered whether we’ve been oversimplifying complex health issues, this one’s for you.

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If you're building a career, starting a business, or just trying to grow into the next version of yourself—this episode is for you.

I’m Dr. Jason Hall, and today on The Trillium Show, I’m getting personal. We’re talking about mentorship: why it matters, how I neglected it in my own life, and the real costs of trying to figure everything out on your own.

I’ve made more mistakes than I can count, many of them because I let pride get in the way of asking for help. But here’s the truth: mentors don’t see your questions as weakness. They see them as connection. And if you want to build something meaningful, whether that’s a surgical practice, a small business, or just a fulfilling life, you can’t do it alone.

In this episode, I share:

The 3 biggest benefits of finding the right mentor
Why going it alone can cost you time, energy, and money
How mentorship helps you avoid burnout and isolation
What I’ve learned mentoring young surgeons, students, and entrepreneurs
And why asking for help might be the strongest move you make

This isn’t a step-by-step guide. It’s a real-world reminder that success is a team sport. So if you’ve ever felt stuck, overwhelmed, or too proud to reach out, I hope this message helps you change that.

Grab a copy of The Art of Aging: Look Great, Not Fake on Amazon
DM me on Instagram @drjasonhall with your questions
And don’t forget to subscribe, more solo episodes like this are coming soon.

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Thinking about breast surgery but not sure if you need implants, a lift—or both? I’ve got you covered.

In this special mashup episode, I’m pulling together the most important insights from across The Trillium Show to help you understand the difference between breast augmentation, breast lifts, and the popular combo of both. We’ll walk through who needs a lift (spoiler: more people than you think), what implants actually do, and—just as important—what they don’t.

Whether you’re looking to restore shape after kids, add volume where you never had it, or just want the facts without the fluff, this episode lays it all out in real, accessible terms.

Let’s cut through the noise and get you one step closer to making the right choice for your body.

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Today we’re diving into a topic I get asked about all the time—what’s the difference between Erbium and CO2 lasers, and which one is right for your skin? CO2 lasers have been around forever, and while they’re effective, they can come with longer healing times and a higher risk of pigmentation issues. That’s where Erbium lasers shine.

In this episode, I break down the real science behind both technologies, explain why Erbium’s higher affinity for water makes it safer—especially for darker skin types—and why I prefer it for both fractional and full-field resurfacing. If you’re considering laser treatment, this is a must-listen to help you make an informed decision. Plus, I’ll share a bit about my new book, The Art of Aging: Look Great, Not Fake, and where you can learn even more.

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Wrinkles, lines, and sagging skin—everyone deals with them eventually, but what’s the best way to fix them for good? I’m Dr. Jason Hall, and in today’s special recap episode of The Trillium Show, we’re diving deep into how combining the right facelift techniques with targeted laser treatments can deliver truly long-lasting results.

I’ll take you back through past key conversations on understanding facial wrinkles, what facelifts can (and can’t) achieve, why the deep plane facelift is so effective for lower-face rejuvenation, and how different lasers tackle skin texture and tone. Ready to finally say goodbye to temporary solutions and embrace lasting rejuvenation? Tune in now, and let’s get you the clear answers you deserve.

Previous Episodes Highlighted:
Ep. 19 - What Does A Facelift Do? And what does it NOT do?
Ep. 27 - The Three Types of Facial Wrinkles
Ep. 42 - Different Lasers, Different Outcomes
Ep. 62 - Jowls, Jawlines & More - All About the Deep Plane Face & Necklift

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Recently, I was a guest on a podcast called Meet the Doctor. Take a listen to the episode here, and check them out on Spotify and Apple Podcast.

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After years of seeing patients frustrated by ineffective treatments and wasting money on beauty products and treatments that don’t deliver, Dr. Jason Hall decided to set the record straight.

To cut through the noise and expose the truth behind skincare scams, influencer marketing, and underqualified providers, he wrote his book The Art of Aging: Look Great, Not Fake.

Dr. Hall breaks down what actually works, what’s worth the investment, and how to make informed choices. He helps readers spot untrained providers, avoid overhyped trends, and build a skincare routine tailored to their biology—not just the latest fads.

Knowing that good skincare is the foundation of any anti-aging plan, he also includes a science-backed framework to guide readers toward real results.
His passion for education extends beyond the book. His podcast, The Trillium Show, has transformed the way he approaches consultations, with patients coming in better informed and ready for more productive discussions.

For Dr. Hall, great results start with teamwork, which is why every first visit is about understanding a patient’s goals before anything else.

Purchase Dr. Hall’s book, The Art of Aging
Listen to Dr. Hall’s podcast, The Trillium Show
To learn more about Knoxville plastic surgeon Dr. Jason Hall
Follow Dr. Hall on Instagram @drjasonhall

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Are you tired of cosmetic treatments that leave you looking worse than before? Today we're talking about how to avoid the dangers of 'Burger King medicine' and get the results you truly want. So what is Burger King medicine? It’s not about fast food—it’s about the fast-food approach to medical treatments, where patients demand quick fixes based on their own research or advice from friends, often bypassing crucial medical advice. This phenomenon is particularly rampant in the world of aesthetic medicine, where the stakes are not just about health but also about appearance.

Today we're going to talk about what Burger King medicine really means—getting it your way, right away, even when it’s not what’s best for you. I’ll share a cautionary tale about why it’s critical to have a proper diagnosis and a tailored treatment plan. In a world where Dr. Google can sometimes override real doctors, I stress the importance of resisting the urge to self-diagnose and instead, setting clear, informed goals for any medical or cosmetic procedure.

Also, don’t miss out on my new book, “The Art of Aging: Look Great, Not Fake,” available now on Amazon, where I discuss how to navigate the minefield of modern medicine with your health and aesthetics intact. Tune in to arm yourself with the knowledge to make smart, safe choices in your healthcare journey.

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We are constantly being sold quick fixes in the wellness world, but nothing can beat the value of continuous investment in a healthy lifestyle. Today, I’m sitting down with an old friend and a true expert in the field of nutrition, Betsy Johnson. With over a decade of experience, Betsy has transformed lives through her dedicated approach to healthy eating and fitness. Betsy opens up about her journey from working in hospitals to launching her successful business, Betsy Nutrition, and her horrifying experience with cyberbullying.

She shares invaluable insights on maintaining consistency and intentionality in your diet, the impact of social media on self-esteem, and how a personal setback led to a breakthrough in how she supports her clients. Whether you’re looking to overhaul your eating habits or just need some inspiration to keep pushing towards your fitness goals, Betsy’s story and her simple, effective strategies are exactly what you need to hear today.

Plus, she’ll give us her take on why professional guidance is crucial when considering treatments like fillers. Join us for a deep dive into how the right nutrition can not only change your body, but your life.

Learn more about Betsy Johnson Website | Facebook | Instagram

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It's the last thing you want to see: eyelid ptosis from Botox injections. It’s one of those complications that can really catch you off guard if you’re not careful. Eyelid ptosis occurs when the Botox affects the levator muscle, causing your eyelid to droop unexpectedly, and trust me, it’s more common than you might think. The real kicker? I’ve seen heaps of misguided advice floating around, especially on online forums, where the blind lead the blind suggesting more Botox as the fix—absolutely not the solution.

In this episode, we’ll clear up the myths and dive into why proper needle placement is crucial and what you can actually do if you find yourself facing this issue. I’ll walk you through the temporary relief that apraclonidine eye drops can offer by stimulating the Muller’s muscle and why your best bet is always to wait it out or get correct advice directly from your injector. Tune in to get the facts straight and learn how to handle one of the most dreaded Botox complications like a pro.

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Ever wondered why so many people say lasers don’t work for facial rejuvenation? It’s time to set the record straight. In this episode, I dive into the real reasons behind these frustrations and how you can avoid them.

I'll share the three crucial factors for successful laser treatments: correct diagnosis, choosing the appropriate laser, and ensuring it’s used correctly. From BBL for pigment issues to TRL for lines and wrinkles, get the inside scoop on selecting and applying lasers to truly transform your skin. Tune in to learn how to make lasers work for you and achieve the radiant skin you deserve.

Plus, don’t miss out on a sneak peek of my upcoming book, The Art of Aging: Look Great, Not Fake, available for preorder now.

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Last year was a rollercoaster, with its fair share of ups and downs. In this episode, I’m sharing the top five lessons I’ve learned: From the critical role of soft tissue quality in plastic surgery results to the undeniable truth that no workout can outrun a bad diet. I’ll talk about why choosing the right partner is the best decision you’ll ever make, the importance of seizing every moment with loved ones, and how writing not only helped me organize my thoughts but also led to my upcoming book on skincare and aging.

These game-changing insights apply not just to my life, but to yours too. Whether you’re looking to improve your health, deepen your relationships, or just get a little more organized, there’s something in this episode for everyone. Tune in and let’s take on 2025 with some solid new wisdom under our belts!

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Ever caught your reflection and wondered why you look so tired or down, even after a solid night’s sleep? You’re not alone. I'm Dr. Jason Hall, and this week on The Trillium Show, we're diving into the world of lower lid blepharoplasty—often just called lower eyelid lifts. We’ll explore how this procedure can help lift those droopy, sad puppy dog eyes and give you a fresher, more vibrant look. But it’s not a cure-all—I’ll break down the realistic outcomes, from what it can do to refresh your appearance to the limitations you should be aware of, like not being able to remove all wrinkles or dark circles.

We'll also get into the nitty-gritty of modern techniques like fat grafting, the recovery process, and potential complications such as chemosis and eyelid malposition. Plus, I’ll share crucial pre-surgery considerations you need to think about, like under-eye fillers and managing dry eyes. Tune in to get a clear picture of what lower eyelid surgery can (and can’t) do for you, so you can make an informed decision about whether it’s the right move for your beauty goals.

Subscribe to The Trillium Show and follow @drjasonhall on Instagram to join the conversation!

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With an array of facial rejuvenation treatments promising the moon, it’s easy to get misled into spending on ineffective, overpriced, or even risky procedures. From the hyped-up electromagnetic muscle stimulation like Emsculpt to the costly full facial rejuvenation with hyaluronic acid fillers—let’s talk about what truly works and what doesn’t.

I’ll break down why certain popular treatments like thread lifts and focused ultrasound don’t deliver and why over-the-counter skincare products might not be worth your dime. Save your hard-earned money and tune in as I share insights from over a decade in cosmetic medicine to help you make informed choices that actually benefit your skin - and your wallet.

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Are you grappling with the decision between surgery and medications for weight loss? On this week’s episode of The Trillium Show, I’m joined by weight loss surgeon Dr. Josh Roller. We’re breaking down everything from the gastric sleeve to the duodenal switch and examining the latest in medication-based treatments like GLP-1 agonists.

Dr. Roller, a veteran of over 12,000 weight loss surgeries, shares his insights on which procedures pack the most punch for long-term success and the real scoop on the benefits and risks of popular weight loss meds. We dive into the effectiveness, patient compliance, and the essential lifestyle changes that accompany these options. This episode is your guide to understanding the best path to a healthier you, backed by years of expertise and real-world results.

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There is a silent epidemic that’s affecting people everywhere: Participation Trophy Syndrome (PTS). Yes, it’s that mindset where constructive criticism feels like a personal attack, every task demands a gold star, and just ticking boxes seems good enough. But here’s the real talk—life doesn’t hand out participation trophies. I’m going to break down how this syndrome is crippling "careers," what it really takes to overcome it, and why our school system is to blame.

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Ever find yourself stuck in a loop, thinking about your next meal right after you’ve finished eating? Today, we are dissecting ‘food noise’—that relentless urge to eat driven by the modern diet’s pitfalls. We’ll expose how processed foods are crafted to keep you coming back for more and what you can do to break free. I’ll share insights on cutting-edge treatments like semaglutide and tirzepatide- but medication alone isn't the answer.

I’ll provide practical dietary guidelines to help you break free from food addiction, including the specific macronutrients and food groups you should focus on. Plus, I'll share tips for staying hydrated and getting enough protein to support your goals. If you're tired of constantly thinking about your next meal, and ready to regain control over your eating habits, tune in and let’s learn how to make a change.

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Interested in shaping up? With the rise of weight loss solutions like Ozempic and major diet changes leading to dramatic weight loss, many are left dealing with the less-talked-about aftermath: excess skin. Whether you’re considering a tummy tuck or a full body lift—also known as a 360 or ‘around the world’—I’ll guide you through what to expect, from choosing the right procedure based on your unique body shape to understanding the recovery process.

I'll explain why these procedures are not just cosmetic but essential for many, how advanced techniques like ultrasound-guided tap blocks are revolutionizing pain management, and why nutrition plays a critical role in your healing journey. If you’re looking to reclaim your body and boost your confidence, this episode is packed with the insights you need. Tune in to reshape your perceptions—and perhaps even your silhouette.

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It's time to the record straight with a no-nonsense rundown of the top 10 plastic surgery myths that might be leading you astray. Think surgery without scars is possible? Or that breast implants need a decade-only lifespan? Think again. I'm Dr. Jason Hall, and today on The Trillium Show, I'm going expose the real story behind these widespread misconseptions.

If you're toying with the idea of cosmetic enhancements or just plain curious, this is the episode you can't afford to miss. Join me as we unpack the truth, ensuring you make informed decisions about enhancing your beauty. Remember, what you want might not be what you truly need. Have any other questions about plastic surgery? DM me @drjasonhall on Instagram, or comment on our YouTube channel!

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This show is all about primary (or first time) breast augmentation - the most popular plastic surgery procedure in the United States year after year!
Here, we will discuss the procedure itself, the operation, recovery and risks. Like with any plastic surgery procedure, the most important aspect of the process is having a goal - what you are looking to accomplish with respect to the "look" you would like to have when surgery is over. I discuss the various choices and decisions that need to be made, such as incision location, implant size, shape, and type.

We have done a bad job as plastic surgeons making breast augmentation seem complex - it's NOT. Based on what you want to achieve, the decisions - such as implant size, type, projection, location, incision, etc - really make themselves.
Please note - I got caught up talking about the risk of infections at the end, and left out the small (<1%) risk of hematoma as one of the risks that I discuss. Keep that in mind when you listen to that section.

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Highlights:

How skincare and lasers go hand in hand (00:00)
Why resurfacing is a better option than surgery for lines and wrinkles (00:56)
Understanding what an ablative laser is and the 3 types of treatment options (01:38)
The NanoLaserPeel treatment (02:00)
MicroLaserPeel treatment and the differences between this and the NanoLaserPeel (03:27)
Full Field Laser Resurfacing and why it’s one of Dr. Hall’s favorites in terms of results (05:54)

Links:

Dr. Jason Hall, MD

Shop my top skin care picks: Get our Favorite Products HERE!!
Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

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Highlights:

Why do women seek out internal vaginal rejuvenation and how does laser treatment help? (00:53)
How tummy tucks can help treat stress urinary incontinence (03:28)
How injections can help improve blood flow and nerve regeneration for sexual health in both men and women (07:05)
The differences between traditional medicine and regenerative medicine (12:18)
How IV therapy works, particularly in post-op patients (15:37)
The role of peptide treatment in regenerative medicine (22:42)
The role testosterone plays in hair loss and common treatment options (30:15)
The use of peptide treatment for pain relief and injury healing (35:29)
The biggest takeaways for combining plastic surgery with hormone treatment including recovery & downtime (41:04)

Links:

RevitalyzeMD: https://www.revitalyzemd.com/

Dr. Jason Hall, MD

Shop my top skin care picks: Get our Favorite Products HERE!!
Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

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Highlights:

Why do perimenopausal and menopausal women typically seek out plastic surgery? (02:23)
How many of my patients are typically on hormone therapy (04:16)
The effect hormones have on common female health issues (07:34)
What effect does hormone replacement have on breast cancer risk? (09:06)
The definition of bioidentical hormone treatment (13:18)
Preventative health checks that are taken prior to surgery (18:53)
Do you have to stop hormone replacement therapy before plastic surgery? (20:21)
Does age factor into recovery from plastic surgery? (25:18)
How hormone replacement and plastic surgery can both address skin appearance (29:53)
How bone loss contributes to common signs of aging (32:47)
The effects of vaginal rejuvenation laser procedures (45:49)

Links:

Dr. Jason Hall, MD

Shop my top skin care picks: Get our Favorite Products HERE!!
Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

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Highlights:

What are the specific needs for patients who’ve experienced major weight loss? (00:44)
The optimal time to have plastic surgery after significant weight loss (01:51)
Proper preoperative bloodwork (05:54)
The most comprehensive approach to the plastic surgery procedure after weight loss (06:35)
Is a Body Lift an outpatient procedure? (11:41)
What to expect during recovery (13:09)
Possible complications and how they’re prevented (14:20)
Which post-weight loss surgeries can be combined to minimize recovery time, and what order should they be done in? (20:49)

Links:

Dr. Jason Hall, MD

Shop my top skin care picks: Get our Favorite Products HERE!!
Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

Links Referenced:

Abdominoplasty or tummy tuck podcast episode: https://drjasonhall.com/podcast/the-skinny-on-tummy-tuck-surgery/
TAP blocks podcast episode: https://drjasonhall.com/podcast/using-tap-blocks-for-a-better-tummy-tuck-experience/
Surgical drains podcast episode: https://drjasonhall.com/podcast/what-do-i-do-with-surgical-drains/

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Links:

Dr. Jason Hall, MD

Shop my top skin care picks: Get our Favorite Products HERE!!
Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

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Highlights:

What is the tummy tuck procedure and why is it so painful? (00:40)
What is a TAP block and why is it done? (02:20)
Benefits of receiving a TAP block with abdominal surgery (03:25)
When patients receive a TAP block (05:47)

Links:

Dr. Jason Hall, MD

Shop my top skin care picks: Get our Favorite Products HERE!!
Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

Transcript

Dr. Hall: Welcome to The Trillium Show, where we help you make the changes you want to see in your body, in your mind, and in your life. I’m your host, Dr. Jason Hall.

Abdominoplasty surgery is typically one of the most painful plastic surgery procedures that a woman can undergo, but there is a procedure that can help significantly reduce the discomfort a woman feels after an abdominoplasty. We’re going to talk about what that procedure is and how I’ve added it to every body contouring case that I do and made the recovery so much better. Typically, abdominoplasty surgery involves something called rectus muscle plication, which is where we take the loosened rectus muscles, which are your six-pack muscles, and we sew those muscles back together in the middle to kind of recreate the six-pack that is stretched out with pregnancy or significant weight changes. Now, any surgery involving muscle—and you know this if you’ve ever had any orthopedic procedures done before—any surgery involving muscle hurts. Now, there is a procedure that we can do that we can significantly decrease the amount of discomfort that a woman feels after an abdominoplasty surgery; that procedure is something called a TAP block.

Now, this procedure is an anesthetic procedure. It is a—it is not a surgical procedure, it is an anesthesia procedure where we use an ultrasound and actually put numbing medicine around the nerves in your sides that kind of come out of your spinal cord from your back around to your rectus muscles and give those muscles and the skin over them sensation. And by injecting some local anesthetic before your surgery even starts, we can significantly minimize the amount of discomfort that you feel during surgery, and by doing that, essentially tricking your body into thinking that you haven’t had surgery, or at least haven’t had the kind of procedure that you’ve had, we can significantly reduce the amount of postoperative pain and discomfort that you have.

So, what is a TAP block and how is it done? I started doing TAP blocks and using these in my abdominoplasty surgeries about a year-and-a-half ago—it’s like mid-2022 right now as we’re recording this—and the beginning of 2021, I started using TAP blocks with every abdominoplasty surgery that I performed. I have an ultrasound that I used here in the office and in surgery. And using that ultrasound, I can locate the area where these nerves come out of your back and travel around the side to the front of your abdomen, and specifically inject some local anesthesia, watching it the whole time, around those nerves. And what that does is it deadens the muscles and skin in the front of your abdomen. By doing that, we block painful feelings from going back into your spine.

How this is effective is that it minimizes the amount of pain that you experience during surgery. Our anesthesia colleagues noticed that after I started doing these, that the amount of narcotic, the pain medicine that patients normally get during surgery was significantly reduced from what they had gotten beforehand. And this is beneficial for a number of reasons. First of all, it decreases the incidence of postoperative nausea and vomiting. That by itself is awesome.

Secondly, it decreases the amount of narcotics that patients require after surgery. Again, a great benefit. Third, by doing this, they can get up and get moving the day of surgery. You’re a little sore, but much less sore than you were beforehand. Being able to get up means lower incidence of clots in your legs, which can be a fatal complication of any plastic surgery procedure but it’s higher in tummy tuck and body lift surgery, and if you work out, you know that the quicker that you get back to activity after a hard workout—and you can look at a tummy tuck as being a really hard core workout—the quicker you get back to normal activity, the less sore that you are and the easier that recovery is as opposed to laying around and not moving and not doing anything for a few days, getting back to full activity can be really painful and really time-consuming, so for these reasons, the addition of a TAP block to abdominoplasty surgery, body lift surgery, really any body contouring procedure where we’re going to be manipulating the rectus muscles, a TAP block is a fantastic addition and significantly improves recovery from these procedures.

The TAP block has been such a great addition to our surgery that I’m afraid I’ve painted myself into a corner because our recovery room nurses have told me that they are not going to let me quit doing them because the patients wake up so much more comfortable, they’re able to get up and leave the surgery center so much easier than they did before I started doing the TAP blocks, I’m kind of committed to doing them forever now, or at least until something better comes along. The TAP block is something that is done before surgery but after you’re asleep. This is something that I do, you know, as we’re getting a patient ready for surgery, they’re already asleep, and then I’ll come in and do our TAP blocks before we, kind of, get everything sterilized and actually begin the surgery. The TAP block is done before anything even happens. And so, you’re asleep, but the block has already started to work.

I hope you found this informative and useful. If you haven’t, go back and listen to the abdominoplasty show. I talk about the addition of the TAP block during that show as well. This gives you a little bit more detail, and you can see exactly what’s going on when we do a TAP block, but do check out that other episode. As always, if there are any topics that you would like to see discussed, hit us up on Instagram, leave a comment below, or send us an email info@drjasonhall.com and we’ll see you soon.

Dr. Hall: Thanks for listening to The Trillium Show. You can keep up with the latest on the podcast at jhallmd.com. Be sure to follow us on Spotify, Apple Podcasts, or wherever you listen to podcasts. If you want to connect with us on social media, you can find us at @jhallmd on Instagram and Twitter and @DrHallPlasticSurgery on Facebook. Remember, be the change you wish to see in the world.

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Links:

Dr. Jason Hall, MD

Shop my top skin care picks: Get our Favorite Products HERE!!
Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

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Highlights:

What are the three major types of wrinkles? (00:41)
Lines of motion (01:24)
Best treatment options of lines of motion (02:20)
Lines of surface damage (05:18)
Best treatment options for lines of surface damage (06:11)
Lines of gravity (08:33)
Best treatment options for lines of gravity (11:19)

Links:

Dr. Jason Hall, MD

Shop my top skin care picks: Get our Favorite Products HERE!!
Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

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Check out last week's episode for more about surgical drains and episode 18 for more on facelifts.

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Highlights:

What a surgical drain is and how it works (1:04)
The body’s internal healing process (2:10)
Why surgical drains are used in plastic surgery (2:49)
Different placements for surgical drains (4:30)
Can you shower with a surgical drain? (7:10)
The basics of surgical drain care (8:05)
What to do if the area around the drain gets irritated (11:58)

Links:

Dr. Jason Hall, MD

Shop my top skin care picks: Get our Favorite Products HERE!!
Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

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In this short, I answer a common question about having a tummy tuck - will I have a scar?

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Highlights:

Establishing better balance in the face with forehead reduction surgery (1:11)
The differences between brow lift surgery and forehead reduction surgery (2:44)
The scar and recovery from forehead reduction surgery (3:22)
The forehead reduction procedure itself (5:20)
How much forehead can be reduced? (7:34)
Hair transplant surgery as an alternative to forehead reduction surgery (8:29)
Can you combine a forehead reduction and a brow lift? (10:10)

Links:

Dr. Jason Hall, MD

Shop my top skin care picks: Get our Favorite Products HERE!!
Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

Transcript

Dr. Hall: Welcome to The Trillium Show, where we help you make the changes you want to see in your body, in your mind, and in your life. I’m your host, Dr. Jason Hall.

Dr. Hall: So, today we’re going to talk about a procedure that not a lot of people know much about. And it is a procedure that has probably one of the highest patient satisfaction ratings of any procedure that we do. That procedure is forehead reduction or hairline lowering. Now, hairline lowering, or forehead reduction surgery, is exactly what it sounds like. It is a procedure that is designed to shorten an elongated forehead and effectively turn a 5 head or a 6 head into a 4 head—sorry for the bad joke.

With forehead reduction surgery, this is something that can really be life-changing for people who need it and who undergo this procedure. When we talk about forehead reduction surgery, much like every other cosmetic surgery procedure that we do, what we’re really talking about is establishing better balance of the face between the upper, the middle, and the lower thirds of the face. When we as plastic surgeons look at someone’s face and as we’re talking about things that we can do to help reestablish balance, what we’re really doing is dividing the face into thirds, vertically. And so, your upper third is hairline to eyebrows, middle third is eyebrows to the bottom of the nose, and lower third is bottom of the nose to the chin.

And when one or multiple of those vertical thirds are out of balance, it can throw off the balance of the entire face. That’s why when we’re kind of talking about things like rhinoplasty or genioplasty—chin implant surgery—that a lot of times, those procedures tend to go together. Because if the nose is a little bit too large, and the chin is a little bit too small, changing one doesn’t necessarily improve things as much as improving the overall balance of both of them. And what forehead reduction surgery does is forehead reduction surgery helps to make that upper third—so from the eyebrows to the hairline—shorter and bring it into balance with the rest of the face, if it is the part that is causing an imbalance or disharmony. Forehead reduction surgery and brow lift surgery is really almost two sides of the same coin if you want to think about it like that.

One of the differences is that with brow surgery, a lot of times modern brow lift surgery is done with an endoscope, and with forehead reduction or hairline lowering, we have to do that in an open technique. So, we make an incision and then shorten the forehead that way. A question that comes up often in the consultation is how is that surgery done and, kind of, what does it look like during healing? And one of the big drawbacks to forehead reduction surgery is that the scar for forehead reduction surgery is right at the hairline; it is very visible while it’s healing. And that scar disappears over time, so in order for this to be something that really makes sense, you have to be able to tolerate that scar while it heals.

When I do a forehead reduction, what I end up doing is making an irregular incision right at the hairline—or a little bit behind the hairline, actually—and beveling or angling that incision really steeply and that irregular incision, it looks kind of like an EKG tracing kind of a zigzag appearance to it, and that helps that scar to hide as it heals. You know, there are no straight lines—Mother Nature doesn’t make a straight line, and so a straight line scar would be very, very visible. An irregular scar breaks up the healing process and makes that less visible with time. Right after surgery, the scar is right at the hairline, it essentially makes up the frontal hairline, so it is really visible.

And as that scar heals, with that heavy beveling, hair actually grows through that scar, and so it looks like the scar actually moves back into your hairline. It kind of disappears as it heals, and that makes it much more palatable for a lot of patients. When you see these long-term results, the scar is really really tough to see because it’s behind the hairline. But during the healing process, you’ve got to deal with a scar that’s very visible. Now fortunately, once the stitches come out, you can cover that scar with concealer or makeup, and for guys, you can use a tinted sunscreen to help cover that, but that healing process for that scar to move backwards can take a couple of months and so you have to be ready for that.

How do we do a forehead reduction surgery? So, we’ll get into a little bit of a surgical details here, just so you know exactly what happens. And for people out there that are kind of students of this stuff and if there are any residents or medical students, forehead reduction surgery really borrows from principles of scalp reconstruction. What we’re doing here is making that heavily beveled incision at the hairline and then going underneath the galea—and the galea is a really tough layer of your scalp; it’s why your scalp doesn’t move around much—we go underneath the galea and actually lift that galea up all the way back to the back of the head. And then once we’ve gotten that space created, we make what are called relaxing incisions in the galea so little incisions to help open up and let that galea move a little bit, almost like opening up an accordion, and letting that forehead—or letting that hairline slide forward over the forehead.

Once we do that, then the forehead that we want to remove is marked and excised kind of in that same irregular pattern, so that that scar heals nicely and without any straight lines that will make it really visible. The important thing in closing that incision is that all of the strength of that closure is on that strong, firm, galea layer so that there is no tension on the skin. And if you’ve heard any of the other podcasts that we’ve done, you know, skin tension is kind of the enemy of good healing, especially when it comes to scars. And so, we want no tension on that skin closure. All the tension and hold needs to be on that galea layer.

There are permanent sutures that are put in through the skin that are taken out at about a week, and then like we said before, once those stitches are taken out, you can start covering that scar with concealer or makeup so that it’s not as visible. That scar starts to move back as the hair grows through the scar, and that process can take a few months, but generally, forehead reduction surgery is very well-tolerated, the scars heal very nicely. One question that comes up oftentimes is, how much forehead can be reduced? And typically with a forehead reduction surgery, we can get about two to two-and-a-half centimeters of forehead skin and remove that, advance the hairline that far. The end of my finger between the tip of my finger and my first knuckle is about two-and-a-half centimeters, so that’s a good gauge as to how much forehead can be removed.

And that’s quite a bit when you’re talking about really anything in facial surgery. You know, the old adage is, “In the face, a millimeter is a mile.” Two-and-a-half centimeters is a long way, and so that can really serve to improve balance between the, you know, upper, middle, and lower thirds of the face. The other thing that we can do to advance a hairline, to lower a hairline, is hair transplant surgery. So, if the idea of a scar across your forehead for a short time is unappealing, a hair transplant can help move your hairline forward without that scar.

Now, the downside of this is that you have to have a hair transplant. Although newer hair transplant techniques, the follicular unit extraction techniques that most hair transplant surgeons now are using are really good. You don’t have to have a scar on the back of your head, which you did with the old hair transplant techniques. And your surgeon will take this device and extract single hair follicles or little tiny groups of two or three hair follicles at a time and then plant those along your hairline to advance your hairline.

And this is a super cool technique. It’s much better than the old hair plugs that people did in the ’70s and ’80s and you can really get a nice, natural result with a newer hair transplant techniques. Now, hair transplant tends to be quite a bit more expensive than hairline advancement and it’s not something that I do, but there are surgeons whose entire practices are dedicated to hair transplant, and they would be good people to talk to if a kind of more traditional forehead reduction hairline lowering surgery isn’t something that you’re interested in. But those are really the two ways, the kind of open technique and hair transplant, that we can use to advance a hairline and shorten an elongated forehead.

Another question that I get is, can I combine a forehead reduction and a brow lift? And the answer to that is yes, kind of. They are really kind of cousins in terms of surgery; the forehead reduction hairline lowering is a cousin to the brow lift. The incisions can be the same for doing an open brow lift. The problem is that doing a brow lift and a hairline advancement is that the forces are kind of competing, you’re trying to lift a brow, you’re trying to pull a hairline forward, and each one of them want to go the opposite direction.

And you really have to be careful doing those two together that closure where all that tension is, is strong enough to be able to keep either one of those from drifting with time. And so typically, I tell patients that if you really want to have both of those procedures and need both of those procedures done at the same time, that we can do it; we have to accept a little bit of uncertainty and the possibility of a revision later, but if we can break it up and do it in two surgeries, that’s always more beneficial because each one, we can get the brow exactly right, we can get the hairline exactly right at the same time.

I hope that this has been informative. This is a short episode, but if there are any other topics that you would like to hear, please write in, let me know info@drjasonhall.com. Thanks again for listening, and we’ll see you soon.

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In this mini episode, I talk more about fillers. I cover their composition, appropriate uses, and myths concerning their use.

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Highlights:

The 3 components of facial aging (2:28)
Limitations of injectable filler (3:15)
Facial aging in the 50s that diminishes effectiveness of injectable filers (6:48)
Frequency of filler injections (11:57)
When filler is a good option versus when it is ineffective (13:23)

Links:

Dr. Jason Hall, MD

Shop my top skin care picks: Get our Favorite Products HERE!!
Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

Links Referenced:

Facial aging podcast: https://share.transistor.fm/s/7a30f004

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In this week's mini episode, I answer the question, "What happens to the belly button during a tummy tuck?"

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Today I talk about one of my favorite procedures - facelift surgery. Many people have an idea of what they think a facelift will do, but there is a lot of confusion about exactly WHAT a facelift does. We clear that up here, and I discuss some alternative treatments for desired outcomes with other areas of the face. Everyone always has questions about the incisions used, so I explain those, as well as address the reality of the “mini” facelift.

I talk about facelift recovery time, putting volume back into the face, and the recently popular deep plane facelift.

Highlights:

The “facelift simulator” (1:26)
The parts of the face affected by a facelift (2:20)
A pitfall of using filler instead of a facelift (4:25)
The incisions typically used in a facelift (5:30)
Mini facelifts? (7:17)
Facelift recovery (8:10)
Putting volume back into the face (8:50)

Links:

Dr. Jason Hall, MD

Shop my top skin care picks: Get our Favorite Products HERE!!
Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

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In this week's mini episode, I answer the question of whether we typically use cannulas or needles for fillers and why.

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If you’ve ever considered a breast lift you might have asked: am I a good candidate? In this show, I talk all things breast lift surgery: who needs it, what the goals of surgery are, and combining a breast lift with an implant. I go over how hormones (of pregnancy and with the passage of time) change a woman's breast tissue and what that means for our surgical plan.

Lots of women I see choose to have in implant and lift in the same operation, and here we will go over that procedure and why it makes sense for a lot of women. We'll also discuss a lot of frequently asked questions about incisions and breast lift recovery.

If you have had children and are interested in breast rejuvenation, this show is a must listen!

Highlights:

Who needs a breast lift? (00:44)
Goals of breast lift surgery (7:46)
Breast lift combined with augmentation: risks and reasons (9:09)
Choosing what size implant to use for breast augmentation during a breast lift (14:17)
The types of incisions used during a lift or lift/augmentation (15:34)
Recovery from breast lift surgery (19:33)

Links:

Dr. Jason Hall, MD

Shop my top skin care picks: Get our Favorite Products HERE!!
Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

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1:20: Why is breast implant removal becoming more popular?
2:32: What is an implant capsule and why is it important?
4:25: “Simple” implant removal
5:36: Implant removal with capsulectomy
9:47: Implant removal with mastopexy

Links:

Dr. Jason Hall, MD

Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

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0:45 - Immediately after surgery to 72 hours
1:38 - First Three Weeks
3:18 - How surgical simulations help patients avoid a postoperative identity crisis
4:08 - Three Weeks to Three Months
5:40 - Three Months to One Year

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On our last episode, I discussed ten things you need to know before you have cosmetic surgery. I got such a great response to this, that I'm going to follow up with ten more things to help make RECOVERY easier.

Highlights:

00:58 Go for a walk
01:53 Take deep breaths
02:50 Take your medicine
03:39 Don’t make big decisions
04:00 Avoid greasy/spicy foods
04:16 Shower
04:59 Really? This is THAT important??
05:35 Leave dressings and drains alone
05:59 Wash your garments
06:24 Don’t exercise

Links:

Dr. Jason Hall, MD

Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

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To help you make a the journey to your surgery a successful one, there are some essential steps that you can take. For this episode, we go through what we lovingly refer to as the “Ten Commandments” for the pre-operative period between your preoperative visit and your surgery day. Each of them will provide some details on what you need to do in order to make your journey a success! Check them out!

Highlights:

Have a driver (00:55)
RTFM (01:17)
Pick up your meds (01:44)
Get hydrated (02:30)
Shower (03:05)
Yuck! (03:28)
Take pre-op antibiotics (03:50)
Remove any and all piercings (04:18)
Wear loose clothing (4:27)
Don’t get your eyelashes done (05:11)

Links:

Dr. Jason Hall, MD

Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

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For this episode I am joined by Dr. Mike Nayak. Dr. Nayak brings his unparalleled expertise in neck lift and facial surgery to the table, and we have a wide ranging conversation about neck lifting, plastic surgery, and work-life balance.

We discuss how he got started in St. Louis, and his roots in Missouri. He reflects on his experience starting a practice with his wife, and shares some secrets on how they’ve been successful alongside each other. Dr. Nayak’s sizable practice also provides him considerable insight into management and delegation, and his efficient system allows him more time to work with his patients. Dr. Nayak has become a neck lift expert and he takes a technical look at working in that space.

Highlights:

Introducing Dr. Mike Nayak (00:00)
What is like to work with a spouse (02:10)
Delegation and working well with staff (08:00)
Training (12:20)
The right neck lift (16:10)
Dr. Nayak’s take on kybella (23:00)
Dr. Nayak “deep neck” techniques and its potential dangers (26:15)
General anesthesia versus IV sedation and local (34:25)
Recovery from a neck lift (39:00)
Time management for surgeons(47:10)

Links:

Dr. Jason Hall, MD

Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

Links Referenced:

Website: https://nayakplasticsurgery.com
Instagram: https://www.instagram.com/nayakplasticsurgery/

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Rhinoplasty was one of the first episodes that I sketched out when I was contemplating starting the podcast, but I am just now sitting down to hit record. I wanted to make sure that I had a robust presentation and thorough examination of one his favorite operations. It turned into a case of "paralysis by analysis", not wanting to really record the episode until all the details were perfect. As it happens, one of the shows I wanted to do first hadn't been done after 10 shows. What follows is a good rhinoplasty overview, but not the broad scope of the operation I'd planned - including the history of the surgery, famous cases, etc. Those will have to come later.

In this episode, we cover how rhinoplasty is one of the earliest, and most popular, cosmetic procedures. Given its popularity it is important to iron out some of the “why's” behind choosing rhinoplasty. I discuss the importance of facial balance, how we see the face in “thirds”, and other keys to making an rhinoplasty blend well. I break down the different kinds of rhinoplasty, the important lingo, and more to help you better understand rhinoplasty as a whole.

Highlights:

Introducing the Rhinoplasty (00:00)
The three reasons for rhinoplasty (1:30)
How to make the nose dissapear into the face (05:50)
“Open” and “Closed” rhinoplasty (7:24)
Some important lingo (9:55)
The role skin place in rhinoplasty (12:50)
Rhinoplasty consultation (15:00)
The surgery and recovery (18:40)
Recap on Rhinoplasty (30:20)

Links:

Jennifer Aniston - She's the One photo

Gaze Tracking in Facial Cosmetic Surgery

Rhinoplasty revision rates

Links:

Dr. Jason Hall, MD

Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

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This episode of the podcast is one for anyone who is considering facial surgery. A year and a half ago, Kris Price elected to have a facelift, and decided to document her entire journey in a blog. The result was a story of self-discovery that has been detailed in a very raw and personal way.

In this episode, Kris discusses the decision-making process that led to her choice to get plastic surgery. She is open and honest about the hardest aspects of the choice, and what it was like to make that commitment. Kris also talks about her own improvements in self-care, and how choosing to have a facelift has made her more in tune with her own needs.

Highlights:

Dr. Hall’s opening comments (00:00)
Kris’s introduction (02:35)
How Kris came to the decision (05:36)
Developing trust (13:08)
Working with the psychology of self-care (17:00)
Recovery and post-surgery (25:34)
Interpreting the artistic eye and the natural result (35:15)
Worst part of the recovery (38:38)
Post procedure and final thoughts (42:14)

Links:

Dr. Jason Hall, MD

Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

Links referenced

Kris’s personal blog: https://www.lifeofkrisprice.com/

Transcript

Dr. Hall: Welcome to The Trillium Show, where we help you make the changes you want to see in your body, in your mind, and in your life. I’m your host, Dr. Jason Hall.

Dr. Hall: Today’s episode is going to be pretty interesting and I think that you’ll really enjoy this if facial surgery is something that you’ve had any consideration in at all. Kris Price is a longtime patient of mine, who underwent a facelift about a year-and-a-half ago when this podcast was recorded in January of 2022. And the interesting thing is that during the course of the interview, her recollection of the surgery and what it has done for her is very positive. And this is interesting because she blogged about her entire journey on her own blog that we’ll link in the [show notes 00:00:57].

And the experience that she shares of going through the process of facelift surgery is very different than what she feels about it now. And this really goes to speak to how the journey of facelift surgery—really of any cosmetic surgery—is one of self-discovery and one of constant change. And it’s something that we try and shepherd patients through, that’s kind of what we do as part of the surgery process, but it is something that patients may not really appreciate when they’re considering having cosmetic surgery. And I think it is going to be very interesting for patients who are considering facial surgery to listen to this show, but then go read Kris’s blog, and listen to her accounts of her recovery, for the first year. She writes very detailed descriptions of what she’s experiencing throughout the first year and being able to see that movie before you live it is, I think, going to be very helpful for patients who are contemplating going down this road. So, I hope you guys all enjoy this half as much as I enjoyed recording it. And without further ado, here’s Kris.

Kris, welcome to the show.

Kris: Thank you so much.

Dr. Hall: So, tell our audience a little bit about yourself, kind of, where you’re coming from, having nothing to do with plastic surgery.

Kris: Okay. I live here in Tennessee. We’ve been here about 27 years. I’ve been married, oh my goodness, over 30 years to my husband, my wonderful husband; we were high school sweethearts. And I have two boys. One is in school in Boston, trying to be a PA. So, bless his heart for wanting to go into the medical field right now.

Dr. Hall: Amen. Oh goodness.

Kris: And my other son has finally decided he probably wants to be a trucker. He wants to just drive a truck. He just loves the autonomy, and he knows the field’s really needed right now. They really, really, really need truckers right now. And so he says he wants to fill that niche.

I have worked mostly in the medical field. I started off in a business office and then I went to medical records, and then I started working in doctors' offices, mostly the front, first person you see type person. But then I did work in a hospital for about five or six years, I was a unit secretary on the floor. So again, the first face you see. Which is very odd for me because I’m an introvert, so it’s definitely very much out of what I’m comfortable doing.

Then I went to the pharmacy in the hospital, worked in the pharmacy for a year, and went back to unit secretary and a couple more doctors offices. And then my husband said, “Your job is done. You have paid for college for both children and you can come home.” I said, “How soon? [laugh]. Where’s the door.”

And about six months later, I came home. I’ve been home for five years. I’m 53 and hopefully do not have to go back to work in the near future. My husband has a good job, and he likes me being home. So. And I like being home.

Dr. Hall: That is awesome. So, you really have had an inside look at the medical profession from a bunch of different angles.

Kris: I wanted to be a doctor when I was in high school. My goal was to be a physician. Unfortunately, when I got to college, I never got bio-one. The first two semesters I was there, there were so many people trying to take biology one. And it was sort of a lottery system to get your classes. You were kind of assigned a number, and I never got it my freshman year.

So, I had to change because I couldn’t wait. I couldn’t do it. So, I guess maybe I decided okay, it’s just not worth the fight. And I was going to go to psychology, so I do have a bachelor’s in psychology. And then I got married and decided I could not do school one more year. [laugh]. I got married at 21, right out of graduating from College of William and Mary in Williamsburg, Virginia.

And I told my husband, “Can I take a year off? Let me get some money, help pay for college.” And I never went back. So, I never did anything with my bachelor’s, but people tell me I’m easy to talk to and people will come to me when they just need a shoulder to cry on. And I’m pretty good at giving advice anyway. So, even without official degree, I’ve been a pretty good person to talk to.

Dr. Hall: Well, I can attest to that it’s been—we hit it off from the very first day that we met. And I would really like to kind of dive into that a little bit because so much of plastic surgery revolves around psychology and how you feel about yourself that really… in a lot of cases, drives the desire to have surgery. And so, talk to me a little bit about the decision-making process that you went through on the front end because I think a lot of people struggle with that part of plastic surgery?

Kris: Sure. I did it for myself, totally completely for myself. I know there’s a lot going on in social media and news and celebrities and everybody’s talking about plastic surgery. And some people love it, think it’s great. Some people are—you should just age naturally.

I’m for both. I think you should age naturally. I don’t think you should become—you know, do too much. I think you want to look natural. And I think you should do it if you want to, I don’t have a problem with it.

I think it’s fantastic. I’ve had two plastic surgeries, not ashamed of it; I’ve been very open about it. I have an Instagram page, I’ve come right out and told people have had it done. And I’ve had people, several people in a group I’m in, gone on to have procedures because of my experience because they were afraid to until they heard what it was like to have it done. And my husband looks younger than I do [laugh] in some respect.

At 40, I quit dying my hair. So, I’m not afraid to age. My hair is silver. But I was tired of, you know, the body that having two children left me, so I had a tummy tuck. And then genetically, I have kind of a double chin. It’s—my grandmother had it, my dad has it, my mom had it.

So, I kind of couldn’t avoid that. I was [118 00:07:34] on my wedding day, and I still have a double chin in my wedding pictures. So, I was tired of looking it, and I said, “I’d like to have it done.” And my husband said okay. So, you know, my background for having it’s basically I just wanted to be happy with myself.

I wanted to be happy with what I saw on the mirror. And I wanted to have it done when I was younger because I don’t imagine when I’m 60 or 70 I’m going to feel like going under the knife. This is probably it for me. Unless my chin [laugh] my double chin falls again, this is probably it. So. [laugh].

Dr. Hall: Well, that’s certainly an understandable sentiment. And just to kind of give everybody a background, you are now over a year—we’ve known each other for almost two years—

Kris: Almost two years. Mm-hm.

Dr. Hall: —we met right before the world closed—

Kris: Yes.

Dr. Hall: —for Covid in 2020. And then your procedure was in October of that year.

Kris: Mm-hm.

Dr. Hall: So, you’re now 18 months out from what’s really, kind of, the big daddy of plastic surgery: Facelift.

Kris: It’s funny you say that because I don’t think about—I didn’t really think about it until you told me that. You said, “This is the big daddy.” And I was kind of like, “Really?” I… I don’t know, it was just a surgery to me. I didn’t really realize.

Then I kind of looked after the fact at all the—I’m reading your op note, and I’m thinking about all that you did. And I said, “Wow.” You know, this is a very technical surgery.

Dr. Hall: From a technical side it is but it also I think, drives a lot of anxiety when patients think about facelift—any facial surgery, whether it’s rhinoplasty, facelifts, eyes, is you can’t hide that.

Kris: Yes. The tummy tuck, you know, if something went wrong, I could still wear my jeans and top and, you know, hide that. That’s true. And then you have your facelift, there’s a little bit of a gamble. But anything was going to be better than what I was uncomfortable with. And I knew that you looked at me and you had no doubt, and you said, “I can fix that.” And I said, “Okay.” And then we went from there. [laugh].

Dr. Hall: And here we sit year-and-a-half later.

Kris: Yeah.

Dr. Hall: What was the hardest part about—if there was a hard part—what was the hardest part about making that decision to move forward?

Kris: The hardest part for me—and I asked my husband this question. I said, “What do you think the hardest part was?” And I want to see if he got the same answer I did, and he did. Was just spending that much money on making myself feel better about myself. Because it’s not inexpensive. I don’t think it’s expensive, based on some of the prices I’ve seen around the nation.

We live in a very nice area where things are more reasonably priced. But it was just kind of like, “Honey, can I spend this much money and have my face done?” For me, that was probably the hardest. But I was ready to jump in. We had my discussion in January, we were going to do it in March, and then we ended up buying a house. So, I had to back out for a bit.

And then Covid came, and so we had to wait till the hospitals were letting us—you know, it was little bit more easy to do the surgeries. Even though you have your own center, we waited to make sure everybody was safe. So, after that, the hardest part was waiting because I was excited to get done. But it is kind of hard to spend money on yourself in that respect. Buying clothes, buying shoes, jewelry, your hobbies, is different; it’s just something you do. But that’s a very personal decision to spend money. Very—it’s very personal. I don’t know how to put it. It was it that was hard. That was hard.

Dr. Hall: Well, your face is kind of the center of your identity—

Kris: It is.

Dr. Hall: —and not only are you changing that—changing it for the better—but you’re still making changes. But it’s also a big commitment in terms of time, time off, financial commitments, and so I can understand. And a lot of people feel that way.

Kris: Yeah, tummy tuck was easier to hide. When I had my tummy tuck I was, you know, you put your binder on, you put your clothes on, you go out , you walk around. And that wasn’t as big of a deal. Your face—when you have a facelift, you cannot go out immediately. I mean, it took me about two weeks.

Dr. Hall: Yeah.

Kris: About two weeks.

Dr. Hall: And that’s pretty, that’s pretty common. And I do want to get to the recovery part and have you kind of share what your recovery was like, but going back to decision making, did you’re—and you’re very open about having had plastic surgery in the past. Did your previous experience with plastic surgery—which we’ve told me in the past was a good one—did that influence this decision, make it any easier—or harder knowing what recovery was what you were in for—then you would think coming cold?

Kris: Both. It was easier in the fact that I already had one done and I had recovered and everything went great. I had a great result. It was harder in the fact that my tummy tuck, I took longer to recover the most people do. Because he did a really good job, pulled me really tight, and I couldn’t stand up easily for a long time.

So, I was kind of a concern that oh, yeah, you know, you told me, “Oh, a couple weeks,” and I was kind of going, “Oh gosh, am I going to be that one person that’s at home for two months recovering from this facelift?” So, it actually having had surgery before was easy. I trusted you. So, there was the trust that we had, and that made it very easy for me to—I was excited the day I got here. I was really excited. I wasn’t nervous at all.

Dr. Hall: And I think that’s the best way to go into it is to be excited. Little nervousness is okay and very normal. You talked about the trust part, you mentioned that just a second ago, and you were like most patients. You looked around and again were very open about the fact that you were looking around. And in plastic surgery, the fit between doctor and patient, and a personal bond there is really important. So, what things led you to say, “Okay, this is where I’m going to be.”

Kris: You were the third person I talked to. I really didn’t want to do the whole thing where a lot of people travel hours and hours away from where they live. I wanted to be able to do my follow-up visits, which with facelift are—you know, you’re following up a couple times after the first initial surgery. I didn’t want to drive four hours to Atlanta, or four hours to Nashville. I didn’t want to do that; I wanted to find someone in Knoxville.

And you were the third person that I interviewed. I was just trying to find names, and I tell you, googling names for plastic surgery is not an easy thing. It’s really hard. And I had talked to other gentlemen, they said that they didn’t think I needed it and that if I was going to have it, I should wait till my 60s. And I didn’t want to wait till my 60s—I’m not sure exactly the reasons I didn’t really go into it.

And I walked into your office and you took one look at my face, and you said, “Oh, yeah.” And I asked you, “Do I need to wait?” And you said, “Why?” [laugh]. And I told you because the other one of the doctors had told me that I had not gone through menopause yet and that I should wait because my face might fall.

Honestly, I don’t care. If my face falls, I will just have another one. I’m serious. I’ve already—my husband has already said if at 60, 65 your face has fallen, we will have you go back in and get a revision done. He’s already on the board for it.

It was your attitude. You were very confident you could fix it. You were very honest about well, you know, but you do have this or you do have this or whatever. And you just really took your time to look over my face and pull it and pinch it and all that stuff that you do. And I just liked your attitude about—your confidence and your attitude about that, you could do this for me. That was the main reason I stuck around. [laugh].

Dr. Hall: And I thank you for that. But I think one of the things that’s important with, especially with the initial consultation when we’re talking—and I say this not having ever seen anybody else do a consult outside of training—is that I get the feeling from listening to other patients that there is a lot of sales in the consult process. And I think one of the things that we really try and do—that I really try and do—is to be very open and honest with you. And if I don’t think something’s going to work, I’m just going to tell you; I’m not going to try and get you to do something because it’d be good for me. And that’s kind of what I hear you saying.—

Kris: Mm-hm.

Dr. Hall: —makes a difference.

Kris: I just sort of felt the level brushed off by the other two, to be honest. It was just kind of real cursory exam, I don’t think they really took the time to just play around with my skin or anything, and you really got in there, and you pulled my cheek here and pulled under my chin there. And you just really—I thought you did a physical exam of my face that these two didn’t even do. They just kind of looked at me.

Dr. Hall: And that is one thing that we have to remember: Even though we’re talking about cosmetic surgery, we’re still talking about medicine and surgery. And I talk to our staff about this all the time. If you want to have a successful treatment, that starts with an accurate diagnosis. You know, we can’t forget that this is still medicine. And that’s very important—the diagnosis is the most important part of it because you can’t plan a successful surgery if your diagnosis is wrong to start.

One of the things with that initial consultation that I hear a lot of is patients that are sitting in the consult room and make a comment that they feel very vain. Sitting in a plastic surgeon’s office talking about facial surgery. And from a psychology background—you can probably speak to this as well as a psychologist and a patient speak to this as well as anybody, did that ever cross your mind?

Kris: We just got back from lunch, and I said, “I feel vain,” at lunch. [laugh]. You mentioned that there is a bit of—I do still feel that way a little bit. Like, I had it done—you know, did I have it done for the right reasons? But I still come back to I had it done for myself, and if that’s vanity so what?

You know, I wanted to be happy. My husband says my confidence is better. He says, “I don’t care.” He says, “I don’t think you’re vain.” He says, “If you were vain, you’d be coloring your hair dark, you’d be having other things fixed, you’d be 100 pounds.” You know, stuff like that. He thinks—he looks at vanity as other things. And he says I’m not vain. But you do kind of feel a little vain fixing something. You do. But it’s all good in the end. [laugh].

Dr. Hall: The concept of vanity, especially in our industry, is interesting because the other way that you can look at that, especially with things like this, is self-care. And where do you draw the line between taking care of yourself and feeling good about yourself and something that is—you know, I kind of consider vanity to be a little bit of a pathological mindset. Where is that line?

Kris: This has actually increased my self-care. I have a result that I want to keep. So, my skincare has gotten better, things like that. I’m back to the gym after having been off from Covid—I quit the gym for a while just for social distancing—I’m back there. I want to be healthy. I want to eat well.

I had some relatives who did not take care of themselves and they died younger than they should have. I don’t want to be that person. So, that’s really all—it all kind of started because I was getting ready to turn 50, and so that’s when it all kind of started. 50 to me was, “Oh, my gosh, I’m middle age now.” You know? “I got to do something,” and, “I don’t want to be gone in my 70s.”

I want to be around as long as I can. So, there is some self-care that does come with this. I think you take better care of yourself after you’ve had the surgery than before I did.

Dr. Hall: I think that is true for most cosmetic surgery procedures is that once you’ve taken that step, you pay more attention to thing. You pay more attention to do you really want the Oreo, or do you need to kind of you know—

Kris: Yeah—

Dr. Hall: —you need to take a break.

Kris: Definitely, definitely. [laugh].

Dr. Hall: So, I think that’s very helpful for people who are on the front end of the decision-making process that it is—self-care is important, and you know, this is a part of it.

Kris: And it’s hard. Self-care is hard these days. Most people are work. They’ve got children. They’ve got, you know, jobs. We’re on 24/7, we have the internet, we have our phones, you have a computer with you 24 hours a day when you have your phone in your hand. There’s no off.

So, you’ve got to make that time for self-care. I really think it’s very important. Turn the phone off, turn the computer off, get to the gym, even if it’s for 30 minutes. I only go 30 minutes, get on the elliptical. And then I lift weights a couple days. I go home. It’s 30 minutes; I’m not there for hours and hours.

I just got to get some cardio in and stuff. But it has made it… it’s made it more important to me, it’s more important, that time off. I don’t take my phone into the gym. I don’t sit there and watch it. I just get away from it.

And I really encourage people, take that, take an hour for yourself every day, get to the gym, or cook a meal you want to cook, or stand outside and look at the nature, or get out with your kids and run around with them, read a book, whatever, it’s so important. We got to turn everything off.

Dr. Hall: And that’s very hard to do in the twenty-four-hour-a-day, seven-day-a-week connected, just, like, that time off, that’s something that I struggle with. My wife and I talk about this all the time that being able to put the phone down—

Kris: It’s hard.

Dr. Hall: —is hard. It’s very hard. Any tips?

Kris: I just really, I try not to have my phone near me if I’m—if I’m watching TV—I did this for a while; I’m bad again—I used to try leave the phone in the other room. I’m back to where the phone is next to me now. But just try to leave the phone in another room or keep the lid on your computer shut and block out an hour. Talk to your spouse or your partner or your kids, and just, “How was your day?” And cook a meal together.

My husband—I love to cook meals with my husband. That’s so much fun. We need to do that more. Just try to find something you enjoy. I crochet. It’s my passion. If I crochet, obviously I can’t have a phone in my hand. So, I found a hobby that [laugh] takes it away from me, anyway.

Dr. Hall: Forced solitude from the telephone.

Kris: Yeah. Or just, you know, some people say just turn it off for an hour a day and do something different for an hour. You’d be amazed, that our becomes two hours and then becomes three then becomes four. Over time not necessarily four in a row. [laugh]. Maybe four little hours sections.

Dr. Hall: Now, you go to the gym without your pho—do you feel naked? Do you feel like you’re leaving forgetting something?

Kris: No I don’t.

Dr. Hall: You don’t?

Kris: No. I’m watching the TV. I belong to a fitness center that has TVs, and so I just watched TV. And I don’t have TV at home. We just stream everything. So, it’s my chance to catch up on the news. So, I watch the news when I’m there. Or HGTV, of course.

Dr. Hall: Okay. I was going to say I’m sorry, if you have to catch up on the news. That would make working out even worse. [laugh].

Kris: [laugh].

Dr. Hall: You have to watch the news. So, getting rid of your cell phone, at least a little bit, is very healthy, but also very difficult.

Kris: It’s very difficult.

Dr. Hall: I try and put it down to go outside, and I find myself looking—like feeling in my pocket and saying, “Oh, my phone’s—what if somebody needs me?” And you know, it’s a hard thing to do.

Kris: I’m back to where it’s in my palm all the time. So, I’ve got to get back to it again. I am not the pot calling [laugh] the kettle black. I can be one of the worst people at times. Yes.

Dr. Hall: Yeah, it can be challenging. One of the things I did want to talk to you about is—along the same lines of the vanity question—is people who are outside of medicine, that this is a foray into a different world for them, really can have a difficult time justifying having an elective cosmetic procedure that’s just for them and undergoing what is a lengthy anesthetic. I mean it’ you’re asleep for—your surgery was five hours?

Kris: Five hours.

Dr. Hall: Yeah. It is a long time to be under anesthesia, and I hear patients every week say is this really smart? Is it safe? It’s elective surgery and it’s going to be this long. And did you have any feelings like that? Or was it was your time in medicine, kind of allay those fears?

Kris: Yeah, kind of because I worked on surgery units. When I was unit secretary, I worked on surgery units. I wasn’t worried about the anesthesia. I’ve had carpal tunnel, which carpal tunnel is a very quick surgery, but I’ve had carpal tunnel surgeries before. I really wasn’t worried about the anesthesia at all. It was not a concern.

The longer you’re under, of course, you’ll be under the influence more when you get home, so you just have to keep that in mind.

Dr. Hall: Yeah.

Kris: So it took me a while. It took me until—my surgery was on a Monday and it took me until Tuesday afternoon. It took a good 24 hours for me to feel better. So.

Dr. Hall: Yeah, it does. Those longer procedures you know getting the anesthetic drugs out of your system, you feel kind of… uh, dumb, for lack of a better term.

Kris: I don’t remember the drive home. It was an hour. You know, I don’t remember it. So. [laugh].

Dr. Hall: Yeah. You wake up—and we do things here like that by design so that you the last thing that you remember is us talking and holding, and then the next thing you know, you’re asleep at home. You wake up in your own bed.

Kris: Well, and I’m one of those I have a harder time coming out of anesthesia, too I think it took your team about an hour to get me out, which was a little longer than they thought it would take them. So, I always—takes me a little bit longer anyway. So, knowing that, I guess I should have been concerned, but I wasn’t at all.

Dr. Hall: Yeah. That’s a good thing. Good thing. Well, I want to shift gears a little bit and talk about recovery—

Kris: Okay.

Dr. Hall: —and talk about your experience after surgery, specifically, and one of the first questions that you asked that most patients who are looking at facelift surgery ask is, “When am I going to be presentable again?” And I tell everybody, about two weeks. What was your experience?

Kris: That is probably about right. It was about two weeks. My surgery was on October 5th, and I did early voting a couple weeks later. I went out, I still had some bruising on my neck. I still had a little bit on the lower jaw because, of course your blood is gravity.

I put makeup on my face, I did my hair, and I took my picture and I stuck it on Instagram, said, “I early voted today.” And you could not tell. Could not tell. My hair is longer, it is shoulder length, so that did help hide a little bit of the bruising that was still on the neck, but I felt good enough to go out. I felt really good. My recovery was—the recovery from a facelift, even if it’s the big daddy of surgeries, is easier for me than the recovery of my tummy tuck.

Dr. Hall: And I find that, in my patients who’ve—we’ve done both operations on to be true. The tummy tuck is a harder recovery because of the muscle repair—

Kris: Exactly.

Dr. Hall: —and you don’t realize how much you use your core until it hurts to use it.

Kris: Yep, yep. No idea. [laugh].

Dr. Hall: And facelift surgery, most of the recovery really is cosmetic.

Kris: Yeah. There was no pain. You gave me pain pills; I didn’t take one. I—was Ibuprofen. It’s all I took. I didn’t even need anything strong at all for that.

Dr. Hall: Yeah. And that’s very reflective of most people’s experience, is that swelling, bruising, is—that’s your recovery is getting over that part of it.

Kris: Yes. Yes. I think that’s the hardest part of the facelift in recovery is the waiting to see your results. That’s the hardest part.

Dr. Hall: Mm-hm. Yeah. Because you’re excited—

Kris: Yeah.

Dr. Hall: —but then—you know, kind of jokingly tell people, you kind of have to get through the pumpkin head phase, which is the first week for most people.

Kris: Yeah. I looked pretty [laugh] swollen the first week. Yeah.

Dr. Hall: And you can see for—just, you know, if you’re other people out there listening to this, you chronicle this on your blog in great detail.

Kris: Yeah, every time you took pictures, I put them up there and said, “This is where I’m at.” And then I did some pictures even in between my visits to see you. And I just wanted people to see what it’s like to have one, and maybe someone would say, “Hey, I really want to have this done. And it’s really not as bad as I thought.” And maybe I can encourage someone to do something for them that they really want to do.

Dr. Hall: Yeah, your blog—and we’ll point people to your blog in the [show notes 00:28:19]—is really a great resource because you took a lot of pictures even in between—I was going through your blog last couple of days—in between surgeries—or in-between visits. You were taking interim follow-ups and posting, you know, day three, day eleven, that were chronicling your recovery, and you can see very clearly when you—and you even say it in there. You said, “He told me it would be two weeks and here it is two weeks, and I finally feel like I’m able to go outside.”

Kris: Yeah. And when your doctor says it will be a year before you will see the final result of your facelift, he is not lying. It took a year I actually think I may have—let’s see, I saw you after a year, so that was October. It’s… my—I think my face has even gone just a little bit slimmer. Just a smidge, maybe. I feel my jaw line’s a little more defined than since I saw you in October. I’m not for sure but maybe just a little bit.

Dr. Hall: It looks great. And your photos—by the time this gets aired, your photos will be on the website so everybody can check it out and they can see it on your blog. To be fair, though, and you talk about this on your blog, and we just talked about it here is your skincare got taken up a notch in that year.

Kris: Yes.

Dr. Hall: And you can really see, that is another thing that really helps with facelift results is taking care of your skin because that is the first thing that people see.

Kris: Well, I actually started using more medical-grade skincare before as a prep, for about a year before I had the surgery done. And I think that helped. My skin was much better. And then I’ve continued it since, and I will not go back. There’s great things on the market and I could use them.

I’m afraid to [laugh] this point because I have a great skincare that works for me and I have found ways to make it stretch a little bit, so it’s not quite so pricey, but my face is worth it. So, it’s the one thing everyone sees, so why would I not spend the money on my face?

Dr. Hall: That’s a great point is that if you’ve gotten to this point, skincare is super important. I do have to know because I know people are going to ask, what are the tricks to s—because some of these skincare, you don’t need many. I did a show on aging; we talked about the skincare, recommended skincare regimen, which is only three products. If you’re listening, go back and listen to that. But they’re one of them in particular is pretty pricey, so how do you—what’s the trick to stretch it?

Kris: Well, most products will tell you to use it morning and night. And I have two different products and I use one in the morning and one at night, which stretches it a little bit. And sometimes at night, I just used a very, very nice inexpensive moisturizer. I don’t always do the morning and night because I don’t feel that my skin at this point needs it. And if I get a little older and I see some more fine lines coming out I might, but for me, I don’t use the morning and night routine.

So, my bottle that’s supposed to last three months lasts me six.

Dr. Hall: Okay.

Kris: So, for me, it works.

Dr. Hall: Mm-hm.

Kris: For me, it works. And then there’s one product I have and it has, like, steps to do it, you know, you have this and this and this. Well, I was told to combine all of them together and put it all at one time. So, you don’t need two pumps. You feel like you have enough to cover your whole skin.

So, I’ve learned to combine few things. Sometimes I’ll put my moisturizer and my sunscreen in the same bit and I get more on my face, so—and sunscreen, very important. Very important. I was not a sunscreen user until a couple years ago.

Dr. Hall: Sunscreen is vitally important.

Kris: Yeah.

Dr. Hall: Now, not going to treat anything, but it’s going to keep you from aging as rapidly.

Kris: My skin is better. It’s not as blotchy.

Dr. Hall: Yeah. Yeah. And it also cuts down on what we have to do during the winter to clean up all the blotchy that you collect over the summer. The other thing that we talk about other than just recovery time itself, is the emotional rollercoaster that patients go through after any plastic surgery, but especially after facial surgery, it is—you can double down on the emotional rollercoaster ride that you go on. Did you experience that?

Kris: A little bit. A little bit. Of course, the bruising took a lot longer because of the gravity. The bruising in my neck. I had that for a good six to eight weeks where that one spot that had a little bit more trauma to when you were removing the fat from my neck.

And I was kind of like, oh my gosh, “What did I do to myself?” You know, “Did I really do this?” But the result is so much better. I was just shampooing my hair this morning, and then I was washing my face, and I was washing my neck and I thought, “Wow.” [laugh]. I have these moments where I’m like, my neck is so thin now. It’s so much better.

So, I would have those moments where I’d be really down and then I would do something or I’d see myself in a different angle. And, “Oh, wow, this was so worth it.” You know, “Yay.” I look in the mirror now, I do have a little bit of extra skin under my chin that I think it’s just I have laxity—we talked about it—

Dr. Hall: Yeah.

Kris: —I have lax skin. So, I do have a little bit below my chin that sometimes I get kind of like oh man, if that just wasn’t there. And then I watch a TV show and I see this celebrity and she has the exact same neck I do, and she’s never had anything done. And I think, “Okay, I look just like her so it’s okay.” You know, you have to see people your own age that have, you know—and you know that it’s normal.

And my biggest thing that I told you is I wanted to look like myself when I was done. And you did that for me. I look just refreshed. And you took a little bit of you know, you pulled everything back a little bit, I don’t look as angry anymore. It pulled back a little bit the downturned mouth.

And I think that is the biggest thing that I’m so thankful for is I can look at any old picture of myself and compare it to what I see in the mirror and I still look one hundred percent like I did before. I just look better. If that makes sense. I still look like myself and that was so important to me. I didn’t want to look—I didn’t want people to look at me and go, “Oh, my gosh, what did she have done?” I didn’t want that look.

And that’s one of the reasons I chose you, actually; that’s the number one reason I chose you is all of your befores and afters on your website, I was like these women look just better, but they still look like themselves. And that was so important to me. That was really important.

Dr. Hall: I very much appreciate that. That is the goal of plastic surgery is that you look like you, we just tweak it a little bit.

Kris: But we see a lot of, we see a lot of stuff in social now where people have just gone a little bit too far. And that’s okay. If they’re happy with it, great. I’m happy that you’re happy. I just didn’t want that for myself. I wanted to look like me.

Dr. Hall: Yeah. And that’s another—to kind of go back to where we’re talking about choosing surgeons from a patient standpoint is that surgeons, not to toot our own horns that, you know, we’re all artists, but there is an artistic component to aesthetic surgery. And if what I think is pretty and what you think is pretty are different things, or you start looking through the website and you think one of those people looks really good, and then the other ten look kind of weird, you can assume that my artistic eye thinks that’s going to look good, otherwise it wouldn’t be online, that’s where patients have to start scratching their heads, maybe I ought to look somewhere else.

Kris: Well, and you had me bring in those pictures. You said [crosstalk 00:35:49] some old pictures and I did, and you looked at those. And that helped. I’m sure that helps you. And you took a long time to give me the result.

My surgery was a little bit longer than you had thought it was going to be, but it was because when you got in there, there were some extra things you had to do to get that result that you wanted for me. And so I really appreciate that you took about an extra hour, I think it was—

Dr. Hall: Yeah.

Kris: —than you had originally thought but you got in there and said, “Oh, wow, I got to do this to make it be what she wants and what I want for her.” So.

Dr. Hall: Yeah, this is one of those operations—like, every operation in plastic surgery is, you know, we don’t want you asleep for a day-and-a-half, but at the same time if we have to take a little bit longer to get what we need done, done, we’re going to do that. We’re in no hurry. So. But yeah, I think that's what people see.

And unfortunately, Kenny Rogers is the, kind of, poster child for facial surgery that’s been taken a little too far. And most patients that have any little hint of being nervous about facial surgery, will invoke his name and say, “I just don’t want to do that. Please don’t do that.” And that’s where I think that the natural result is really what is the hallmark of what I consider to be good plastic surgery, is that if you just look better, and you have to tell somebody that you had something done, that’s probably the biggest compliment that anybody can pay me.

Kris: I’ve had people say, just in the last year or so, people—and like I said, I’ve been very honest on Instagram, Facebook, I journaled my journey on my blog, and I’ve been very honest about people, I’ve had it done. I guess because I didn’t want any questions [laugh] in case it didn’t look right—

Dr. Hall: Heading them off at the pass.

Kris: Yeah, but I have had so many people say, “Kris, you just look amazing. You just look so refreshed.” And I get people—my son—oldest one—is 28 and he has friends, and he was showing them pictures of his family, and his friends looked at him and said, how old are you? Because he made a comment that we’d been married over 30 years. And he said, “Well, I’m 28.” “How old is your mom, is your dad?” And he said, “Well, they’re 53.” “Well, they look like they’re in their 40s.”

Because… it did help. [laugh]. The facelift did help; it did make me look, like I said, more refreshed. The lines aren’t there. I am doing Botox in my elevens, between my eyebrows, and that has helped I don’t look angry anymore.

So, I think that has helped. But that’s really that skincare. That’s all I’m doing. And I don’t know. I like people telling me I look younger than [laugh] I should look for my age.

Dr. Hall: Well, of course.

Kris: That’s nice. [laugh].

Dr. Hall: Last question is kind of procedural-related question. What was the hardest part about recovery? What’s the—you look back and you say what was the worst part about the recovery process?

Kris: Oh, hated the drains. They only last a day.

Dr. Hall: Yeah.

Kris: I was worried about how they would feel coming out. That was my worst worry. They didn’t feel—I didn’t feel anything, so if anyone’s afraid of the drains, don’t be afraid of the drains. It’s not as bad as you think it’s going to be. And just that wait.

The recovery—recovery, you think of surgery, oh it’s a couple of weeks, but a facelift really literally is a year. And that wait to see that final results is hard at times. By nine months, you got a pretty good inkling. But there were still some changes between 9 and 12 months. I mean you can see them in my pictures.

There’s just a smidge more tightening and stuff like that. But the home recovery, everything was hunky-dory after about two weeks. It’s really not bad at all. And there’s no pain; you’re not having to worry about taking pain pills—for me. For me, there wasn’t a lot of pain.

I encourage anyone, if you want a facelift, go get one. It’s, just make sure you have the doctor you trust and have good relationship with. And… but I—[laugh] who knows what I’ll have done next. [laugh].

Dr. Hall: [laugh].

Kris: Let’s see, my eyelids are a little hooded—no, just kidding. [laugh].

Dr. Hall: So, now I just have to jump in. You looked awesome at—whenever that was—at six weeks when you went voted.

Kris: Yes.

Dr. Hall: It wasn’t a year before you look great.

Kris: It was less than two weeks, right.

Dr. Hall: Two weeks. Okay.

Kris: Uh-huh.

Dr. Hall: So, even better. So, two weeks you were out in public and looked great. It’s just between that two-week mark and the year, there’s all sorts of little fine-tuning things that just continue to improve over time. I just don’t want to scare somebody off go, “Oh, man, it’s going to be a year.”

Kris: No, no. The year part is just to get that final fine-tuning with the—everything tight and where it should be and stuff. But I would say I had my initial result probably in two months. I think after two months, I looked pretty where I was going to be.

Dr. Hall: Yeah.

Kris: Yeah. All the swelling was pretty much down after two months. So, and then you didn’t see me again, until six after two months.

Dr. Hall: Yeah. Yeah, we saw you here for laser, but I think I was running around like a chicken with my head cut off—

Kris: As usual. [laugh].

Dr. Hall: Yeah. As usual. I very much appreciate you being on the show today. But is there anything that we haven’t hit on that you wish you would have known two years ago about all this?

Kris: I really don’t think so. I think that I did some skincare stuff with you for that first year. I did some lasering and I did the elevens. I had never done Botox before; never tried it, and your injector said, “You know, it would help and you would look a little more refreshed because you look a little angry.” I said, “I know.”

And we talked about that at my laser. And I think in the year while you’re recovering, I think you ought to play around with some extra stuff and find some things that maybe help you keep—I think you need to keep what you’ve spent the money on. And I’m glad I did that. And I don’t know if people think about that. So, I think I might have played around a little more was some of the other stuff.

But it was nice that your office members were just really nice and encouraging, and say, “Well, try this.” And they pointed me to some skincare, and they wanted me to have some sunscreens and stuff to try and everything. So, be friends with the staff at your plastic surgeon’s office because—especially, you know, the injectors and your skincare specialists because they're worth coming in to talk to while you’re recovering.

Dr. Hall: Mm-hm. That’s great advice. And one of the things that we have done since you had surgery is made that more of a part of our initial planning is that post-procedure recovery, and really trying to teach you on the front end, how important skincare and little things—

Kris: Right.

Dr. Hall: —a little Botox here and there, a little bit of skincare, which products, laser treatments, treating pigment, but all of those things, talking about those on the front end because you’re a good testament, we kind of hit that as we went along, instead of planning it up front, but the skincare makes such a huge difference—

Kris: It does.

Dr. Hall: —at your one-year mark. And then you have since kind of transitioned into maintenance mode, which is a whole lot less work.

Kris: It’s a lot less work. [laugh]. Yeah, and I have to say they’re right. Well, for me, the Botox, I don’t have to come in every three months; it’s staying a little longer, which I had read usually happens once you’ve been using it while.

Dr. Hall: Yeah.

Kris: So, that’s nice. So, I was able to skip my treatment today. I’ll see in about a month or so. [laugh]. So.

Dr. Hall: Okay.

Kris: But I’ve been really just so happy with the whole experience, I would do it again. And I will consider this to get actually, I will. If ten years down the road, you know, I’m not happy, I will do a revision, and I’m not afraid to. And by then my husband’s probably going to be, you know, 60 looking like he’s 40 still, and I’ll have to catch back up to him again. So. [laugh].

Dr. Hall: Kris, any final thoughts?

Kris: Well, it’s been interesting sitting here and thinking back because I really didn’t prepare for this. I didn’t know all the questions you were going to ask me. The most important thing I want your listeners to know is you have your own journey. And whatever your journey is, don’t let anyone dissuade you from what you want to do, your journey into self-acceptance. Because that’s what this has been about for me is my personal self-acceptance.

I have had my facelift for me, not for anybody else. And I don’t care what other people think, but I hope everyone just chooses to do what they want to do that will make them the happiest. That’s what I want people to get out of this interview that you’ve done with me is whatever makes you happiest. And I also want to say a huge thank you for being with me on my journey. I have trusted you the whole time and you have to have a certain trust in me, too, to do the things that I’m supposed to do, you know, wear the wraps or coming from my follow-ups and all those things.

And your staff is fantastic and you listened to me, you gave me the exact result that I wanted which I can look at a picture of myself from 15 years ago, 20 years ago, I look just like myself, just better. And that is exactly what I wanted, and I am so happy. I’m just really, really happy. I was—that’s probably one of the things I was most worried about was what am I going to look like one year after I have the surgery done? And I just thank you from the bottom of my heart for everything that you’ve done for me, and I’m really, really just thrilled with my results.

Dr. Hall: Well, thank you. That really means a lot. And I don’t think that there’s any honor that a patient can give me in my staff than trusting us with your care. So, thank you for trusting us and allowing us to help you on this journey. It’s been really special.

Kris: It really has.

Dr. Hall: Thanks again, Kris.

Kris: Thank you.

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Plastic surgery on occasion tackles some sensitive topics. Today’s subject, labiaplasty, certainly belongs in that category. While other surgeries may have more social prevalence, such as breast augmentation or rhinoplasty, there is an emerging sensibility about the role labiaplasty plays.

In this episode we cover the rise in popularity of labiaplasty here in the US, and how the taboo around it is slowly going away. We discuss the importance of understanding what a labiaplasty actually is, what it ultimately does, and the changes it can make for the women who choose to have the procedure.

Highlights:

Introducing labiaplasty and getting to the better information (00:00)
What a labiaplasty actually is (02:00)
Who gets labiaplasty (04:45)
How the surgery is done (07:07)
Recovery (12:15)

Links:

Dr. Jason Hall, MD

Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

Transcript

Dr. Hall: Welcome to The Trillium Show, where we help you make the changes you want to see in your body, in your mind, and in your life. I’m your host, Dr. Jason Hall.

All right, welcome to the show. On today’s show, we’re going to talk about a really sensitive topic. Now, most of plastic surgery, most of the stuff that we discuss on the show is really out in the open. Labiaplasty surgery is not there. It is still very hush-hush, obviously, and is not one of those procedures that people talk about at parties, or that you’re going to discuss with a casual group of people like you would a breast augmentation or rhinoplasty surgery.

However, labiaplasty is really becoming more popular in the United States, largely due to social media and a more relaxed attitude towards plastic surgery enhancements. Every year, there are about 10,000 labiaplasties performed in the United States and that number is going up. So, labiaplasty is a thing, for lack of a better term, and it is one of those things that people are looking for information for. And the reason to make this show, in particular, is that there really is not a lot of good information out there. There’s a lot of social media stuff; not a lot of great information.

So, why I really wanted to record this episode is to give you good information about what a labiaplasty is, what it treats, and what else is out there because there are other non-surgical treatments that are out there that are kind of aimed at the same population, but not really. So, let’s start with what a labiaplasty actually is. Now, without going into great anatomic detail here, there are two main portions of the female external genitalia that we surgically manipulate. One is the labia majora, which are large and largely fatty tissue on the outside, and then the labia minora, which are on the inside—so medial or inside of the labia majora—and are right at the edge of the vagina and urethra. This is the very thin tissue that does have muscle in it that is highly sensitive and sort of shields the opening of the vagina and the urethra, as well as providing cover for the clitoris.

In labiaplasty surgery, what we’re primarily doing is altering the labia minora which is that thin tissue on the inside, which can get stretched out or enlarged, or some women are born with it enlarged. Now, why would we want to perform a labiaplasty and remove this tissue? Well, there are medical reasons for that, mostly chafing, pain, discomfort with activity or exercise, something called dyspareunia, which is pain with sexual intercourse, but a lot of the reason for labiaplasty is cosmetic and psychological: Women feel that their labia are too long, that they’re too protrusive, that they’re asymmetric, that they are embarrassed to wear tight clothes or swimsuits, or they’re self-conscious when they’re undressed. And all of those things can really damage a woman’s self-esteem and lead to difficulty with sexual relationships.

This has actually been studied in 2016, in a behavioral science journal, and women who demonstrate a positive genital self-image demonstrate higher levels of sexual self-esteem, which make them feel more sexually attractive. And I think that’s probably a no-brainer of a statement, but if you feel good about the way that your genitals look, you’re going to feel more sexually attractive. And this is really, I think, the driving force behind a lot of women seeking labiaplasty surgery. So, that gets to, kind of, the next point which, who gets labiaplasty? Some of my labiaplasty patients are moms who are done having children, but many if not most of them are in their early-20s, never had kids, but are embarrassed by the appearance of enlarged or asymmetric labia minora that make it difficult to wear swimsuits, tight clothes, exercise without discomfort, or they’re just embarrassed at the way they look naked.

And, like we kind of said before, this can really damage sexual relationships and sexual self-esteem. Some of my labiaplasty patients are moms who are done having kids and who have very similar complaints but feel that the changes that they see in their labia minora are largely due to childbirth changes, with hormones that come with age, but we end up treating essentially the same problems. Some women have seen their gynecologist, who have tried to dissuade them and told them not to worry about their problem, that it wasn’t a big deal, that the surgery was very dangerous. And what we see, as plastic surgeons, is that many gynecologists traditionally have a very dismissive attitude toward the surgery because, in their literature, labiaplasty surgery does carry a fairly high complication rate of about 20%. Now, you can contrast this with the quoted complication rate in the plastic surgery literature, which is one-fifth of that, which is about 4%.

And there’s probably room for jokes between the specialties there, but gynecologists, in all fairness, have no training in cosmetic surgery, where plastic surgeons, we learn how to do this operation during our training. But it’s also, from a principle standpoint, very similar to a lot of the other procedures that we do, specifically an upper lid blepharoplasty. The techniques are a little bit different, the way we approach the operation is a little bit different, plastic surgeons tend to be more liberal at using labiaplasty surgery because of its low complication rate and because of its very high patient satisfaction.

So, let’s talk surgery. How’s the surgery done? So, first thing, before we talk about the surgical details is, I want to differentiate between labiaplasty and vaginoplasty. Labiaplasty, which is what we’re talking about here, is removing excess skin on the outside of the genitalia. Vaginoplasty on the other hand, is tightening the vaginal canal.

This is often the result of childbirth or birth trauma such as an episiotomy, and can also occur naturally with menopause. Surgical vaginal canal tightening is muscle repair. It’s tightening the muscular wall of the vagina to narrow it. And when we do that, that is oftentimes combined with labiaplasty surgery but doesn’t have to be. There are also non-surgical vaginal tightening methods which are out there, there are lasers which can tighten the muscles of the vaginal canal, and these offer—compared to surgery—fairly modest results that are less predictable because we’re relying on muscle tightening as a result of heating. Some of the very same principles that we talked about in the laser show apply to that procedure as well.

Now, the important thing to remember with vaginoplasty surgery is the need for vaginoplasty can often be accompanied by other medical problems, problems with the—genitourinary system, pelvic floor laxity problems—and so a more extensive medical workup is really necessary before a vaginoplasty is performed to make sure that there are no other issues that need to be addressed at the same time.

Okay, so let’s talk surgery here. There are two main labiaplasty techniques. One is the wedge resection, the second is the trim technique. Now, the wedge resection is just what it sounds like. It’s essentially taking a wedge or a pie piece out of the excess labia that includes both skin and muscle, and then sewing those two edges together to shorten the labia and make them smaller.

This technique works but has a much higher rate of complications. There can be notching, there can be dehiscence, or where the suture line comes apart, and the need for revisions if any of that happens because essentially, the whole thing comes apart, falls apart completely. Because it’s a non-anatomic resection. Contrast that with the trim technique—a modification of which is what I do—is where excess tissue is removed laterally and no muscle is removed. It is essentially skin only.

And this is really where the similarities between labiaplasty and blepharoplasty are most apparent is that we’re taking off skin, hiding incisions, really in plain sight in tissue creases where they’re right there. But because of the way the skin is removed and closed with no tension and buried sutures, which are underneath the skin and dissolve and never need to be removed, that we’re able to reshape and really beautify that entire area, with incisions that are almost invisible. Trim labiaplasty is often combined with clitoral hood reduction to elevate and expose the head of the clitoris, and that can be easily done with the same hidden incision as used for a standard labiaplasty. Dehiscence, or the suture line coming apart, really is not a problem with a trim technique because we respect the natural anatomy; we put those incision lines in natural skin creases, we’re not removing muscle.

And so if a suture gaps a little bit, or God forbid, there’s a blood clot or something else goes wrong right after surgery, the entire thing doesn’t come apart and need to be redone. And, you know, whenever we talk surgery, the discussion of complications as important, and the trim technique just carries a lower chance of problems, even though the chance of problems is low already. Surgery itself, in my practice, we do this under general anesthesia. Takes about an hour; you’re asleep the whole time and go home the same day. I know there are some surgeons that do this as an outpatient procedure under a local in their office.

For my patients, I just find that it’s easier and much more comfortable to do this under an anesthetic, you’re asleep, you don’t have to worry about whether something that I’m going to do is going to hurt, and it just makes it a much more pleasant experience for everyone. In terms of recovery, you’ll be able to return to work after labiaplasty within a few days, but you will really need to avoid any exercise or any other strenuous activity for about a month.

A couple of recovery tips after labiaplasty. Number one is, wear loose cotton undergarments and avoid any clothing that’s too tight or too irritating. And you’re going to want to follow that one for about a month. You just want to make sure that nothing is too tight and constrictive. You’ve just had surgery, you don’t want to constrict that area, and goodness knows, you don’t want to disrupt the suture line. But you also—if things are tight, it’s just going to be uncomfortable, so avoid anything that is tight for at least a month.

Number two is, wear a maxi pad is covered with a lot of antibiotic ointment. You want to make sure that the suture lines stay covered in antibiotic ointment for at least the first week after surgery to really let those incisions heal. Those incisions in my practice, all of the sutures are buried, so there’s no stitches that are going to be sticking out or catch, but you don’t want anything sticking to that suture line and pulling and potentially disrupting it.

Third is that ice is going to be your friend. And this—you could probably say that about every plastic surgery procedure, but ice is going to help reduce swelling and reduce discomfort, especially during the first two or three days after surgery.

Tip number four; biggest question we get is, “When can we have sex?” And what I tell patients is you want to wait a month. Give yourself a month, no tampons, no intercourse, and avoid crossing your legs for about a month after surgery. Again, you just want to let this area heal without any unnecessary trauma. In my practice, we see our patients back for their, kind of, clearance checkup at six weeks, and the incisions after labiaplasty are really difficult to see at six weeks.

At the three-month mark, they’re practically invisible. And my patients will tell me afterwards that they’ve been to see their gynecologist for their annual checkup, their gynecologist couldn’t even find their incisions. And that to me, that tells me that I did a good job, is things look… natural, look pretty, and incisions are almost invisible. So, this is a shorter show, but really wanted to get this out there because, you know, labiaplasty is a rapidly growing procedure here in the US. It is an incredibly beneficial operation that offers not only functional improvement but improves a woman’s quality of life and self-confidence in a way that’s really difficult to describe. So, if you’re interested in learning more about labiaplasty, you can check out my website for more information, or hit me up on social media @jhallmd. Thanks, everybody.

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For this episode we are joined by an old friend, Claire Balest, owner of Claire Balest Hair + Makeup who has worked all over the world for her work in the wedding industry. At a pivotal “crossroads” in her career Claire decided to branch out into her own business, and her path has been nothing but meteoric since then.

In this episode, Claire talks about the nuances of starting her own business and how her go get it attitude drove her success. She also gives us some wisdom on how to build out a robust team of experts that translates to any field. Claire has made empowering her clients a central ethos for her business and a thoughtful refocusing of what beauty can be. The result is a stellar example of success in the industry!

Highlights:

An introduction to Claire and her work (00:00)
Claire takes a different direction with her career (02:00)
Claire’s perspectives on building a great team, and empowering her clients (06:23)
Finding the “right fit” with clients (13:20)
Navigating the industry in the age of overwhelming information (19:20)
Problems in hair and makeup that Claire is tackling (23:53)
How Claire discusses beauty with her clients, deconstructing “perfectionism” (30:50)
Lessons to take from the French and focusing on skin care (39:30)
Claire’s recipe for what makeup to use (46:20)
Claire’s message about beauty (51:15)

Links:

Dr. Jason Hall, MD

Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

Links Referenced

Claire Balest Hair + Makeup: http://www.clairebalest.com/
Instagram: https://www.instagram.com/clairebalest/

Transcript

Dr. Hall: Welcome to The Trillium Show, where we help you make the changes you want to see in your body, in your mind, and in your life. I’m your host, Dr. Jason Hall.

Dr. Hall: So, welcome back to The Trillium Show. Today I have the distinct honor of being joined by Claire Balest. Claire and I have known each other for a long time. She is the owner of Claire Balest Hair + Makeup.

She has been recognized by Martha Stewart Weddings, Brides magazine, all sorts of industry publications, for her work in the wedding field, in makeup. She has traveled around the world to do destination weddings at places where you would definitely recognize and is a fixture up at Blackberry Farm for their wedding events. So Claire, welcome to the show.

Claire: Thank you.

Dr. Hall: Now, you have been all over the world for work, and some of the places that we were talking about before we hit record, places like Aspen, the Yellowstone Club, the Bahamas. What’s the coolest place you’ve been for work?

Claire: It’s not really a fair question, but I could give you a top three, maybe. Yellowstone Club is amazing; Montana has my heart, but I have to say we just did an event in Aspen at Kevin Costner’s ranch out west, and it might be my favorite, simply because I thought I would run into Rip out there, from Yellowstone. I was hoping it didn’t happen, but there’s always next time. And maybe he’s going to hear this podcast, and… I don’t know.

Dr. Hall: So Rip, if you’re out there listening, an invitation is an order. So—

Claire: [laugh]. I’m just putting it out into the universe. I mean, my husband knows. He said he would be honored. I mean, Rip from Yellowstone. I can’t. Anyway, Brush Creek Ranch was amazing. Aspen was definitely an incredible destination to have worked.

Dr. Hall: You have a background in the theater and have been working in film behind the camera after your theater career. And then I heard a story that you kind of had a pivotal turn, you know, one of these times in life where your life is headed in one direction, and a decision that may take you 30 seconds to make totally changes the course of your career. Tell me about that.

Claire: Right. Yeah, so it was one of those crossroads where, you know, I had a job and I had a choice to make. I had a phone call about production with a production company that I had been trying to work with for a long time. And I had to choose between continuing to do what I was doing with this other company, which I was grateful for, but it essentially meant that I was breaking off and going on my own. And I actually had a conversation with the person that I reported to at the time, and she was like, “I completely understand your decision, but we just can’t—you’re not going to be able to continue working, you know, with us.”

And so that was when I broke off and started working on my own. And that was it. I mean, it was truly one of those like, “Okay, I’m going this direction.” And it was just such an incredible decision. But it was truly a leap of faith, which any business owner understands. I mean, it is, like, a faith-based business, you trust that work is going to come to you and the right work is going to come to you, and it definitely has.

Dr. Hall: I would imagine if you’re anything like any of the rest of us who have gone out on their own and started their own business, that there were a lot of sleepless nights in there. You didn’t have a set schedule when you made that decision. It was a one-time thing.

Claire: Right. When I started doing that it was you know, I was freelance. So, you basically sit and wait for the phone to ring. But when you’re good, you know, I always say talent is a given, but you have to really be present. You have to make an impression and show people who you are, which is to say, are you timely? Are you dependable? Are you always going to show up, no matter what? Are you looking out for other people on the team? And I am just inherently one of those people and that’s just how I work, and so that kind of spread rapidly and people started passing my name around, and it grew from there.

Dr. Hall: That’s a great answer and said with a lot of confidence that people starting out could look at and say, “Well, you know, of course. She’s Claire Balest; she’s successful now.” Did you feel that same way? A week after you made that decision?

Claire: Did I feel the same way?

Dr. Hall: Did you have that same level of confidence in yourself, a week after you made the decision to go out on your own?

Claire: I didn’t have the perspective a week after I made the decision. I didn’t even know that what I did, that who I was unique. Which is to say, you know, I’m at the stage in my life where I realize that most people aren’t going to go above and beyond, right? They’re going to do the job and they’re going to leave. And I just—that’s really not in my DNA.

I am a great wingman. I’m a great person to work with because I’m looking out for the people, not even on my team, but the people on the crew, or the—you know, how can I help? So, I didn’t have the perspective to know that it was all going to be okay, that the brand was going to grow into a brand far bigger than I had ever expected, but it was just one of those, like, left foot, right foot, breathe. Keep doing the right thing, and, you know, hopefully, eventually magic happens.

Dr. Hall: I think it’s obvious that it did. And one of the really interesting things that you just said in that answer was talking about the perspective that you’ve gained over time, and how important that taking care of the team was, but also how rare it is for people to actually show up and give 110%.

Claire: Right.

Dr. Hall: You’ve built a great team. How do you pick people that are going to give 110% like you do?

Claire: That is the magic question, isn’t it? I mean, everyone’s looking for these perfect employees. I have to say, there’s not a perfect answer. I’ve had people come out of the woodwork, and find me, and pursue me. There’s a difference in people saying, “Hey, you know, I really want to do hair. I want to be a makeup artist. Can I shadow you?” No, you have to touch 1000 faces a day, and grow, and make mistakes, and make good choices and bad choices, and then you come and work on the team. That’s not how you become a makeup artist or hairstylist.

The people that have sought me out have just… there’s something about, like, their email that just clicked with me that I thought this person understands. Like, the way that they’re talking to me is unique, and so, you know, have a phone call with them and see how that goes. I always tell my team, like, people don’t remember what you did to their hair, they don’t remember the color lipstick you put on them, but they will always remember how you made them feel in the chair. So, the way that we work to make our clients feel is empowered, is special, is beautiful, is you know supported. And, you know, finding those people that ascribe to that same mentality is difficult, but somehow I’ve done it. They all kind of came to me differently.

Dr. Hall: That your business is principle-based, here in your answers, we’re talking a lot about making people feel empowered, making your clients feel empowered, and basing what can be seen as very superficial business—much like cosmetic surgery [laugh]—

Claire: Absolutely.

Dr. Hall: —but making that about making people feel better, I think is very unique. And how did you come to that? Or is that just you?

Claire: I think it is just me. But it grew over time to where I realized that one of my superpowers is to champion my clients. It’s just something that I have grown to realize that they need and that I am able to do well, and it goes far beyond hair and makeup. There’s so many women who sit in my chair and just start to tear themselves apart about, you know, “I need a facelift, I need injections, I need—oh my goodness, look at my skin.”

And it’s just like, they can’t sit down in peace. They’re just tormented by maybe they think that I’m looking at them and criticizing because I’m in their personal space. Years of seeing women do that has caused me to completely reframe the way that I see myself and the way that I see other people. Because we don’t need to do that. We don’t need to do that to ourselves, we don’t need to do it to each other.

This idea that we’re not okay the way that we are and that there’s something out there that we haven’t gotten to yet, but if we just did that, then we would be okay is, you know, sad and endless. So, I see beauty in everyone that sits in my chair. I try to speak beauty to everyone that sits on my chair. When I start working on different areas of their face. I’ll speak to it, “Your skin is amazing.” Or, “You have the longest lashes,” or, “Your eyes are the most incredible color.”

I think that it’s important to speak it because it allows them to reframe the way that they see themselves. Because they’re not looking for what’s right about themselves; they’re looking for what’s wrong. So, part of my job is I feel like I should call out beauty. And so I do. Much to my—my husband is always like, “Can we just order dinner? Do you have to tell the server how beautiful her brows are?” “Yes, yes, I do. And then we’ll order dinner.”

Dr. Hall: That is so refreshing because we both are in an industry where people come to us because they either want to improve something that is already there or because they are unhappy with a part of themselves. And realizing, recognizing, and pointing out people’s natural beauty, I think goes a long way towards reframing a conversation about beauty, across the board. Because it’s there in everybody. And one of my questions for you is, you do hair and makeup, and so you’re probably more qualified—or here more than just about any therapist out there—

Claire: Absolutely.

Dr. Hall: —about people’s insecurities. How do you speak to that to your clients?

Claire: You know, it’s part of a way that I get to know them. Let’s say that we’re speaking about one of my bridal clients, or someone that I’m going to work with more than just one time, it’s going to be over the course of months, or four days. I am always studying my clients. When I talk to them—I’m sure you do this—when I talk to them, I am trying to glean as much information as I can about the way that they see themselves, what they like about themselves, what they dislike about themselves, what makes them feel beautiful, what doesn’t make them feel beautiful. And I’m storing all that away and trying to figure out the best way to come alongside them and support them.

So, if I can become aware of their insecurities ahead of time, I’m going to be able to support them better over the course of, you know, our four days together at their destination event, better than if I was just picking out lipstick shades for them. All of it goes hand-in-hand and all of it goes towards their overall experience of what happens in the makeup chair. They don’t know all the psychology that goes into it. They don’t need to know all the psychology that goes into it. They need to walk away feeling like their hair and makeup team was their ride or die, and that we had their back until the very end. And we have developed these inexplicable bonds with our clients as a result of this. And so many of our clients tell us that their favorite part of the weekend was in hair and makeup. I don’t think that’s an accident.

Dr. Hall: That’s awesome. I think that’s testament to what you do and how you treat the clients that you work with. When you’re interviewing a client or a client is interviewing you—and you can explain to me how that process works—are there people that you interview to work with—or that are interviewing you to work with that don’t share those same feelings? And how do you deal with that situation?

Because that happens—and I’m asking that partly for myself because that happens in my office fairly frequently. People come to me with requests that are—while they may be physically possible, may not accomplish the goals that they don’t even know that they have for themselves, yet. And so how do you deal with that situation?

Claire: You know, I think initially, I thought that I was supposed to book every client. Now, I have come to the place to realize that I shouldn’t book every client. There is a great hair and makeup team for everyone; it’s not necessarily always going to be us. And I think that you learn that through working with people who perhaps have a different—a very different aesthetic than you, and you feel like you’re really not doing your best work and giving them what they want most because that’s really not what you’re known for. I am known for natural beauty, glowing skin, barely-there makeup.

We can definitely—you know we love to play around with more dramatic looks over the course of the weekend, depending on what the party is, but for the most part that is what we have come to the most sought after for. So, as a result, when people come to us and they want something completely different, yes, it can be done. But if the client just isn’t the right fit, or if the aesthetic isn’t the right fit, I don’t have a problem directing them somewhere where I think that they would be happier.

Dr. Hall: I think that’s a good way to answer the question. The right fit, though, really is something that I’m interested in learning myself because, like you, our practice has the same issues. And I’ll be honest, I’m still looking for the best way to deliver that message. Because it’s a hard message to deliver.

Claire: I think it’s more coming from an angle of what’s best for them. Not that, you know, you don’t like what they’re wanting—whether or not you do—and just being honest about what you do and what you do best, and empowering them to make the decision about maybe there’s someone out there that does what you’re looking for better than what I do. I mean, I’m certainly not attempting to advise you from a medical perspective.

But yeah, if I mean, if you can tell that it’s not a good fit, then I like to hand people a solution and say, “Here’s where I would go. I think this person would be a great fit for you. I want to make sure that you feel supported. I want to make sure that you get exactly what you’re looking for.” But I will say that my team and I, for the most part, you know, I believe that like attracts like, and so many of our clients come to us because of what we really do best. And that situation is not the norm.

Dr. Hall: I’m sure you get clients that come in armed with YouTube and Pinterest and things. I’ve heard you say, in other places that—you liken YouTube and Pinterest, to the WebMD of the aesthetic industry, which I thought is hysterical—

Claire: It is.

Dr. Hall: —and true at the same time. [laugh].

Claire: It is exactly the same thing. It’s way too much information for the general public. They’re only going to hurt themselves with it. It leaves everyone confused. They’re all diagnosing themselves with cancer. They’re all trying to contour from some video that they watched on—I mean, it’s too much we need to shut the platform down. Do you think we can do that together? Should we, like?

Dr. Hall: Maybe. I don’t know—they may hear this and de-platform us, and we have to find something else.

Claire: We’re about to be canceled right now.

Dr. Hall: Yeah. [laugh].

Claire: But yeah, it’s too much information. I don’t feel like our bridal clients, that doesn’t so much come into play there. It’s more when women are trying to learn how to do their makeup, they are so inundated with information that they can’t figure out what they’re supposed to do. I mean, we are so filled with information from the second we wake up to the second we go to bed, we don’t know how to filter any of it, and we’re going on and seeking more.

And it’s just—you know, I try to be a voice in the beauty industry that uncomplicates things. I totally believe that the beauty industry is one of the most confusing places ever. It makes billions of dollars off of keeping women confused. There are some great brands out there, there are great products, but for the most part, we don’t know how to navigate that space. And I like to, kind of, be a voice that will uncomplicate that very complicated industry, and simplify it, and just say, “Here are the things that you need.” It’s very, very basic.

Which is how the beauty box came about, where I customize boxes for my clients, or for people who just want the basics, their every day, tell me a few products that I need that are just going to make the most difference. They don’t need 20 products. They don’t need 10 products. I think five products for everyone is—it’s different; not everyone needs the same five products, but I have a way that I customize products for people, and it’s kind of like a lesson and a box. And it’s my way of, kind of, demystifying the industry to a place where you don’t have to go into Sephora and try to navigate a store that has hundreds of thousands of products in it. Let me tell you what I would recommend.

Dr. Hall: The beauty industry is incredibly confusing, and makes a fortune every year keeping people confused because confusion leads to panic-buying, leads to filling your makeup cabinet, filling your bathroom with makeup and skincare products, and all sorts of things you don’t need.

Claire: Right.

Dr. Hall: And that’s one of the things that I’m trying to do with this show is educate because our industry, plastic surgery industry is very similar. And one of the earlier shows, talked about breast augmentation specifically because that is our equivalent in the surgical space because women will come in having been all over—probably from one end of the internet to the other—gathering research from who knows where, and come in and sit down in my office with a bunch of pictures and essentially, tell me how to do their surgery. And it’s because Google has made everybody think they’re an expert.

Claire: Right. Well, and there’s no barrier to entry on the internet, right? There’s no one screening. You can put anything up there, any pictures, any—you know. And that’s research. I love that you said they’ve done their research and they come in. Well, who’s doing the research on the research? It’s all just unfiltered information out there that is, I think, doing more harm than good.

Dr. Hall: I totally agree. That being said, do you have clients use Pinterest, or YouTube, or Google to bring in photos of things that they like?

Claire: Absolutely. I think Pinterest, and Instagram, and image-driven platforms are wonderful tools for people to communicate what they like or what they don’t like. I think it’s very helpful to have inspiration images but to know that those can’t really drive the engine. It’s just inspiration; it’s just a tool. Hire people who are going to give you the end result.

Don’t give them a picture and say, “Do this.” Just say, you know, “This is something I gravitate towards. I’m really not sure what it is about it.” Because a lot of times, a client might bring in a picture of a model with a smokey eye and say, you know, “I love this. It’s just so natural.”

Okay, perfect. Let’s unpack that. What she’s really talking about is the skin. Maybe it’s like, beautiful lighting, and the model has on very natural lip and her skin is gorgeous. But she has a smokey eye. If I didn’t ask more questions, my client is going to end up with a smokey eye. And I’m thinking, “Well, she thinks that’s natural.”

It’s all about the consultation. It’s all about reading our clients’ minds. And they don’t have the verbiage; they don’t have the context for understanding what it is that they want. They know what they don’t want, but it’s our job to interpret what they’re bringing us, what they’re thinking, what they’re hoping to achieve, you know, we have to pull that out of them.

I can’t blame her if she shows me a picture and I recreate that picture. That’s not her fault. That’s my fault. You know, I think the consultation is everything, talking to our clients is everything because we can really get to the heart of what it is that they’re hoping for by asking more questions, instead of assuming that they’re not the expert. We’re the experts, so it’s our job to really get to the heart of what they’re wanting.

Dr. Hall: I couldn’t agree with that more. I tell my own patients, when we start having these conversations in consultation, is that your result happens in the consult. The operating room, the makeup chair, that’s time for execution, but the result is planning, it is consultation, it is all the boring stuff that happens before you actually sit down in a makeup chair—

Claire: Right.

Dr. Hall: —lay down on the operating table. That’s the important part.

Claire: I mean, I have to say ours is slightly less permanent. We can change a lipstick color. [laugh].

Dr. Hall: [laugh].

Claire: But yeah, I see where you’re going. Yeah, it’s all about the consultation.

Dr. Hall: Yeah. And so taking the time and setting your client—your patient—up for success by having a beat getting into the psychology of what they’re trying to accomplish and why is so important. So, let’s shift gears, we’ve kind of gotten really deep, which is good.

Claire: [laugh]. Have we? [laugh].

Dr. Hall: I love it. I love it. Anytime you get a plastic surgeon and a makeup artist sitting here, talking about psychology—[laugh].

Claire: Right. We may need to take a break.

Dr. Hall: We may need to take a break. But I do want to shift gears and ask you about some aesthetic things because there are a lot of things that you take care of that I take care of as well. One is eyebrows. And women have been pulling eyebrow hairs out—

Claire: [laugh]. “Pulling out.”

Dr. Hall: —for—plucking—

Claire: Yes.

Dr. Hall: The term.

Claire: Yes.

Dr. Hall: Plucking is the—

Claire: I’m looking at you right now. You’re not doing that. So—

Dr. Hall: No, no. I have bushy, like, Burt and Ernie eyebrows.

Claire: [laugh].

Dr. Hall: But what problems are you seeing that you are trying to correct with makeup?

Claire: We’re mostly trying to create full brows these days. Most clients have overplucked their brows, and what we are doing is going in and filling them back in, trying to recreate a full brow, which is very on trend right now. And honestly, I hope it stays that way for forever. A child of the ’90s, I overplucked my brows within an inch of their lives, and there’s no hope for me; it’s all makeup.

But this younger generation, they need to leave their brows alone. They don’t need to be plucking. Full, feathered brows are what’s beautiful, and truly, we can shape them a little bit, but a client’s best look is what she’s born with, and shaping those slightly. But the brows are everything, the brows frame the eyes, so it helps to kind of ground the whole look. I think that brows are one of the five products, I would say for sure that everyone needs, unless they just naturally have full brows. We all need to, like, play up our brows a little bit more so that everything else is balanced on the face.

Dr. Hall: How much does shape matter? Because from a surgical standpoint, what has happened with the brow fullness, unless we’re talking about hair transplants—which is certainly an option—is kind of in the past. What we’re looking at is position and shape. How important is it for you when you’re doing a wedding when you’re helping a client with makeup to get the shape right? And what shape are you going for?

Claire: It depends on what their face is. It’s very different client to client. It would be like me asking you the same thing, right? I look at a client and it’s a completely different canvas and I’m working with what they have, their features, and I’m creating shape around them. That being said, some people are so used to being overplucked that they can’t handle if I were to give them a full brow. They couldn’t handle the way that looks.

So, I do take into account clients’ comfort levels with how full I’m going to take their brows. But full brows are it. I love a full brow. I want the full brows to stay. I hope that we never go back to the plucking. To the arched, overplucked brow.

Dr. Hall: I do too because those are—for us—are difficult to get right because there’s not much there to shape and position. And in some ways, it gives the surgeon a little bit of a free pass because there’s not much there to alter. You know, when we’re talking about surgical brow reshaping, a lot of it is position-related and shape-related. And that’s where you see a lot of these surgical misadventures where the people have these constant surprised—

Claire: Right.

Dr. Hall: —look on their face, from trying to overcorrect and exaggerate that arch. And really, I feel exactly the same way you do in terms of what is beautiful, what is pretty, is something subtle.

Claire: Right.

Dr. Hall: You want a little arch, but it doesn’t need to be exaggerated. It doesn’t need to be a look of constant surprise or shock.

Claire: Right. I think it’s interesting. When people look to what’s beautiful, they’re looking at other images. They’re rarely looking at themselves and thinking what is it I can play up about myself? What are the things I love about myself? What are the features I love about myself? What are ways that I can enhance those features?

They’re looking to change their look entirely based on other images or other people that they see. So, for me, I love to celebrate the beauty within each client. I mean, forgive how cliche that sounds. But for example, when I have someone who’s covered in freckles, right, a beautiful ginger who’s covered in freckles, I am never going to try to cover her freckles. I want that to come out. I mean, that is a signature statement in and of itself. I want to give her beautiful skin. I don’t want to try to mask or hide anything.

And you know, it’d be like for her to look at someone else and say, “Oh, but if my skin was”—you know, well, that’s unrealistic. It’s unattainable. I think that we need to be looking more at ourselves for inspiration on what beauty is and on how we can be our own unique beauty rather than trying to create it off of something we saw on Instagram.

Dr. Hall: That’s so true. That is so true because what that ends up setting up is this endless cycle of chasing something else, of chasing some unattainable image of self, of whether it’s eyebrows, or cheeks, or lips, or breasts, or stomachs or—because what I think what a lot of people don’t realize is—and maybe I’m off base on this—is that a lot of stuff on social media is heavily edited.

Claire: Oh, yeah.

Dr. Hall: And so the images that people are bringing in, you know—certainly the things that I see—are airbrushed or Photoshopped to within an inch of their life, and there’s no way to make that happen in real life.

Claire: Right.

Dr. Hall: And so part of my consult is actually being a photo critic.

Claire: Absolutely. And helping them unpack, like, what’s actually happening in the image.

Dr. Hall: Mm-hm.

Claire: Right.

Dr. Hall: Yeah. How do you talk to people? Kind of, getting back to what I think is a very unique view of beauty and addressing each person individually, talk to me about the conversation that you have with somebody who is sitting in your chair and beating themselves up because they don’t like their skin, they don’t like the way their eyes are shaped, or their lips are too thin. Walk me through that conversation?

Claire: Like how I would start to do their makeup or—

Dr. Hall: No, how do you talk to them? How do you get those people, those clients of yours that are very hard on themselves? How do you get them to start to flip that script around and start to see the natural beauty in themselves, to allow you to be able to bring that out?

Claire: Right.

Dr. Hall: Because that speaks to the psychology of what we do and how do you have that conversation. Because I have very similar conversations in my office every day, and I’m interested in what conversations you have.

Claire: So, when a client sits in my chair, I can almost instantly feel their energy, how they feel about themselves, the way they present themselves, just from the way that they’re sitting, or the way that they hold themselves; it’s a whole vibe. And I will start asking questions, I will start talking about what we’re trying to achieve. When I register that there is a client who is in the depths of self-dislike, I will start really trying to buoy her with affirming things that I see about her that I like. I will never just make things up, but there are always things, there is always beauty. And so when I see it, I’ll speak it to her and try to just start building that up, build the trust level.

There are times where clients are so self-deprecating, that I will—I’m a very touchy person, I will put my hand on their leg and I will be like, “Not in my chair.” You know, you are not allowed to talk about yourself that way in my chair. Or we’ll start—you know, I’m incapable of being too serious. I don’t know if that’s come across yet here, but I really tried to make them feel comfortable. I tried to disarm them.

You know, it is a very vulnerable thing to sit in someone’s face and be in their 18 inches, and they’re thinking I can see every aspect of what might be wrong with their skin, or their, you know, whatever it is going on that they don’t like about themselves, so I instantly want to make them feel like I am on their side, that I am not criticizing whatever they feel is going on. And I just look for ways to support them. Because in a situation like that, it is not about the makeup. There is a lot more going on. I’m never going to be able to affect the way that they see themselves just from makeup alone. If I can affect it at all, but I can certainly try.

Dr. Hall: Yeah, like I said, there’s another area where our careers and you know what we do in consultation really is very similar because I see the same types of things. And there are some people who you can do a wonderful job, get a wonderful outcome, but because of what’s going on inside that patient’s head or that patient’s heart, it’s not going to affect—

Claire: It’s lost on them.

Dr. Hall: Yeah, it is.

Claire: They don’t experience it the same way.

Dr. Hall: Right.

Claire: Well, and I think that’s an interesting segue into, like, let’s talk about perfectionism.

Dr. Hall: Mm-hm.

Claire: I told you before we started recording that there needs to be a divorce between the idea of perfectionism and what beauty is. Like, if you think about that long enough, your brain is going to start to melt. How did we ever marry those two ideas: Beauty and perfectionism? They’re completely separate entities, and yet, we’re all—in our culture anyway—our society celebrates this very unattainable idea of perfectionism.

It is very American and we don’t celebrate individual beauty. So, I think the fact that we are the experts—so we get to, as business owners, as the experts within our respective fields, we get to kind of drive the narrative about what we see beauty is, and communicating that to our clients, to our patients, and creating our own movements.

Dr. Hall: The topic of perfectionism comes up daily. And around my office, it’s the P-word. We don’t talk about being perfect. Because perfect is, like you said, is an unattainable goal.

Claire: It’s unattainable, and it’s unidentifiable, and yet we all use that word all the time.

Dr. Hall: Mm-hm. You can’t identify something that’s perfect because it’s a very subjective term.

Claire: It is very subjective. Perfect to me is very different than perfect to you.

Dr. Hall: Right. And we’re beauty comes into that—you can nerd out on, you know, the golden portion, and all the measurements and all this other stuff, but at the end of the day, just like perfection isn’t—beauty is subjective. And really, beauty for an individual has to do with their own feelings of themselves, not how their eyes look, not how big their breasts are, not you know, whether their jawline is nice and defined. You know, those are nice things to have, but they don’t necessarily make beauty.

Claire: Right. And they aren’t necessarily perfect. I feel like such a small voice in an abyss of this movement in our culture of perfectionism, so I realize that, like, I’m yelling into the void here, but I really believe that if we could spend all the time—at least women—if women could spend all the time on other things besides self-criticism and this sprint towards perfectionism, we could literally solve the world’s problems. I mean, we spend so much energy chasing after things that are completely unattainable. I mean, you probably don’t experience it because you’re not a woman, but, like, women—all of the women out there listening, they know what I’m talking about. We spend so much useless time thinking about what we should change about ourselves instead of celebrating, celebrating things about ourselves. And regardless of what we all look like there’s always things to celebrate.

Dr. Hall: Oh, absolutely. And I think before we pressed record, we were talking about the French, and they’re this celebration of, really, of life is really what it boils down to—

Claire: Absolutely.

Dr. Hall: —is celebrating life. You can go in the internet, research on the internet, the number of articles written about French women and their croissants, and their wine, and their cigarettes, and all the things that are taboo for us—

Claire: Right.

Dr. Hall: —you know, you’re supposed to do that because you want to look good. You don’t want to eat carbs. Cigarettes are bad for you—cigarettes are bad for you, though. I mean, I’m a doctor. Cigarettes are bad for you. But—

Claire: [laugh]. The French aren’t going to get away with that one.

Dr. Hall: No, they’re—

Claire: We’re going to go ahead and shut that down.

Dr. Hall: No. But about how they enjoy their life, and they enjoy their life despite the fact—it’s almost like despite the fact that they do all these terrible things, they still manage to enjoy themselves.

Claire: Right.

Dr. Hall: And that’s a mindset that has nothing to do with what’s in your glass of wine or—

Claire: It’s so true.

Dr. Hall: —or what croissant you eat.

Claire: It’s funny, Barbara Close, who was the owner and creator of Naturopathica, said, “Everything in moderation, including moderation.” I went on a retreat with her, and she said that and I thought, “That is so true.” And I think the French really embody that whole mentality of just everything in moderation, including moderation. You know, Americans are the opposite of that.

Not to hate on the Americans, but you know, we overcomplicate everything. Everything is overdone, overwrought. And you know, the thing that we are so obsessed about—at least I am so obsessed about with French beauty is the simplicity, the lack of perfection. It just seems effortless. Whereas American beauty is full of effort. Even that no-makeup makeup look is full of effort.

And the French have just kind of perfected that imperfectly perfect beauty routine, Joie de vivre. They’ve got it down and we’re obsessed with it. And yet we continue on the train that we’re on going the other direction. But we’re very obsessed with—and I think it comes back to we need to simplify. I think during the pandemic, we all streamlined our beauty routines, we all rethought what’s really important that I do.

Like, hmm, I think skincare might be more important than makeup, and so skincare sales are going through the roof because nobody’s really wearing makeup because people are in masks and so people start taking care of their skin because they don’t have makeup on. Which, by the way, is much more important than wearing makeup.

Dr. Hall: That’s exactly where I was going to go with that is, unfortunately, the skincare industry has followed right along with the makeup industry in trying to make skincare absolutely as complicated and difficult as possible when it doesn’t need to be.

Claire: Right.

Dr. Hall: I spend a great amount of time in my office, essentially talking people out of buying a hundred different skincare products, there’s about three that most people need.

Claire: Right. You talked about it on your podcast last week, right?

Dr. Hall: Right. In the aging podcast an episode or two ago. You know, there are three things that people need, and then it’s a matter of restoring youthful skin to a point where it can age naturally. And we’re not—we’re essentially undoing years of ultraviolet and environmental damage. So, you know, we’re not giving somebody perfect skin. You know, to get back to what we were talking about—

Claire: Right. Doesn’t exist.

Dr. Hall: —doesn’t exist. What we’re doing is we’re making skin healthy again, so that God’s design can kind of keep doing its thing.

Claire: Right. And for me as a makeup artist, I mean, you’re thinking, of course, medically. I’m thinking, if a client sits down in my chair and they have done their job, which is to say they have taken care of their skin, I can do my job. But when they neglect their skin, and they sit down on my chair, I can’t affect texture; there’s nothing I can do. That happens long before they sit in my chair.

If they do their job and take care of all of the things that they need to do before the wedding weekend, for example, then I’m able to make their skin look like they have no makeup on. But if they haven’t taken care of their skin, you’re going to see the makeup. So, I think about it from a much more cosmetic standpoint. And for me, you know, good skin, it’s not age-driven. Again, back to French beauty.

I love the idea of looking beautiful at every age. Your skin isn’t suddenly not beautiful because you’re 30, or 40, or 50 you know, I’m sorry, if Brad Pitt can be 60 now, like, what is 60.

Dr. Hall: Is he really sixty?

Claire: I think—isn’t he 60? Is he 50? It doesn’t matter. The point is, Brad Pitt—

Dr. Hall: He’s been around for a while.

Claire: So, you know it’s—age has been completely redefined. So, I don’t think that beautiful skin is age-driven. I think that our goal should not be preserving our 20-year-old bodies or our 20-year-old skin; we need to look great at every age. Which again, is what French women have figured out. I think glowing skin, hydrated skin, those are, you know, the non-surgical ways.

Dr. Hall: I agree with—I think what you’re—where you’re going with that is healthy skin—

Claire: Yes.

Dr. Hall: —is pretty skin—

Claire: Is pretty skin.

Dr. Hall: —no matter what age is.

Claire: Right.

Dr. Hall: I can’t give somebody who is 60 the skin of a 20-year-old. If they’ve got genetics that keeps their 20-year-old skin through 60, that’s awesome. But there’s nothing that I can do that’s going to turn back that clock. We can work towards making that 60-year-old skin really pretty, really naturally pretty.

And that’s one of the things that you had just talked about, looking good, looking like you don’t need makeup because of the texture—

Claire: Right.

Dr. Hall: And things like that. That’s actually one of the things that I love seeing in my office is the women that come in with foundation caked on and complaining that there are makeup cracks around their eyes, right, because it’s so heavy. And they just—you know, they’re looking for Botox. And then six or eight months later, they come in wearing powder or tinted sunscreen because they don’t need their makeup anymore—

Claire: Right.

Dr. Hall: —because we’ve been able to make their skin what it should be at that age.

Claire: Right. And it’s counterintuitive. You know, like, so many people think like, “Oh, you know something doesn’t look right, so they want to pile on more and more and more makeup.” The reality is, you need less makeup when your skin is looking great. The point of foundation is to even out discoloration in the skin; it’s not to really affect texture change.

So, that happens with skincare. And then if you need a little extra coverage, you know, my favorite is a tinted moisturizer, especially for women, I generally don’t speak to age because essentially, we all want the same thing when it comes to makeup, but I will say that the older our skin gets, we obviously have more texture to it and less is actually more. Like you said, you see these women, you know, you’re not sure exactly how to speak to it, maybe but, like, you know that her foundation just was not right. She had too much foundation on. She’s not fooling anyone; it looks like foundation. Nobody believes that it’s actually her skin.

If your skin is looking great, you need less of everything. So, a tinted moisturizer is actually the best choice for women as we age. It’s not going to sit in lines. It’s going to give us just enough coverage to even out any excess redness or discoloration in the skin, but essentially, it’s going to allow your skin to come through and to not sit on top of the skin.

Dr. Hall: I don’t even know where to go with that.

Claire: [laugh]. Sorry.

Dr. Hall: Agree. Completely agree. I completely agree with all of that.

Claire: I concur.

Dr. Hall: I concur. So, other than a moisturizer, which you just talked about, what are things that every woman needs? Because I know people are going to look at the title of this, they’re going to see your picture, and they’re going to say, “I want to tips for makeup.” So, what are some things that most women are going to benefit from? Because if most women are like most women, they’ve got a makeup cabinet that full of junk that they’ve been sold when they walk through Sephora or Ulta—

Claire: Right.

Dr. Hall: —that they don’t need.

Claire: Right. And they get home and they’re like, “Wait. What was this for, again?” And then it just sits—

Dr. Hall: Why did I spend $300 on this?

Claire: Right. Right. Yeah. First of all, I want to empower everyone listening with the fact that you do not have to buy what you’re being sold when you go to either a department store, or Sephora, or Ulta. I guess everyone’s buying online now so maybe they’re not being, you know, sucked into the sales pitches, but it is so hard to know what to buy when you feel like you’re being sold. So, you don’t have to buy anything.

So, the other thing, nine times out of ten, every woman needs a great under-eye concealer. There’s always that one person who’s blessed with great genetics and they just don’t have any discoloration or darkness under the eyes, but for the most part we all could stand to be brightened a little bit under the eyes. So, a good under-eye concealer, and typically I like for those to be peach or pink-based, so that’s going to cut any you know gray, green, blue under the eye. It’s going to cut that discoloration and brighten and lift under the eye. And I like multi-use products, so like a lip and cheek, you can use the same blush color as a lipstick.

If you have a cream blush, and a little pot, you can put that on your cheeks and pop some on your lips, and two products in one. I think we all need a little brow help unless you naturally have full brows. A brow pencil, or even easier is a wand that you can deposit pigment on and brush through your brows to get just a little extra tint especially for blondes or gingers, they tend to need a little bit more color and their brows because they’re so fair. And a mascara. But you know, if I could only pick two things, I would say an under-eye concealer and the lip and cheek product.

Adding color to the lips and cheeks. Gives that youthful—you know we all have more color when we’re younger, right? And our lips and our cheeks, you want to look like you took an invigorating walk. So, all the color that, you know, the flush that comes to your cheek when you exercise, place that on the apple of your cheeks and put it on your lips, and it does a whole, whole lot, goes a long way.

Dr. Hall: It also serves to highlight those areas that tend to lose volume as we age.

Claire: Absolutely.

Dr. Hall: So, in some ways, faking a little bit more cheek volume, which is very youthful.

Claire: Faking. You say faking; I say playing up.

Dr. Hall: You say playing up? See?

Claire: I can’t—

Dr. Hall: You say ‘po-taa-to,’ I say ‘po-tah-to.’

Claire: [laugh]. But you know another tip for aging skin. And again, generally don’t speak to age, but anytime you put an illuminator or something that has a glow to it, or something that has pearlescence, or—God forbid—glitter in it, if you put that on your cheekbones and you’re concerned with texture in your skin, what is that going to do? Highlights or draws attention to whatever area that you use it in. So, if you put it on a heavily textured area, then it’s going to bring that area out.

So, I might recommend not using—you know, use something that has hydration to it, that’s going to add a glow that looks like it’s coming from within, but maybe don’t use a pearlescent topical highlighter. Does that make sense to you?

Dr. Hall: It does. It does, yeah. Very well. Very well. So, I’m still thinking about this two-for-one product and I’m—

Claire: Your mind blown.

Dr. Hall: My mind is blown. I’m also—you’ve inspired me. I’m going to, on the way home today, I’m going to go buy one of those, like, shampoo-body wash combos.

Claire: [laugh]. It’s the same idea.

Dr. Hall: Same—

Claire: Yeah.

Dr. Hall: Totally same idea.

Claire: See, women are masters at multitasking. So, we just continue to blow your mind about how we can multitask.

Dr. Hall: I think if most guys take any more shortcuts to their daily grooming routine, like, it would be a bad place to live.

Claire: Right.

Dr. Hall: Yeah.

Claire: It’s over.

Dr. Hall: Yeah. Yeah. Because you live with three of them, so—

Claire: I do.

Dr. Hall: —you know how that goes.

Claire: I have two small boys and one large boy: My husband. And it’s not pretty. It’s not pretty in my house.

Dr. Hall: I joke around that I’m my wife’s oldest child.

Claire: I say that same exact thing. But here’s the problem. It’s not a joke.

Dr. Hall: No.

Claire: It’s the—it’s the truth.

Dr. Hall: No it is very, very true. Very true. So, I very much want to be respectful of your time, so we can kind of wrap this up. Is there one message that you would like people to take away from our conversation today?

Claire: There are no industry secrets out there. They’re all on the internet, right? We’ve talked about that. I think the secret is that it’s not that complicated. I think that women need to not let the beauty industry overwhelm them and look for the simple ways that they can play up a few things that they like about themselves, and believe that is enough.

Choose a few things that you like about yourself—which means you have to stop and identify a few things that you like about yourself—this is actual homework—and find a way to play that up. If you have great lips, if you love the volume in your lips, lip, and cheek color. Instantly going to bring so much life and color to the face. If you have great brows, play them up. If you have great eyes, play them up.

But don’t fall victim to the idea that you have to have all the things, that you have to be contouring, and highlighting, and wearing a smokey eye, and have these full brows, and have this—it’s too much. All of it’s too much. I think simplicity needs to be our goal, not perfection.

Dr. Hall: I think that’s a very profound message and one that I think we could all learn from. So, where can people find more about you?

Claire: My website, clairebalest.com. My Instagram, clairebalest, pretty simple.

Dr. Hall: Pretty simple. We’ll link all that stuff in the [show notes 00:53:02], so that if you’re listening and want to learn more about Claire, you can go there. Do check out her beauty box. That is the one thing that my wife asked for Christmas was one of Claire’s beauty boxes. So, check that out; they’re super cool. And, again, simplistic and designed to, kind of, bring the best of you out. So Claire, thanks a bunch. We’ll have to do this again.

Claire: Thank you.

View Details

When it comes to lasers and cosmetic medicine there are some important distinctions to be made. There is a wide array of lasers out there, and their respective uses range across the cosmetic spectrum, from hair removal to skin resurfacing and all things in between.

Lasers for cosmetic medicine are broken down into two broad categories: ablative and non-ablative. I’ll discuss the primary differences these two, and also the various procedures they can be used for. I cover their role in regard to skin pigmentation, acne, skin aging and other lesser know applications.

In this episode, we cover:

An introduction to lasers and how they work (00:00)
The broad categories of lasers: non-ablative and ablative and their role (03:10)
An overview of non-ablative lasers (08:55)
An overview of ablative lasers (12:10)
The importance of knowing your lasers (16:25)

Links:

Dr. Jason Hall, MD

Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

Transcript

Dr. Hall: Welcome to The Trillium Show, where we help you make the changes you want to see in your body, in your mind, and in your life. I’m your host, Dr. Jason Hall.

Dr. Hall: Hi, this is Dr. Jason Hall and welcome to another episode of The Trillium Show. Today we are going to talk about a subject which I have grown to love over time, which is lasers. Now, lasers are one of these areas in aesthetic medicine and surgery that kind of get a bad reputation because the category of lasers is so vast and so broad that people can have a laser treatment and say, “I had lasers and it really didn’t work for me.”

And the problem is that unless you know exactly what type of laser that you had, it’s very easy to say, “Well, it didn’t work,” because just like in any other area in medicine, if you aren’t using the right treatment for the right problem, you’re not going to get a result that’s anywhere close to what you were hoping for.

There are two main types of lasers: On one hand you have the non-ablative lasers; then on the other hand, you have the ablative lasers. Now, these two broad categories of lasers really do exactly what they say they’re going to do. The non-ablative lasers do not damage the skin itself. The ablative lasers do; they ablate or destroy parts of the skin, and what parts of the skin they damage depends on what problems that we’re looking to treat. So, I think before we really get into what the difference is between non-ablative and ablative lasers are, and what each one of those treat, we need to do just a really quick, like, 30,000 foot view of what lasers are and how they work.

Lasers and light treatments in general—and we’re going to include IPL, or Intense Pulsed Light, or BBL, or Broadband Light in with the laser category—how light treatments work is they work by selectively heating tissue. And what tissues they heat really is dependent on the wavelength of light that we’re using. The targets are known as chromophores, and there are three main chromophores that we talked about in aesthetic medicine: There is reds, or blood vessels and blood cells; there is browns, the pigment, so the melanin that’s in our skin; and then there’s water. And by selecting which one of those chromophores that we’re going to target, we get different results based on that itself. So, not to get too detailed, to sciency, in any of this, but that’s kind of a basic overview of what we are trying to do when we’re talking about lasers.

So let’s, kind of, get into the broad categories of lasers. And we’ll start with the non-ablative lasers. With non-ablative lasers, the object is to obtain a result without damaging the skin. And with the non-ablative lasers—and again, we’re going to include Intense Pulsed Light and Broadband Light which are not technically lasers, but thought of by the lay public as being lasers—what we are trying to do there is heat up tissue and change it without destroying.

So, we’ll talk about indications first, and you can see how these different lasers work to accomplish what we want to. So, the main indications for non-ablative lasers are treating red pigment, treating brown pigment, hair removal, anti-aging, and acne treatments. How do the non-ablative—if we’re destroying tissue, how do they work? Well, the mechanisms behind a lot of that aren’t exactly known with reds. And when we’re talking about reds, we’re talking about things like rosacea, which is dilation of capillaries in the skin, typically along the cheeks; we’re talking about broken blood vessels of the cheeks and around the nose and eyes. Those are little angiomas, but those are the things that we’re talking about treating when we’re talking about treating reds with laser or BBL.

The chromophore for that particular problem is the red blood cell, and so by using this light, we are heating the red blood cells and we’re destroying the small blood vessels in the skin. It’s important to note when we do that, though, that we’re destroying the large blood vessels in the skin—or relatively large blood vessels that you can see that bother you—but we’re not destroying all of them. And so there’s a possibility that those vessels can come back somewhere else later.

With browns, which are another target chromophore, the pigment is another target chromophore of the light, what happens—and this is where the biology is kind of squirrely—is that we don’t know exactly why it happens. But by treating the skin with light, the brown pigments—from sunspots, from some lentigo or birthmarks—can be lifted up to the surface of the skin, and they kind of flake away with time. Typically, that takes a few days for that to happen. What’s interesting is that the melanocytes, or the pigment producing cells that are in the skin themselves don’t go away, they’re not damaged, and so they keep working. And that’s why if you’ve ever had an IPL treatment for brown spots, we will treat those brown spots, but then once that flaking has gone away, we’ll want to put you on a medication such as hydroquinone, which is an over-the-counter skin lightener, to turn down the production of melanin by those melanocytes in the skin to help prevent that brown from coming back because it will come back because we’ve treated the symptom, we haven’t really treated the melanocytes which was a problem.

And you really don’t want to damage the melanocytes, otherwise you start running into problems with hypopigmentation and white spots, which is, in this business, considered a complication. We’ve discussed treatment of red and brown. The third indication that we really need to discuss, and a reason that a lot of people seek laser treatment, is anti-aging. Now, this might be a little bit controversial with some people, but non-ablative laser’s role in anti-aging medicine and skin rejuvenation really, is limited to maintenance treatments. These, in my opinion, are really not good treatments, if you are looking to improve lines and wrinkles, surface texture, they just don’t have the power to do that in a cost effective way. You have to have a lot of treatments over a long period of time to get the same result with a non-ablative anti-aging laser as you would with an ablative single treatment laser.

So, the way that the anti-aging properties of non-ablative laser treatments work is very similar to the way that they treat reds and browns, which is heating, but heating deep into the skin, in the second layer of the skin, called the dermis, which is where the collagen lives. Heating that collagen will cause it to kind of uncoil and destroy it, and then your body goes back and tries to rebuild that. And by trying to rebuild that collagen that has been destroyed, it causes some thickening and tightening and new collagen deposition. Now, if you think about how that works, and after we talk about the ablative treatments, you’ll really see that the ablative treatments just logically are superior in terms of collagen formation and wrinkle elimination, as well as just overall skin health.

That brings us to a discussion of hair removal, which is really probably one of the more common things that people hear about when you think about cosmetic lasers: Laser hair removal is kind of right up there. And the way that works is these lasers, again, heat their target to cause a change. So, in this case, the laser is heating the hair follicle by heating the hair and you heat the hair, you think of it as, like, a little wire that goes down into the hair follicle; that little wire gets hot, burns the hair follicles where the hair grows, and kills the hair follicle so the hair doesn’t grow anymore. The problem is—and if any of you listening have had laser hair removal or know somebody who has, it takes a lot of treatments to get rid of the hair, and even then you don’t get rid of all of the hair. That’s because hair has a cycle, and only follicles that have a hair in them can get damaged. Not all the follicles do at any given time, so you’re constantly chasing the hair cycle trying to get all of the hairs that are still around and treat those at any given treatment.

Lastly, and one of the lesser utilized non-ablative laser indications is for acne. Acne is one of those things that if you’ve got bad acne, it’s really a problem. If you don’t, you don’t really think about it much. But acne can be really challenging and really frustrating for both physicians and patients to treat. Where the nonablative lasers role in acne treatment comes in is that we can use these lasers to heat the skin without damaging it, but can heat-kill the bacteria that live in the skin that cause the acne.

We can also use that same non-ablative heating, using a little bit different wavelength of light, to heat the surrounding tissue, causing new collagen formation and improving the appearance of some of the acne scars. This is one of those areas where a lot of laser companies like to sell it as though it’s the best thing since sliced bread, but non-ablative laser treatments for acne scar treatment really are substandard when you have other ablative technologies out there, but it can help to minimize the amount of scarring that’s there when we’re actively treating the acne, as opposed to coming back after the fact, trying to clean up all of the scarring from untreated acne.

There in a very brief overview is non-ablative laser treatment. So again, our indications: Reds, browns, anti-aging, hair removal, and acne. And again, where the non-ablative treatments really shine is treating reds and browns, and hair removal. Those are the three indications that I think are most popular out there, certainly most popular in my practice.

So, let’s talk about the ablative lasers now. And in a surgical practice, ablative lasers really are the workhorses. They get the best results of any of our other laser technologies, when it comes to treating a problem that we see. Again, maintenance, the nonablative technologies do a great job, but for treating fine lines, moderate lines and wrinkles, even deep lines and wrinkles, treating thinning skin, treating surgical scars, there really is no better option than an ablative laser.

There are two categories of ablative lasers that are important for you as patients to know about, and those are the fractionated ablative lasers and the non-fractionated, or full-field, ablative lasers. And we’ll talk about each one of these.

So, fractionated ablative lasers are just what they sound like they only treat a fraction of the skin at a time. So, you can think about them. If you’ve ever seen a golf course or a yard that gets aerated, where they make those little holes so that they can fertilize the lawn. A fractionated laser works very much the same way. It uses laser light to make millions of microscopic little channels in the skin that go down into the dermis or the under—the second, kind of, deeper layer in the skin, and let your body produce collagen to help remodel the skin’s surface.

That’s why you can see thickening in the skin. That’s why you can see remodelling of scars in improvement in fine to moderate wrinkles because what those wrinkles are are just, like, pleats in a wrinkled shirt. It’s a result of things getting thin and wrinkly, and if we thicken that up, a lot of those lines can improve. Downtime with a fractionated ablative laser is typically limited to redness and swelling, and kind of like with the full-field lasers, the deeper and more aggressive we are, the longer that redness and swelling is going to last. Typically for most of our treatments, you can figure between three to five days of noticeable redness and swelling, and most of that you can wear makeup—for the ladies—to cover that.

On the other hand, the second category of ablative lasers are full-field lasers, and these are good for much more severe lines and wrinkles, and severe textural or pigment problems. A full-field laser is exactly what it sounds like. It treats the entire surface of the skin during a course of a treatment. If we’re sticking with our landscape analogies, this is like mowing your lawn. And the more aggressive we get with our full-field ablative laser, the lower and lower and lower and lower we make the deck of our lawn more to the ground.

With light or superficial treatments, that’s like, kind of, taking the tops off the grass; with very deep or aggressive treatments, it’s the equivalent of taking it down to the dirt, and then laying sod down on top of that. And we can adjust our treatments anywhere in between. Typically, that adjustment comes with a discussion between you and me of what we’re looking to treat, how aggressive you want to be, but then how much downtime you want to deal with after that treatment. If we’re doing superficial treatments, you can guess maybe a day of just some light peeling, maybe some pinkness, if we’re going down deep kind of where we’re laying sod down, that’s four or five days you’re not going to want to leave the house. The recovery is pretty intense. And so we have to talk about where you are on the spectrum of results in recovery to figure out which ablative full-field treatment is right for you.

Lasers are really an integral part of cosmetic medicine and surgery, but kind of like with skincare, it gets really confusing really fast, if you don’t start out and really understand what you’re treating, and then you compound that by not really understanding what the treatments are. And so a lot of people spend a lot of money on treatments that really aren’t right for them because neither they nor their aesthetic medicine provider has taken the time to make an accurate diagnosis and then recommended an accurate treatment plan.

To go over again what we talked about today, there are two main categories of lasers: There are non-ablative lasers—and in that we include IPL or BBL—and there are ablative lasers. Non-ablative lasers are really good in treating things like red pigment and blood vessels, brown pigments, they’re at good maintenance treatment for skin aging, they are good treatments in conjunction with topical and oral treatments for acne, and they do a very good job at laser hair removal.

On the other hand, ablative laser treatments come in two different varieties. You have your fractional ablative lasers and fractional ablative lasers are really good for mild to moderate skin wrinkling, they are used to rejuvenate and thicken thinning skin, and they are used to help remodel and improve surgical scars, trauma scars, and acne scars. Full field ablative lasers really shine when it comes to making significant and dramatic improvements in surface texture. An added benefit to that is that it will treat pigment at the same time. And we can dial in the depth of treatment, the downtime, and the results based on your individual preferences.

I tell my own patients that we can either take the scenic route, or we can take the highway. We get to the same destination, it just depends on how long we take to get there. If we choose an ablative laser—whether that’s a fractional or full-field—we choose a treatment with minimal downtime, it’s going to take us a number of extra treatments to get to our same result—we’re on the scenic route—as opposed to being aggressive and needing one treatment or maybe two treatments to get to that same endpoint, but your downtime is much more significant.

One of the things that I hear people complain about is that they’ve had a laser treatment somewhere that didn’t work. My first question is, “What treatment did you have?” Because oftentimes, it will be somebody looking for wrinkle reduction or an anti-aging treatment who has had a non-ablative laser treatment. And right there I say, “Well, that’s probably the reason is that the treatment just wasn’t powerful enough to accomplish your goals.” If they’ve had an ablative laser treatment, that’s when I really would like to know what was used and what was done because oftentimes, it’s a matter of patients and their laser provider not having a detailed discussion about results and downtime because a lot of patients see laser as being this magic treatment with no downtime, and that just isn’t the truth.

And as a result, these patients show up, they’ll have an ablative fractional laser treatment and it won’t have been very deep, they didn’t have much downtime, and then they are upset because they didn’t get much of a result. And in those cases, that’s when we have this discussion about the scenic route versus the superhighway. You can have the treatment with minimal downtime, but it’s going to take a lot of those treatments to get to the same endpoint. So, just take that with you, understand that there’s a lot to discuss when you start talking about laser treatments, there’s a lot of questions to ask, and I hope this show really helped to provide you with some background to be able to ask those questions so that you’re getting a treatment that is going to accomplish your goals with the downtime that you’re looking for, and in a manner that really suits both your timeframe and your budget.

I appreciate you taking the time to listen to this, kind of, science-y background, nerdy laser part, but I hope it helps you to understand the different types of treatments that are out there, and why certain treatments may not work for certain patients. So, thank you a bunch. I appreciate you listening. As always, give us five stars if you liked it, and subscribe on whatever platform you like enjoying podcasts. Thanks.

Thanks for listening to The Trillium Show. You can keep up with the latest on the podcast at jhallmd.com. Be sure to follow us on Spotify, Apple Podcasts, or wherever you listen to podcasts. If you want to connect with us on social media, you can find us at @jhallmd on Instagram and Twitter and @DrHallPlasticSurgery on Facebook. Remember, be the change you wish to see in the world.

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This episode is all about facial aging and the three main areas of facial aging—skin aging, volume loss, and structure. A foundational rule of thumb for any cosmetic treatment, including facial rejuvenation, is that treatment is based on your anatomy and biology and not on your age! Understanding this concept will set you in the right direction during your consultation and as you continue to take care of your face and skin.

As we walk through skin aging, volume loss, and structure, I’ll discuss specific treatments based on each of these three areas. We’ll also explore at-home and office treatments for facial aging, what you should focus on during your own research, and my personal skincare recommendations.

In this episode, we cover:

Skin aging: Understanding what causes the skin to age, why your goal should be to minimize wrinkles over time, and what you can do now in your 20s and if you are over 30. (02:25)
Loss of volume: Facial volume loss is an easily recognized aging appearance—even if you may not know what to call it, and we look at the benefits of fat grafting and why it is preferred over fillers. (16:48)
Structural aging: This is the result of facial volume loss. We look at facial rejuvenation surgery, a caution against skin tightening, and the findings from the Twin Facelift Technique Study. (20:17)
For patients considering facial intervention, here is what you can do to stay better informed as you go into your consultation - and why it’s important to start off with physician-dispensed medical-grade skincare products. (24:29)

Links:

Recommended skin care products
Twin Facelift Technique Study

Dr. Jason Hall, MD

Skin Care page: https://drjasonhall.com/non-surgical/skin-care/
Main Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

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Over time, we've seen the standard of "beauty" shift when it comes to breast augmentation. In 2021, "natural" is in, and the "adult entertainer" look is out. Regardless of what look you are going for, the internet is full of recommendations and opinions on how to get the result you want. This means YOU, the patient, feel like you have to make a ton of decisions that are your responsibility. Feelings of overwhelm , confusion, and anxiety about this operation are the result.

In this episode, we’ll explore the ins and outs of breast augmentation and the role patients play during consultation through recovery. We’ll also discuss implant types, shapes, textures, and placement - why certain combinations yield different results - and why your final outcome (not the different implant, incision, and shape choices) should be your main focus going into your consultation.

In this episode, we cover:

Implant Type: The pros and cons of saline and silicone implants and how to determine the best option. (03:19)
Implant Shape: An overview of round and anatomic implant shapes and how rotation may impact the decision to go with one or the other. (06:39)
Implant Profile: Profiles can go from low to ultra high, but the most common is the moderate plus profile. (08:23)
Implant Texture: How smooth and textured implants differ and a brief look at BIA-ALCL, also known as breast implant-associated anaplastic large cell lymphoma. (10:08)
Implant Position: Patients either have over the muscle or under the muscle placement. The combination of texture and position will also affect the capsular contracture rate. (14:01)
Incision Choices: A look at inframammary, periareolar, transaxillary, and TUBA incisions and why inframammary and periareolar are recommended. (18:56)
Pre-consultation: How to prepare for your breast augmentation consultation and what to ignore when researching online. (22:10)
Consultation: During your consultation, patients and surgeons discuss goals, 3d photos are taken, and a digital simulation of the surgery is performed to narrow down the implant size and profile. (29:48)
Surgery and recovery: For most patients, avoiding activity during recovery is the hardest part! The key to a long-term, stable breast shape and size, is avoiding those urges and following the recommended recovery guidelines.

Links:

Dr. Jason Hall, MD

Breast Augmentation: https://drjasonhall.com/surgical/breast/breast-augmentation/
Main Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

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A tummy tuck, also known as abdominoplasty surgery, is very common in the United States. Last year (2020), nearly 100,000 tummy tucks were performed in the US. This procedure serves as a safe solution for excess skin and results in the restoration of your natural silhouette.

In this episode, I’ll break down what a tummy tuck is - and more importantly, what it isn’t. We’ll go over the goals of the procedure, the operation itself, and what to expect during recovery. With every surgery, there are always potential complications (which most people don’t want to discuss) – I’ll touch on those, too.

In this episode, we cover:

The three main goals of abdominoplasty – safety, reestablishing your curves, and removing excess skin. (01:57)
What goes into a tummy tuck procedure? From determining the incision location to performing the surgery, there is both art and science behind every detail. (17:17)
Recovery time: Making recovery smooth, when to return to work, and when to return to working out. (27:26)
Complications: Little “p” problems and big “P” problems…hear about what can go wrong. (33:28)

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Links:

Is the umbilicus truly midline? (No…and there’s science to prove it)
MyFitnessPal (they’re not a sponsor - they just have a good product)

Dr. Jason Hall, MD

Abdominoplasty page: https://drjasonhall.com/surgical/body/tummy-tuck/
Main Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

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When we talk about facial cosmetic surgery, what comes to mind for most people is a facelift. However, there are many types of facial procedures one may consider. Whether it is a laser facelift, eyelid surgery, rhinoplasty, or even injectable fillers, each of these require a thorough consultation to ensure that the result will make you feel confident and rejuvenated.

There are a ton of ways to prepare for your consultation. The more information you can bring with you, the better your consultation will be. Goal setting is an important part of any procedure, and it is no different in this case. In this episode, I’ll guide you through the four main goals of a facial consultation, from pre-consultation to recovery, to help you understand what to look for and to empower you to be part of the process.

Topics covered in this episode include:

Goal 1: Do you and your surgeon/injector have aligned goals? The first goal is to determine if you both have the same measure of success. (02:41)
Goal 2: Are you the right candidate? It is important to explore whether you are mentally, physically, and psychologically equipped to undergo the procedure. (06:12)
Goal 3: Are we compatible? The relationship between you and your surgeon is a major component of the overall process. (08:04)
Goal 4: When should I schedule my procedure? Adequate recovery time is essential and it is likely to affect your professional and personal life. Another point to consider is that many cosmetic surgeons are booked months in advance. (09:13)
What to expect on the day of your consultation, who to bring with you, and what to consider if you are over 50 and/or have chronic medical problems, such as diabetes or high blood pressure. (14:45)
Why evaluating your skincare plan is a vital part of the consultation. (18:59)

Links:

Dr. Jason Hall, MD

Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

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In this episode of the Trillium Show, I’m joined by my good friend, Dr. William Gibson.

Dr. Gibson specializes in the surgical treatment of breast cancer and serves as the general surgeon at Parkwest Medical Center in Knoxville, TN. In this conversation, we explore breast cancer and what may come along with a diagnosis, both physical and emotional. Through the lens of compassion, Dr. Gibson shares his advice to patients who are navigating their breast cancer treatment and prevention, provides an in-depth look at oncoplastic breast surgery, and much more.

In this episode, we cover:

An overview of Dr. Gibson’s background and we discuss the tremendous, life-long impact of our study abroad experiences in college. (00:23)
Dr. Gibson shares his perspective on the statistics related to breast cancer diagnoses in the U.S. and provides a deeper look at inflammatory breast cancer and its causes. (4:19)
Understanding estrogen receptors and how endocrine therapy differs from chemotherapy. (09:13)
What patients should know about staging for breast cancer - and a look at the two most common options for first-line treatment after an initial diagnosis. (13:41)
How oncoplastic breast surgery proves to be a significant improvement in the surgical care of breast cancer and what qualifies a patient for this type of treatment. (19:13)
Why Dr. Gibson recommends reconstruction surgery after a single or double mastectomy - and his advice to patients on finding a treatment team to help them navigate along their journey. (28:12)
Dr. Gibson’s recommendations for women and their families who are facing a new breast cancer diagnosis. (34:00)

Links referenced:

Breast Cancer Staging TNM 8: Download the mobile app
Breast360.org: https://breast360.org

Dr. William Gibson, MD, FACS

Premiere Surgical Associates: Dr. William Gibson

Dr. Jason Hall, MD

Website: https://drjasonhall.com/
Twitter: twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

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Approximately 300,000 women undergo some form of breast augmentation each year. While information on these procedures can be found online, the internet and reality TV shows (like Botched) can be misleading and ultimately increase anxiety before you even have your consultation. In this episode of The Trillium Show, I give you some tips to help prepare for your breast augmentation consultation and discuss the four main goals of the consultation for both patients and surgeons.

Highlights:

Why Google and internet searching can be overwhelming. (00:15)
Goal planning: Why you and your surgeon should have the same goals before the procedure. (1:52)
Are you a good surgical candidate? Ensuring safe surgery (7:07)
The importance of patient/surgeon compatibility - and how you can manage expectations. (9:51)
Get the date that works best with your schedule - recovery time matters. (11:43)
Consultation tips: How to make the process as seamless as possible. (14:52)

Links:

Dr. Jason Hall, MD

Website: https://drjasonhall.com
Twitter: https://twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

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Welcome to The Trillium Show. In this introductory episode, I explore my long journey towards becoming a physician, the inspiration behind this project, and what to look forward to in future episodes.

Plastic surgery as a specialty focuses on change - both physical and psychological. The Trillium Show will explore these changes through candid conversations and real-life experiences - with me, with my patients, and with guests both related and un-related to medicine who have either dealt with significant personal changes or help shepherd others through life changes themselves. Follow along, as we take a deep dive into both the physical and mental aspects of change to help us navigate the changes in our body, our mind, and our life.

Links:

Dr. Jason Hall, MD

Website: https://drjasonhall.com/
Twitter: https://twitter.com/jhallmd
Instagram: https://www.instagram.com/jhallmd/
Facebook: https://www.facebook.com/DrHallPlasticSurgery/

The Trillium Show with Dr. Jason Hall: Recent Episodes

Dr. Jason Hall