The Truth About Injectables

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Ready to talk with an expert? Visit bill.com.proven to get started. And grab a $250 gift card as a thank you. Terms and conditions apply. See offer page for details. Hi, I'm Raj Punjabi Johnson, head of identity content at HuffPost. And I'm Noah Michelson, head of HuffPost Personal. Welcome to MI Doing It Wrong, the show that explores the all-too-human anxieties we have about trying to get our lives right. Okay, Raj, what is your experience with injectables? You know, I just turned 40. I haven't done any yet. But I see that stuff in my future because I have a lot of friends who they feel really confident and happy because they get a little thing injected once in a while. And I love that glow about them. So, you know, I'm open to it. What about you? When you look in the mirror now, though, do you feel like you see stuff that you want to change? Oh, that's a good question. About my body, yes. Not so much my face as much. Okay. I'm still pretty happy with my face. Yeah, you look good. I'm really happy with my face, actually. I'm 46. I haven't had anything done yet. But I never say never. Yeah. Here's the thing, though. I'm cheap. All I want to do is spend money on tattoos and shoes. You're responsible. Yeah. Okay. And I can't imagine forking over $500, $800 every six months or more. It's a lot. To do this. But I also know nothing about injectables. So, I'm super curious to hear maybe my mind's going to be changed. We'll see. Yeah, we've got the best expert ever. Dr. Sherwin Parikh, he's a dermatologist, founder of Tribeca Skin Center here in New York, and a professor of dermatology at Columbia Presbyterian. Let's do it. Dr. Parikh, thank you so much for being with us again. We're so excited. So excited here, too. Thanks. Let's get started. I'm really, really excited about this topic because I am an injectables virgin. I have not yet. Oh, I have not yet tried them. I really want to. There's so much stigma. I don't exactly know what the difference is. So, let's get into first the different options. What's the lay of the land? What categories of injectables are there out there? In broad strokes, you break down injectables into two categories, mostly toxins, Botox, Juvo, Xeomin, Disport. Those are the toxins that help stop muscular contraction to create like this sort of placid, smoother skin face where you want to. And the second one is fillers, but they also come in different varietals as well. And those are even more specific, all the varieties of fillers. So that's your broad brush strokes, two separate categories. They're completely different. They do different things entirely, and you choose based upon what your desires are. Okay. So the toxins, which that's terrible marketing. But in our field, we say tox is a shorthand. But yeah, Botox was first to market, right? So it was the first thing at the turn of the century. I'm going to rebrand it. They're going to be called Toxies. Toxies. Exactly. That's cute. So you told us what Toxies do. What do fillers do? I expect they fill. Yeah. Exactly right. So they take up volume loss, or they fill increases or crevices, or they give a little bit of projection to the face or other places where people are putting fillers now too, which is a deep dive. Oh, we will get to that. Yeah. Yeah. Yeah. They come in different varietals, different like G prime, different forces, different viscosities, whether they're, well, this gets really detailed, but whether they're crosslinked or non-crosslinked, how thin the filler is, how thick the filler is, where does it hold, where is it the best placed? So that's really kind of interesting and exciting for people who know how to use them really, really well, and a little daunting for people who don't know what they want. Yeah. And the general idea is that as you get older, one, you wrinkle, and two, you start to hollow out. So that's why you would be doing these. Yeah. You're right. Exactly. You're when we get to be 95 years old, God willing, we're skin and bone, right? Well, we're missing is the subcutaneous structures like the fat and our muscle isn't as thick. Everything kind of goes between the skin and the bone that kind of keeps things looking plump. That's what people will say, oh, you know, I got a little bit of weight on me. I look a little bit younger for a little bit longer, or I ran the marathon. I look really gotten old now. I mean, you hear these kinds of things all the time in the practice, and we find out that people have reasons why they want to have filler very specifically, not just non-discriminately, just I don't want filler. I want filler. You're like, what exactly are you looking at? What do you think is a problem? Right. And if it's volume loss, people will say traditionally there's anecdotes of like, oh, people lose a teaspoon of collagen every year after 30. I mean, these are all like odd scare tactics. Now you base in some kind of science, but the truth is, yeah, no matter what, we start to lose our baby fat, probably like late 20s to mid 30s. You don't have that same brownness to your face you had in your teenage years or 20s. Some people retain it. Some people's skin is a bit thicker. They look a little bit younger for a little bit longer, if that's the word that you want to use, you know what I mean? Like that's, but people lose their volume. Correct. Okay. So what I'm hearing is if you're like me and you haven't tried anything yet, you don't want to go into the derm and be like, I want this filler I've heard about, you want to say this thing is happening. What can I do? Correct. It's really easy. If you know your face while you're your body, while you say, this doesn't seem fun for me or I don't love this part. I'm feeling self conscious about this. Great. Tell us what it is and, you know, we can talk about it. Right. Yeah. We got so many questions from people. So we're going to sprinkle some of them in from other people. So this is based on a question from Lizzie. She's saying, is it risky to do filler near your eyes, like your crow's feet? And what kind of filler can be used safely for under eyes? Basically, I need my eyes fixed. Eyes are definitely a holy grail. And that's that people often conflate botox and filler in that area too. And truth be told, for crow's feet, those are around the sides of the eyes when your eyes smile and squint and you get little creases that come out. That's where you put two drops of botox, three drops of botox, and those wrinkles don't happen. And it keeps them at bay for five, six months. And you repeat it if you like the way it looks. Super easy. Filler is not great for crow's feet. And some would argue that filler, myself included, isn't amazing for under eyes either, right? But there are a lot of people who do put filler under their eyes and some people can handle it more than others. But yeah, filler under the eyes isn't our favorite thing to do at the center amongst the five dermatologists. We do do it for select people who have really naturally hollowed eyes. They're younger. They have great bone structure to support the filler where it can sit. But on someone who's a little bit older, there's not a place for filler to sit well. It won't look good. It can sort of pool or look a little bit unattractive. You've seen that. Is that what migration is? It's not a great word for it. But yes, exactly right. It's moving. It's moving, but it's not. It was already put there by somebody where it shouldn't have really been. It wouldn't have worked for them because that person's mid-40s or 50s and they are naturally, that skin is getting thinner under the eyes. So how will it hold the filler well? You need a certain amount of viscosity under that thinner skin to hold the filler and a good amount of bone structure to put the filler on deep in the skin so it puffs up that area super gently. And you don't want to cause more problems with filler. So some of this, as a doctor, you can see you don't have the right anatomy for to go there. But some of it trial and error where you're like, I don't know what's going to happen when we put this here. We can do a little. So you would never do that. Absolutely not. Okay. I mean, that's a hard no. I don't think that anything with filler should be trial and error. Okay. That's good to know. And also not with Botox. And again, in this day and age, everyone should know how to do this stuff well enough if they're a practitioner of it. So no. It's predictive. What about trial and error in terms of how much you're getting? Would you ever say, okay, this is your first time we're going to do a little tiny bit and then we'll increase? Sure. And also you want to let stuff settle for a week or two and see how you like it. And it's totally fine to say, oh, I'm a little bit underdone. I'd like a little bit more. That's totally fine. It's a little bit more annoying or even problematic when you're like, I think it was just too much. Now what do I do? Do I wait it out or do I reverse it? Yeah. Again, those are the two options. I didn't know you could reverse it. That's one of my friends. So filler. So most filler is based in hyaluronic acid. It's a naturally occurring gel that you can put under the skin. It's the same thing you see in moisturizers. Hyaluronic acid is gel based. Yeah. And it's very small aliquots placed strategically. I like to call it my favorite SPF. Okay. Strategically placed filler. And if you do it correctly, it looks really, really good. But if for some reason someone's had it done because they, you know, went to some bargain basement situation or they got controlled and do it by some random place and they don't like it, you can have it reduced or removed with hyaluronidase enzyme, which can dissolve it quickly and safely. So it can be undone. What is, you know, changing on social media from having too much filler to all of a sudden looking better, right? Because they may have very well decided, I have too much filler in my cheeks or in my lips. That's their choice. And they want to reduce it. So they do it. Okay. They look so good. You know, yeah. Can you reverse Botox or you just suck? Botox, you have to wait out. Okay. Correct. And again, there should be fewer mistakes with any of these things if they're done by a certified professional who's got a board degree, board certification, yeah, I mean, dermatology or yeah. Okay. I am excited about this topic also, because I feel like it has been injectables have been stigmatized sometimes. And also people have a lot of misconceptions about that. So let's start with just like things that could go wrong. And then we'll like build up to like some of the more positive stuff. So if I'm like starting out, and you want to make sure that I have the best experience possible, what will you tell me to watch out for? So we always say anytime you're going to be injection very much like anytime you have any needle put in your skin or even a drawn blood, blood draw, you could get bruises. So if you want to mitigate bruises, stay hydrated, maybe take some Arnica supplements before don't have any alcohol, Advil or aspirin 24 hours before, because that increases bleeding. And for the day afterwards, try to avoid it. It's not a big deal if you don't, a bruise will go away. And that's probably one of the most common things people will see from any injection. I've definitely seen one of my girlfriends have like a little bruise when from her like lip stuff. I'll tell tale. You know what I mean? And again, there's no shame in the game. Like if you're like that's what I had done, it's what it is. But some people are like, I don't want blah, blah, blah to know at work or at home. And you're like, okay, we can try to do our best. You can camouflage or put some makeup on. Um, bruises will fade. I mean, all of my girlfriends who do do the lips absolutely love them. They have like great people and they're like, fuck this bruise, it'll be gone tomorrow. My lips are big. Yes, people, you know, some people aren't born naturally with those lips. You know what I mean? And they want them and they get them. I am all for that life. Yeah. I mean, right. And uh, some people also begin to realize their lips were bigger like 10 years ago and they miss them. So they want them restored. There's reasons for that. Yeah. Yeah. There. Okay. So anything else you would tell me to watch out for? Yeah. Someone was asking us about drooping eye syndrome or some. That's usually with badly placed Botox. Okay. That really should not be happening in 2024 or five. Got it. Again, if you're seeing someone who knows what they're doing, yeah, that's, that's Botox place a little too low or a little too lateral. We're all of a sudden it's hitting some muscles where it shouldn't be hitting and it just knocks them out. So the like lid droops instead of going up. No, no, that's, that's kind of amateur. It shouldn't happen. Okay. Could happen, but yeah. And we'll go away. Right. Oh good. That's what I get the sense that like you can wait some stuff out. I built feel bad for celebrities though, because I feel like their picture is being constantly taken. There was this one that circulated of Jennifer Aniston a few months ago where her face looked a little wild. It looked like to me who doesn't know this stuff too much filler. Like it was very puffy and the people rode her and all the tabloids. They were just like this. What happened to her face? And then a dermatologist was interviewed and he was like, you know, it could be that she got too much filler and she looked deflated a few days later. But is that what have you seen that picture? She is my rider dial like Rihanna's yours and mine too. But I can't with her. I with her ever since her tour de force of Rachel green. Like, and you know, that performance in good girl. I'm like, I can't with right. Like Jennifer Aniston can do no wrong in my life. Yes. I know what you mean. Yeah. Conceptually when you see girls like something you're like, why and whatever, could it be too much of that or too little that it can all be undone or it can be weighted out. And you can return to your normal state. None of this is a revocable. We're not looking at the faces that we used to see from about 20, 25 years ago. We're like, Oh my God. Right. Yeah. What was that? Was that silicone that was put in the face? That is really being done like I did not know that. Oh sure. And it's probably still is in certain communities. Some people still using it. Yeah. Less expensive or whatever. Or was that a bad plastic surgery? Sure. Right. That's irrevocable. Those kinds of things are, but these things all slowly over time can let you return back to normal. So you can make a choice to sort of stay away from the, from the dermatologist plastic surgeon for like a year or two. And you can kind of get back to what you wanted. Yeah. Yeah. Danielle is wondering, and I'm wondering this too. You hear about young people getting preventative Botox now. Does it actually prevent anything? And how young is too young? I mean, you hear people who are getting like, I guess they call it baby Botox. Yeah. And they're like in their 20s, they don't really have wrinkles yet. Is that preventative? I think they have nothing else to do. You're like, really? Do you really need to do that? I guess there are people who you see are really sun damaged. They grew up as cheerleaders or tennis stars or they were outdoors for like years at a time. Got a lot of sun. They got a little extra wrinkled or they have a kind of a movement line that's just in their family, a deep furrow in the middle of their brow that you see on 20 year olds. They want to Botox out. So is it too early? That's super personal. I do think that it's nice to see what your face looks like from 20, 25 to 30 and just watch it. Yeah. Kind of change naturally. But I totally get people like, oh, I do have this deep crease. I frown so much. There's a deep furrow right in the middle of my brow that you could have seen when I was 12 years old. It's getting so deep. So conceptually, yes, you're right. Now, if you Botox it, you will teach your body not to make that face for a good four to five months. Right? It's very akin to someone wanting to get a six pack or eight packs of abs. If they keep doing crunches, they'll get those lines in between their muscles. That's no different from what's happening in the middle of your eyebrows. When you keep crunching your eyebrows, you get a little crease in the middle. So we're undoing that. And it teaches a lot of people like, oh, if I don't make that face. Yeah. Like I haven't Botox my forehead yet. I probably should. But, but yes, I had a mom at age when I was 12 years old. Don't move your forehead. Don't wrinkle because when I blow dry my hair, you will get wrinkled in your forehead. And she's not wrong. If you go like this, they're always right. Unfortunately. Oh my God. You know it. But say though that I'm 24 years old. I have no wrinkles in my forehead. I don't have that deep like crevice. Yeah. I start getting Botox. Will I never get wrinkles? You'll get wrinkles in other places that you don't care about your neck or your other mouth. The wrinkles are going to find those. No, it's not that. It's just that the idea that I don't think that people should do Botox if they don't have some visual sign that they're making lines and furrows on their face. Right. I often say to patients, listen, look at your photographs for two to three seasons in a row, spring, summer, fall. And if in every season over the course of one year, you're like, I can still see that line in every picture, at least a bunch of pictures from three or four seasons in a row. It wasn't just hydration. It wasn't just the water. It wasn't just the humidity outside. I got a line forming. It's not too late. Right. Yeah. It isn't a great idea to do Botox where there's when there's no lines or wrinkles because what are you doing it for? Right. Yeah. What's the point? I totally agree with that. No. Watch how your face moves and decide, okay, I'm not going to do that. I'm not going to furrow my brow or I'm not going to crinkle my eyes so much. And if you're like, you know what, I can't. Right. I always do that. Then fine. Get your Botox because you know that you keep moving your forehead or your eyes, your face too much in a certain way and you don't like the way it looks. But also, you don't have to look at your face that much. Yeah. But we do a lot more because of zoom now. Yeah, it's crazy. So we're looking at our own faces while we're talking. Have you noticed an uptick in, okay. 100% since the pandemic. I truly have been reading about like more surgery, more like everything because we're staring at our own faces, not other people. Low key, it's like mental. It's like how that works. It's bad. It's not good for us. We should not be looking at ourselves while we talk to people. We should be just on podcasts, talking to people. So if we can look at our podcasts, we're the best. I totally agree. I totally agree. Let's take a quick break and we'll be right back. The old adage goes, it isn't what you say. It's how you say it. Because to truly make an impact, you need to set an example. 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And that's why I created the Manny system so you can have that salon perfect manicure right at home. And guess what? The best part? Each Manny only costs two dollars. Yep, you heard me, two dollars. No more 30, 40, 50 dollar salon trips that eat up your day. Now you can paint your nails whenever you want, wherever you want. And trust me, you're going to be obsessed with your nails and everyone is going to ask you where did you get your nails done? And here's a little something extra. Head over to oliveandjune.com and get 20% off your first Manny system with code perfectmanny20 at oliveandjune.com slash perfectmanny20. That's code perfectmanny20 for 20% off at oliveandjune.com slash perfectmanny20. You're all set for a nail glow up. Let's get those nails looking fabulous, shall we? Welcome back to Am I Doing It Wrong? Can you be too old to start injectables? Can like a 75 year old start or is the skin already kind of soft and it's like harder to hold stuff? No, but I do think that probably, and this is again, this is more my philosophy and the dark germs that we all work together at Tribeca Skin Center, we kind of have this feeling that like, you know, you bank all this stuff up in your sort of mid-years, your 30s, 40s, 50s so that you dividends are later where you don't have to do that much work to kind of look good. It's like everything else. If you land up at the office at 70 years old having done nothing, I'll be like, all right, why don't we do a little bit less, not more. Because if we do too much, it's going to be a, jarring to people who know you to look so different and b, yeah, it won't look natural to you yourself when you look at them. You're like, oh my god, I'm wrinkle free everywhere. It's not fun for people. Okay. So it's not that you can't do it. No, you can, I can have a seven year old come in first time and say, oh, you have like a little vertical crease or a couple horizontal creases. We'll put in a few drops of Botox, they'll soften beautifully. They may not go away completely. Yeah. We'll all be happy. You'll be happy. Your friends will be happy. No one will call you out. Yeah. It's funny how different people react to this. And I do feel like it's gendered. I went to a restaurant a couple of months ago, and one of the owners came up and said hello to our table and she was gorgeous older Cuban woman. And I was like, I was just like, I can't tell exactly how old you are, but you're like, she was sexy. And then she's like injectables girl. She's like I'm 73. And I was like, what? Like, I will show you a picture after this. She's a stunner. And like Calvin was like, Oh, I can't totally figure it out. She like looks kind of older, but she doesn't have wrinkles and like whatever. And I'm like, sometimes I feel like straight men are perplexed by that. And women are just like, yes, yes, yes. It's we all perceive these things differently too. And like the concept of what you're supposed to look like as you age. Yeah, that's definitely changed. Right. Yeah. And I think for a lot of people that feels difficult, you know what I mean? In terms of like, we are seeing more people getting these procedures done, especially in Hollywood or on TV and things. I think some people feel like they have to get them to even maybe they don't want them. That's the worst position to be in here. Yeah. Yeah, it really should be from the heart where you're like, this would feel fun for me. And I think I might enjoy it. It might be really great. And also not so much chasing youth, but it's okay to sort of want to feel vital. Yeah. To feel energetic, to look glowy, to get a sense of your own. Like I feel up and alive and awake. Yeah. I'm not trying to look young. Young is for people. And that's I think probably what you're describing with this woman in the restaurant where you're like, she just looks kind of fantastic and healthy and alive. Yeah. Not trying too hard. Exactly. Like good injectables can be injectables to the soul too, I think. Like you feel sexy. That's a different show, right? Yeah. I'm getting woo woo. Yeah. No, you're right though. And I think like you said, like people should do it if they want to do it. Yeah. There are places where it also looks really good and places where I think your eye will catch it a little bit more. And that's also what you have to sort of look for for yourself. Can you tell us where, what's a place you want to be careful of your eye? Well, people's eyes. I know eyes for sure. Definitely. And I think lips have become, have now become that thing where people are like, oh my God, they inject their lips. Yeah. And you're like, yeah, they do. So, yeah. Or, yeah, that's not for you. It's for them. They like it. You don't have to like it, which is one of those things. But people just assume then that filler is always terrible, but it's not. You place filler strategically in the cheekbones and you make someone have like a Bella Hadid moment. Like it's great. Like there's nothing wrong with that. People, because we naturally, our male or fat pads naturally kind of like get a little bit more flattened and they sink. And for some people, that's a little bit attractive, that kind of like slightly gone to kind of getting into the middle age. But other people are like, I don't really like it. I want my baby cheeks back. And they'll suit me right now because I have a voluptuous this or that or this is my vibe and it works well. Or little smile lines that happen between the nose, crease and the mouth. People say, these are really deep on me because my dad had a really deep one. Yeah. And they'll just, again, if we strategically place little aliquots of filler, like just a little hyaluronic gel, like putting earth into a valley, it's like just spackling it up to level. And nobody in your world is going to be like, oh, you did that. Because there's such small little things. So there's places where people are not going to see it. They're not going to know that you did that. And other places where you do it, they'll be like, girl, love your filler. Yeah. And you're like, oh, thanks. So depends on which person you want to be. Right. Yeah, yeah, yeah, yeah, yeah. I love that. So this might sound like a dumb question, but once you start doing these things, you have to do them forever. Not a dumb question at all. I think that, uh, the answer is, no, okay, you also do them a lot less often, I think as you start to bank what you've already done, because I do think there's a longevity of these things on some level, even the idea of the injections themselves, just that the needle itself creates a slight bit of trauma where the skin responds by forming collagen. That's the theory behind microneedling, right? So if you disrupt the skin through a little bit of organized trauma, it'll grow back a little firmer, a little thicker. But now that's about the fillers. As they slowly wear off, whether it's a year and a half, two years, or even longer, we know now, you can sort of decide to not do it just yet, or do it now, because I've lost too much weight, or I've actually gained some weight, so I'm not gonna do it. But it's about sort of forming a relationship with your provider and them knowing you for a period of time and going, I remember your face when you were 28, and I know you're 37 now. You ready? And then you'll be like, yeah, I'm ready, great. You've known each other for like less than, or about a decade, and you kind of figure out that this is a good time. Do you know what I mean? Oh, can you do that for me? 100%. You're still like a baby. Oh my God, from your lips to God's. But I haven't met your mom too, so like I know what's up. Yeah, the future. Yeah, yeah, which also helps. Okay, okay, good. You're gonna be great. You're the Oracle. What about with Botox? Once, if you stopped doing that. So same thing, a lot of people stop doing Botox because they're pregnant, or they don't want to, or they moved out of the country, and they didn't find a provider for two years. It doesn't make a difference. You can redo it again two years later. I mean, will it wear off? Oh, of course. Yeah, then you're on the hook, because it's not gonna last. It's four to six months, maybe a little longer if you're lucky, a little shorter if you're not as lucky. But I would say that, yeah, twice a year, thrice a year maintenance for people who end up liking it. Yeah, you're on the hook for it. You don't want to open that box until you're ready to be like, oh, this looks really good. That makes sense. Because then it wears off. How do you make it last as long as possible? Because some of us are on a budget. It's like with my contacts, where I wear them for an extra three or four days. Oh my gosh, same, right? Trying to like, you know, yeah. So bad, so unhealthy. You know the same though. This shit is expensive. Yeah, yeah, yeah. So is there anything we can do? That's a tough one. I do think the whole thing about diet, and exercise, and sleep, and just hydrating and drinking lots of water, and you know, there are all these random supplementals that might make things last longer, taking zinc supplements for your Botox, or taking collagen supplements for your filler. Fine, fine. We can't tell you it's definitely gonna work, but the truth is, just go slow and steady. See what works for you, and then see what a clip it lasts as, right? But there are other skin treatments that'll help, like lasers and heat treatments can help produce collagen and promote collagen without injectables, or in conjunction with injectables. So all of a sudden, you're buying yourself more time. Okay, I love that. How much are these things supposed to cost? Cause like no one has told me anything, they're just like, this is really expensive. But we all choose to spend our money where we choose to spend our money, yeah. It's a luxury good to be sure, and you can find a range from burrow to burrow, I'm sure, right? But stuff in Manhattan is expensive, yes, yes. And so people will charge, you know, what they think is worth their value as the practitioner. That's also the practitioner, and like how experienced you are, okay? There's no doubt that if you're on the upper, if you're on Madison Avenue, somewhere in the 70s or the 80s, you are going to pay a premium, but you are. That's just what it is to step foot on the real estate, I think. You know, we're in Tribeca, I think we're reasonable, and people mostly seem to agree, right? But that's a tough one, because you're right, it's a luxury good, how much do you wanna spend? I feel like you also don't want to cheap out on your face. This is the thing, right? It's like, this is your body, you're putting something in your body, this is not the same thing as like our last episode is bargain shopping, where like, you know, you get something, yeah, jeans, great. No, you're putting something in your body, yeah, yeah. If you got something for 300 bucks, so an injectable 300 bucks, and you were like, it worked out really great, great. Thank your lucky stars, right? It went well for you, you got it for 300, 400 bucks, and it worked out well, awesome. Maybe get you six months or a year of beauty and enjoyment. Great, you may not be as lucky the second or third time, totally fine if you form a relationship, and that situation seems really good, but. Okay, that's fair. Yeah, someone was asking one of our listeners, how do you feel about a dermatologist like yourself versus a med spa? And maybe you're biased because you are a dermatologist, but what would trigger someone to think, I shouldn't go here? I think you get triggered when you get upsold with coupons or groupons, like you get triggered, you should kind of take that as a bit of a orange flag, I guess. Okay. I don't want groupon injectables. Yeah, I think you want to like your practitioner first for their capabilities, for their education, for their communication with you first. Just get that sorted out first, meet somebody, decide you like them. It's totally fine if you're going to a nurse practitioner, and he's not an MD or a DO, or not has a board certification in dermatology. If you've decided they're really good at what they do, and it suits your vibe, terrific. It can work. Okay, excellent. Lindsay asks, who is not a good candidate for filler or Botox? Any surprising factors aside from pregnancy that mean you absolutely shouldn't get this kind of treatment? Good one. Yeah. And weirdly, Allergan even did studies on pregnant women, and it's considered safe even in pregnancy. So that goes to show you how much people like Botox that they signed up for these protocols. Totally. But, and filler you shouldn't get because you're going to be gaining weight during pregnancy, so you wouldn't really know what your face is. Now, who's not a great candidate? I think people have incredibly thin or sun damaged skin that is sort of papery, and you've seen that on some people. Lots of brown spots. Other things that you'd rather fix first to create a glow in someone's skin. There's so many other ways to make someone feel and look more vital. Lasers are one of them. Tixels is another one. These sort of treatments that are used heat, radio frequency, ultrasound, these treatments that use heat and these kind of modalities to kind of tighten the skin more naturally without the use of effectively subjective things. Like subjective things like injectables are like how much and where. Got it. That's so dependent on the person who's doing it, and you have to trust their eye or their art. Whereas lasers and heat modalities, the person who's getting it done is just waiting for their body to respond three or four weeks later. So you're never gonna look strange or different from yourself. You're always gonna look a little bit better, a little bit better, a little bit better, and you'll improve things like brown spots or dullness or roughness. That alone can be gorgeous, right? You see so many beautiful actors who are of a certain age who have tons of little wrinkles. You're like, God, she's gorgeous. Because the skin is one milky tone or one creamy tone. And you're like, that skin tone is what also attracts someone else's eye. Having pretty skin. Wrinkles are not. Gray hair or not. That's not what it's about. It's having pretty skin. So you can achieve that with good skin care and even lasers if need be. And you don't have to touch injectables. That's not your vibe. Okay. Let's take a quick break and we'll be right back. Hello, everybody. Hey! Can you tell us what you're doing? Sopla, sopla. Ah! I'm wearing the sleeves. They're 45. When you're 45, you have to soplar a lot of candles and get tested against colon cancer. Because when you detect early, it's more treatable in 9 out of 10 people. Use the Cologuard test in your home's privacy and send it back to get your results. Cologuard test is a recipe to detect colon cancer in people who are 45 years old or more at average. Positive results should be followed by a colonoscopy. It can give you positive and negative results. Cologuard test doesn't replace colonoscopy in high-risk patients. Don't use Cologuard if you have adenomas, if you have inflammatory and intestinal disease and some miscellaneous symptoms or a personal or family history of colon cancer. Ask Cologuard for more information in Spanish. Visit cologuard.com. Try it. Thank you for calling the Bamba's Comfort Line, Bamba's McSocks, Slippers, Teas and Underwear, made with the highest quality materials. Press 1 for Comfort, 2 for Style, 3 for Donation. You chose Style. Bamba's is Styles for whatever you enjoy. You can run in Bamba's, lounge in Bamba's, dress them up, dress them down, but always give back in Bamba's because with every item purchased, another is donated. Bamba's Comfort worth calling for. Go to Bamba's.com slash audio and use code audio for 20% off your first purchase. That's B-O-M-B-A-S.com and use code audio. Over 90 of the top 100 US accounting firms trust Bill to simplify and secure BillPay. That's proven financial infrastructure built on over a trillion dollars of secure payments. Visit bill.com slash proven for a special offer. Welcome back to Am I Doing It Wrong? Can we talk about some of the other things that people are getting injected? I just saw Heather Gay from the Real Housewives of Salt Lake City at a talk and she owns a med spa in Salt Lake City. And she was saying the two craziest things that people are asking for now and I guess she does them. One is women are getting it and fillers injected into their feet, the balls of their feet. Because then they have a little pad there and it makes it less painful. That's kind of genius to wear hot heels. Designer shoes are very painful. I buy them in my sample. I'm trying to get injections in the bottom of your feet with filler. It's a lot more painful. Have you done that or seen that? No one in our practice asked for that kind of stuff. Have I even seen it? Not really. Do I believe that there's four people in the world in one town who do it? I suppose. I feel like these things are often overblown and I just, I in my feeble brain can't believe that there's a buttload of people who are doing it. But sure enough, there probably are. Does that seem medically unsound to you? I mean, as long as it's done safely and you're not hitting a tendon or a blood vessel and you know what you're doing, I suppose it's totally fine. But again, really, you can't just put in some insoles. But like, I know, look, you're right. Maybe it has to do with the value of it. I mean, insoles would do the same thing. Yeah. Put some band-aids, I don't know. Don't wear those shoes. I don't know. The other thing that I've been hearing about is. Where to shoes? The P shot so you can make your labia and your penis puffier. Do you see it? Or bigger. But really, don't you think you have other problems at that point? I would think so. Puffier, is that hot? I guess labia can be less puffy as you get older. Okay. And so it makes your vagina look younger. Okay. If I were a, this is, I think like sex workers might be, you know, I don't know why. I think that's what you see it on. Yes, I've seen this in socials. Whether it's an enhancement of an area to make it look more aesthetically, yeah, 3D. I mean, really, it's sort of out there more. You're filling something or you're puffing it up. That makes more sense to me in terms of like labia, but I don't think I would inject my penis with filler. That seems like there's more thing. My penis, but I just feel like your penis is doing more things. Your labia is like decorative in a lot of ways. Yeah, it is decorative, absolutely. You're not peeing through your labia or doing other things. I'm using my penis for things. It's not like the door to the. Do you feel like injecting injectables into a penis is medically sound? I don't love it. Okay. I don't think that people should do it, but you're right. If that's your source of income, and you can definitely see an uptick in your subscribers and your rates, then like, God bless. Yeah, I was sent a PR email about this, and I had to sign up to look at the photos they had before and afters, and they sent me like 100 photos of it, and I was doing just my work. And you, exactly. Yeah, exactly. Were you impressed with the four afters? No, I wasn't really. They looked plumper, girthier, I would say, but not hugely. There's the word. I love girthier. There's the word. It didn't make them longer per se, and I just felt like they looked kind of like. Yeah, so I think that's what it's gonna do. It's gonna be that. It's not gonna be that. I mean, yeah. But again, I guess if it's safe, which I'm not sure that it is. I don't know that we know 100%. Now, how do you know that a couple years down the line, you're not having some trouble, which can happen just naturally anyway, you go, maybe it was from that. Yeah. I will also say though, maybe this is too much information, but like I'm happy with the size of my penis. That's good stuff. And if you aren't, I could understand why, maybe this would be something that you would want. I just think it's hard to put yourself in someone else's shoes and understand why they want something and what it's gonna make them feel like. And that's what the bottom line is for me, for all of this. If it makes you happy. Yeah. Yeah. I mean, bottom line, people are putting their bottom, people injecting, right, sculpting right into their buttocks. Right. I mean, I'll also do that safely, because that's like, we did a lot of research. You've heard some back, you've heard some stories about it. Like, unfortunately, people put doing black market stuff and it's so dangerous. Oh, like cement. You could actually legitimately die. Yeah. Yeah, so like, you've gotta be careful with this stuff. You don't want stuff falling off your body or your limbs or appendages, necrosis or no. So you refer to the injectables process as an art and it really is, right? Because you wanna choose someone like, Noah and I love tattoos. We're very particular about the artists who do that. Yes. This is similar, right? Because you're creating a look. How, if you don't have a dermatologist already, how do you find a person? Ask your friends. Like look around people, to your point, right? People do talk about it or also like just after, you know, at the end of a night or after dinner or drinks, people start to get a little loose. So like, listen, hey, I'm thinking of this. Like, I love your face. Do you do anything? People who are your friends will tell you. I love your face. Do you do anything is so good. Yeah. Like what should I do? Like what can I do? And who do you trust? Like what, your friends and what you like, they will steer you right. Yes. You know, that's the best. I mean, you could use social media, but then you end up seeing things you don't really want to see. Yeah, no, never the answer. And people's faces that actually scare you. Yeah. Do you ever have to tell your patients like this is too much or if they come back and they like can't see it anymore, it's kind of a dysphoria? It's hard to confront someone with that. Because that's sort of part and parcel of other issues they may be having, right? But it's nice to be able to say, maybe this isn't the best idea for you. Maybe we want to make you healthier in other ways first before we go down this route. It just feels like a really uncomfortable conversation, but I'm sure you'll see it sometimes. No, you get used to doing it. And also, not often, not often. I think maybe it's a self-selecting population of people who know us and who know me for so long and who know friends of friends who see me and patients and friends and physicians who refer to me. I think it's sort of over time. I mean, physicians, spouses come to me. Like over time, people who come to you are of the same ilk. If there's a, this is the reason why I think that social media can be really problematic. Because if you're randomly choosing your doctor or you're randomly as a physician choosing your patients based on social media, because it's a two-way street, all of a sudden you just don't know who's in the room with you. And you want to have some thread of connection where you're like, oh, I get what you're talking about. But if someone comes at you, and that happens rarely, where I go, ah, I feel as if you're not a great candidate for a lot of this stuff, because there's maybe some other sadness or anxiety or worries about your body that are going on more globally. I think we're good at that, right? Like physicians especially have been hopefully trained to recognize those things. If we do get the name of a doctor from a friend and we go to see them for the first time, we've never had anything done, what are some things we should ask that doctor before we have the procedure or before we do it? What are the side effects? What are the downsides? And also what will I look like in a few days or a few weeks? What should I expect to look like? How good will this be? How subtle will this be? There are people who will say to me, I want my forehead to just not move. Like, oh, you want that LA look, you want that like whatever. Other people will say, please, I still want to have expression. Everyone's different. And I'll say, I got you. I know exactly what you mean by that. Let's watch your face move. We're gonna only do this much at this spot in these ways. And there's a certain expertise where you get to know somebody. And even when you first meet them, you're like, oh, I get it. You are low key about this. You're super low key about this. We're gonna really be subtle. And if I'm too subtle, you can come back in two or three weeks. We can readdress it. You know what I mean? Yeah, that's great. I love that. I do think when I get, the few times I get my makeup done for like an event, I really like a really dramatic smoky eye more than people usually do. So I tell them, I'm like, make me look like a French stripper like the morning after who like went out and they get it. Yes, yeah. And I'm like, lots of just smoke, smoke, smoke. I've been, you know, out on the town and they get it. And it's okay to be dramatic. It's okay to like, if that's what you want, that's what you want. I famously like famously, she wrote a book about it, but I did a little bit of filler on someone. I mean, 20 years ago, it was doing her lips. And I thought to myself, it wasn't even trendy. It was like pre Kylie Jenner or pre like all of that stuff, right? And I was like, this is, you do know that if I do it this much and you want it bigger, it's gonna make you look a little bit like, and she goes, what? And I go, I don't know. Like, and she goes, what, why do you think I pay you in cash? What do you think I do for work? Yeah. And I was like, oh my God, I got it. That's the look that you want. You work in an industry. That like it really works for you, right? And then, yeah. And really like 20 years later, she's still hot and can still do it. Do what she does. Yes. I love that. As a doctor, what is one thing you would never do if you were getting an injectable? If I were getting an injection myself. For yourself, yeah. What's one thing you would never do? I think we covered it with the under eye filler is the most precarious. And that's fairly well known because of like how bad it can look and whether it can like, you know, cause long-term annoying issues of like visual and like congestion and puffiness and fluid retention because of the type of filler that's used in the area. That's sort of our least favorite amongst us. There are people who do it and do it really, really well, but it's not, it's sort of one of our least favorite. I think that's- And what about what is one thing you would always do? And not in terms of like getting a procedure, but again, like medically, safety-wise, like what is one thing you should always do? I think when you get those little vertical lines right between your eyebrows. And you're like, oh my God, why is everyone saying I look mad? Why is everyone saying I look angry? Angry 11. Yeah, right. It couldn't be easier. It's the most, you're not doing your whole forehead, you're not doing your crow's feet, you're not doing your whole thing. You know, buddy will know if it's done beautifully that you had those done. Do that. It's also a little dip your toe in the water and see if you like it, cause you will. And you can stick with that for the rest of your life, twice a year and you'll never have to go down some slippery slope. Get your little like 11, your little frown lines treated. I mean, not if you're Paul Mescal cause that like, that crease looks kind of amazing. But like, but you never know. At some point, 10 years from now, it might feel a little bit like you wanna blunt it a bit. You wanna change that up. People have a look, it's true. You don't wanna change your look, but I think that those are, that's an area that people can do really safely, really easily, feel really good about it and never feel like they've overdone anything or look like they look different from themselves. Makes them look happier and friendlier and just gets through that little angry line and it makes a big difference to people. All right, the starter pack. I'm ready, wear those needles at. You are ready. I think you are ready. Does it hurt? Did they hurt? No. No, this is, I mean, yes, there's a little bit of discomfort, but we always, our practice was like ice first before, ice afterwards and it's super quick. And in fillers, there's anesthetic in the syringe. Oh, that's a lot of work. So it's going in, it starts to get a little numb. And beauty is pain and pain is pain. I know, it says like the heavily tattooed colors. Exactly, if you want it badly enough. Yeah, totally. It's over and it's always worth it. Four seconds, you know? Is it really? Not the tattoo. But I'm imagining the both of us. Oh yeah, they're talking over and four seconds, fillers over and like three or four, well, I mean, depends on what you're doing. A little bit longer, but there's anesthetic in that syringe, so that's fine too. And it's all manageable. And like you said. If you want it, and yeah, and it makes you feel good. And what's nice about it is you see it. Like you actually see what you've done. You feel like you know what it's for. Different from just putting on a cream and you're like, is this really working? Do I feel good enough with this? Do I? You actually, it's a binary proposition. Like all of a sudden you see a little bit of a change or a dramatic change in your own mind. And you know that something's happened. I love instant gratification. That's it. Thank you. This has been amazing. You're super welcome, yes. And I can't wait to see Raj's new face. I love that! Me too. Me either. It's time for Better in Five. These are your top five takeaways from this episode. All right, number one, if you're a beginner, it's better to tell your doctor what you're hoping to achieve rather than what kind of injectable you want and wear. Number two, you can get really great results around the eyes, but it's usually not a great place for filler. Number three, you can't be too young or too old for injectables, but talk to a doctor about what you're a good candidate for. Number four, when it comes to injectables, the practitioner and their expertise is the most important part of the equation. And number five, if you're looking for a provider, ask your friends who they see. Word of mouth can score your grade doctor, or just ask a hot stranger. Love that. Okay, Raj, so where are you at now with injectables? Has your mind been changed? Are you even firmer in your resolve? What do you think? Well, I would like my skin to be firmer. Well, you know what? I actually am feeling even more open-hearted toward injectables than when we started this episode. Because I feel like Dr. Parikh is right. Like the practitioner is really important. Like if you have someone you trust, they can help you be your best self. And I just don't believe I am the personality type to go overboard. We don't know what's gonna happen, but like, yeah, what about you? Yeah, I also was just thinking while we were talking that these things have gotten so much better, even in the last five years, definitely in the last 20 years. And so I think that as we keep marching forward in time, it's just gonna keep getting better and better. That makes me feel better. I love that. Science is cool. It is, but I also remain very cheap. So as long as I keep getting up in the morning and looking in the mirror and thinking, you know, I like the lines I've earned right now, I'm pretty happy with my face. I'm gonna save that money for something else. Listen, Noah is feeling himself okay, and there's nothing wrong with that. And I'm gonna spend that money on, you know. Tattoos and shoes. Yeah, food, like cookies, I don't know, something. But again, never say never, we'll see what happens. Truth. And until next time, as long as there are things that we get wrong, we're gonna be right here to help you do them better. I love y'all and y'all faces. Do you have something you think you're doing wrong? Email us at amiddoingitwrong at huffpost.com and let us know. I'm Craig Melvin. Cheers. Cheers. Cheers. I've always been a glass half-bull kind of guy. And now I'm talking to some people who look at the world that way too. Some really fascinating folks who share defining moments, their triumphs, challenges, their stories, their funny, and my candy. So I hope you'll join me each week. And who knows, you might just come away with your own glass half-bull. Search Glass Half-Bull with Craig Melvin from today on YouTube and wherever you get your podcasts. Hey, this is Paige DeSorbo from Giggly Squad. And today I wanna talk to you about Boost Mobile. Quick question, why are we letting our phone bills bully us? Here's a money tip. Stop paying a carrier tax. When you bring your own phone and switch to Boost Mobile's $25 unlimited forever plan, you can unlock up to $600 in savings. That's real-life money, not money trapped in a pricey phone bill. $600 is a trip, a shopping spree, or paying something off. Your money belongs in your life. You get unlimited data, talk, and tax for $25 a month with no contracts and no minimum line requirements. Your phone, your rules. 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