Aesthetic Medicine – Extreme to Mainstream

Link to the Episode

Anshu Bahanda: Welcome to Wellness curated. This is your host Anshu Bahanda and today I’m going to talk about something which is personally of a lot of interest to me because I want to learn about it. There’s very little that I know about this subject. And like most podcasts, while we want to make sure you learn things from every podcast, we also want to learn. And this is an area which is a real grey area. People don’t know enough about this. We’re going to talk about ‘Aesthetic Medicine: Extreme to Mainstream’. We have with us today Dr Barbara Dalbos. She’s an aesthetic medicine and psychiatry doctor at the Sha Clinic… the Sha Wellness Clinic, in Spain. Welcome to the chat Dr Dalbos. And thank you for making the time to be here with us today. I know you’ve had a very, very busy day, so thank you. So I want you to explain to our listeners what you do. What exactly do you do? And we’ve done a really fun podcast in the past on plastic surgery. So tell us, how is aesthetic medicine different from plastic surgery?

Dr Barbara Dalbos: Alors…aesthetic medicine…the thing about it is we are not invasive. So it’s something that normally you can do and after you can go to your normal life without any problem. Only when you are doing some treatment of laser, you can have a post…But normally it’s very well tolerated and it’s not definitive. So it’s something [where] if you have any problem, we can resolve, and you can come back to the initial state. The idea of aesthetic medicine is more, now, to aid people to age better, to improve themselves, to be the best version of what they are without changing completely.

AB: And it’s always non-invasive, is it?

Dr BD: Yes. Maximum of invasive that you can do – with needles. Some needles, I don’t know what’s invasive for each people is different, but you can do with needles with some kind of… but no. Normally, it is quite non-invasive.

AB: Okay. And the thing is, what we want to do through this podcast – because, you know, the podcast reaches people all over the place. So, we want to make sure you give people some tips so that when they go for an aesthetic medicine procedure, they don’t get taken for a ride. So I know that today it’s become mainstream. Right? Botox, microneedling, lasers… lots of people do it. Tell me, what are some of the common procedures?

Dr BD: Common procedures? I say the difficulty for aesthetic medicine is not really the common procedure. [The challenge] is to find a medical [expert] and somebody who’s good. Someone you will be comfortable talking to about your own necessity. So in which way we can help you to improve yourself? For example, I like to explain so each… all the people are different. Depends on your age, depends on your education, your situation, the tolerance to pain, your sex and what you’re expecting. So I think it’s very important to talk with people to know what really they are expecting of aesthetic medicine.

AB: Okay, but also, can you tell us that when patients come to you, what would the top ten procedures be that they want?

Dr BD: Alors. Here, we have a very special consultation because people, when they’re coming to see me, they don’t want nothing.

AB: Okay.

Dr BD: We are in a place with very special [experts], with an anti-aging clinic… When we are talking about holistic treatment to help people to age well… by the global team.

AB: Yes.

Dr BD: So why we have aesthetic medicine in the beginning in this area? Because we think that interior and exterior is only one piece; one unit. And if you can help people to see themselves [as] better, they are going to feel better. So we are, here, always asking them why you are coming here. You are expecting to feel more healthy, more clean, more happy. People will come after a concern, will come after a divorce or things like that… difficult moments of their life. And what can we do with our tools, aesthetic tools, for them to feel more confident, more happy.

AB: More beautiful.

Dr BD: It’s not more beautiful, it’s more self-confident.

AB: Okay, so what tools which are non-invasive? So you’re saying the difference between surgery and aesthetic medicine is basically that aesthetic medicine is non-invasive?

Dr BD: Yes.

AB: While surgery obviously is surgery.

Dr BD: Yes.

AB: Okay. And also, just so we can guide people going to different doctors in different parts of the world, what qualification should they be looking for when they go for an aesthetic medicine procedure? Because I know that every beautician is doing Botox now – with a weekend’s training, a week’s training.

Dr BD: So, that is a problem, normally, in this part of the country and the continent also, normally, you have to be a medical [expert], but you have some countries, like for example, England…or you can be a nurse and some other places, a beautician. For example, me, [that] doesn’t exist in my world – I don’t know what is a beautician.

AB: So someone who would sort of do maybe, you know, do your makeup and cut your hair and do your nails.

Dr BD: When we’re talking, we’re talking about aesthetic ‘medicine’. So I think the term is very explicit: Medicine. You have to have a medical [license]. Why you have to have medical [license] because always when you are doing this kind of act, you can have some complication. And we’re going to talk about that. And it’s not to do the treatment, [the need for a medico] is if you have a complication, who is going to solve it? Who is going to help you in this situation? And you have to be a medical [expert] to help people to resolve the problem. So it’s very, very important to have somebody with form for that.

AB: So you’re saying there could be a complication. Tell me, let’s discuss what kind of complications can there be, or that you’ve heard of or seen…that your patients come to you to sort out.

Dr BD: No, but also I have complications. The complication is not something [that arises] because the practitioner is not good. It’s because it’s like with medicine, you have a percentage of complication in general. So body is not a science exact. So you can always have a strange reaction and allergies to a product, or complication like thrombosis. So you are talking about the main treatment and the main concerns. I think everybody knows Botox. Well, Botox is quite safe. The only risk is just to have a dose…It means that the close of the eyes that you come back by yourself. So we love Botox. Because Botox… if it’s well done, you don’t have complications. So I think that if not very well done, you can have a strange face.

AB: Exactly.

Dr BD: Your face.

AB: Yes.

Dr BD: That is technique. But it’s not dangerous for your health.

AB: It’s not dangerous for your health. Right.

Dr BD: With a filler, with the injection of product in your face… normally, now, while using filler, we are going in with the assumption that your body is going to eliminate it by itself. Normally it’s very safe, but it’s a gel. Normally we use hyaluronic acid. So it’s something that we have in the body. So it’s very safe normally. But first we can have allergy to everything. People have allergy to strawberry or whatever. So why not this kind of gel? It’s not your own gel. After, you can have some reaction with- not allergy – with the reject of the product, because it’s not your own product.

AB: Right.

Dr BD: Normally people who have autoimmune illness, when you have autoimmune illness…

AB: Autoimmune disorder, any kind of autoimmune disorder, [you] should be careful.

Dr BD: Yes. Because when you have autoimmune disorder, what does happen? Your own body is fighting with your own cells. So, of course, if you’re injecting something with not your own cells, you have much more probability to have a reaction against it. After what I see in the complications that we can have when you’re injecting this gel… it’s a gel and if you inject it in a little vein or little artery, you can block it. If you block it, what does happen? The blood is not passing. If the blood is not passing, you’re going to have a necrosis.

AB: Necrosis? What is necrosis?

Dr BD: The tissue is going to death. Going to die. So you can have dying…

AB: Dying tissue in your face somewhere. Wow. Okay.

Dr BD: Yeah. So what happens with that? You have to dissolve the product. You have to put anti-inflammatory, you have to put some packs, you have to do some massage, you have to reverse [it] and to maintain the blood [flow].

AB: So you have to take anti-inflammatory steps and dissolve the product.

Dr BD: You have to dissolve the product… Anti-inflammatory… You have to massage, you have to take…You have many steps. First, you have to be a medical [expert] to recognize [this] to make the prescription because somebody who’s not a medical [expert] can’t make the prescription – it seems to be stupid – and to do the act. So the risk when you don’t have practitioners or medical [experts], if you have any problem, they can’t solve it.

AB: Wow, okay.

Dr BD: And that can be risky. I think that you can have some hole or some spot but also you can lose your eyes.

AB: Lose your eyes. Wow. Okay.

Dr BD: Normally it’s not scary. Depending on where you’re injecting your product, all this stuff is not very dangerous. But if you’re injecting this place or here where you have an artery, we go directly to the eyes. If you block his head, the best resistance to the eyes is blocked.

AB: Right.

Dr BD: So careful when you are doing adjustment on this path, people have to inform you. We have to tell you what can happen, we have to tell you the signs if you have anything: if you have any pain, it’s not normal. You have to come back to see the medico and yes, he has to be able to help you to solve it.

AB: Wow. Okay. So you’re saying make sure someone’s a medical [expert] because you have to check your own health situation and be very open with the doctor, the aesthetic medicine doctor, about your health situation because if you hide something, you could get into trouble. Of course. Tell me like we talked about the risk of thrombosis and… is there any side effect that can happen because it’s been done wrong?

Dr BD:  Of course. Why we want [the expert] also to be a medical because normally when you are medical, you are doing asepsis.

AB: You’re doing?…

Dr BD: Asepsis. Asepsis means that you are doing the treatment with the good condition of cleaning… antibacterial.

AB: I see.

Dr BD: When you’re in a clinic, normally you clean it.

AB: Yeah. Okay.

Dr BD: Because when you are doing micro needling… what is micro-needling? Microneedling is a lot of little needles going to your skin. So if you are not wearing disinfectant, if the product or the machine is not affected clean, you can have infection.

AB: But on that note, I know people who are doing micro-needling at home. Isn’t that dangerous?

Dr BD: Yes. Alors, normally me, for example, I say to people you can do… I love when you do the roller, but not too deep.

AB: Okay.

Dr BD: But the danger of that, the roller, you have to throw it away because all skin is going around inside it and you can’t clean it very well. So after you can infect your skin.

AB: Right. And tell me in terms of the procedures that are there, what are the state-of-the-art procedures that most of us wouldn’t have heard of? Like the really latest development which can help people feel more confident, as you say?

Dr BD: Whatever seems important when somebody is coming, we are talking about what he’s looking for. So you have people who want just to age well – what I told you. So for that we have, for example, a lot of machines. We can help you to stimulate your skin to have collagen and elastin, too, have a skin which is aging better with better elasticity. For that, the two main processes are radio frequency…

AB: Radio frequency? Yes.

Dr BD: And HIFU and ultrasound.

AB: And, ultrasound? Okay.

Dr BD: Both are different ways of heating the collagen and shrinking the collagen and obliging your body to create more collagen. So it’s a big simulation of the skin. How to oblige your body to…

AB: Make your body create more collagen.

Dr BD: Exactly right. Which is not invasive… just by a machine with heating and creating stimulation. When people are doing that? When you want to improve your skin without changing your face or expression, it’s a good way to be. After, I told you. Yes, aging is many things. Aging is loss of tone and collagen, of tightening, but also is loss of volume.

AB: Losing not just the tone, but also the volume.

Dr BD: Yes, you are losing many things. You are losing the bone, you are losing the muscle, you are losing the fat.

AB: Yes.

Dr BD: The problem when you are losing fat, muscle and also bone, so that’s when you have escalator, you can know at which age he died because with the time you are losing bone.

AB: Wow. Okay. Yeah, you’re right.

Dr BD: So we do some injection. Normally, the injection, if well done, is maintained… helps to maintain your structure.

AB: Okay.

Dr BD: Not to change your face. So that people are very strange to see. People? No, it’s not that. Normally, we will just compensate what you are losing.

AB: Right.

Dr BD: For that at the end, it’s not so much medicine or technique, it is more in this case also how you do it, it’s art.

AB: But I want you to tell me a little bit about… I agree with you. It’s an art and it’s not just a science, it’s also an art. I 100% agree. And how you do someone’s face, it’s like painting. It’s an art. And I know you’re a painter, so you understand it’s like painting. But my question to you is what is the latest development which people would not have heard of? Which people will go ‘oh my God, I can’t believe you can do that’.

Dr BD: I don’t think… I’m not changing so quick, hopefully, because it’s medicine. When you’re doing some medicine…

AB: It’s not like technology, which is changing like this.

Dr BD: When you are using something in medicine, you can use it after many studies, many experiences, you have to be approved by FDA. So it’s not so [snap] like this for that is medicine. Of course, what is improving: all the technique of all the machines are less invasive, less painful. The products that we are using are more safe; also, they are more adapted – better with our own skin, they mix better with our skin.

AB: Dr Dalbos, do you ever say to a patient who said, do this, do this, do this, do you ever say no?

Dr BD: Many times.

AB: You do? You refuse people?

Dr BD: Many.

AB:  Interesting. Give us an example of some.

Dr BD: No, that is a problem of personal thinking. But I told you, yeah, we don’t want to change people. I think if it’s well done, nobody has to see what has happened. You have to think that you never do nothing.

AB: You don’t want people to think, oh my God, she looks different.

Dr BD: But that’s not good. I don’t want to change people. I want them to eventually be themselves. It’s better. So when I see people, when I think that they did too much and it’s not nice, it’s not natural, I think I can’t do that because I don’t do it well. And I think also, when you choose an aesthetic medical [expert], you have to find a medical who has the same philosophy and perhaps the same taste.

AB: The same philosophy and taste as you. That’s very important. Now, I want to talk to you about one thing: I’ve been reading, in Korea, apparently the young girls, really young girls, tweenies are getting their aesthetic fillers and medicine and, you know, procedures done because they feel, if you want to look good, why don’t you start early? What is your view on that?

Dr BD: I think twelve or something is ridiculous.

AB: It’s really young.

Dr BD: Twelve or something? Yes, it’s ridiculous. But it depends. If you’re talking about acne.

AB: Right?

Dr BD: Because what we want is to make the people feel good. And we know that, for example, that’s a big problem. Because we’re treating acne. If you think it can be a procedure [that helps you]? Why not?

AB: So what would you recommend to young girls going through acne?

Dr BD: To go to a dermatologist and to an aesthetic medical [expert].

AB: Okay.

Dr BD: Because we have treatment, we have cream, and we have things; we can help them to pass this period.

AB: Okay. And tell me about a time when you felt really good about helping someone. So give me an example. I’m sure you have loads of examples. And I remember when I spoke to Dr Raghuvanshi about the plastic surgery, he had some brilliant examples. I’m sure you’ve got some as well. So tell us a time when you felt so good that someone walked in feeling not that good and walked out feeling so confident.

Dr BD: And I’m going to be very… not very shy, but I do that every day.

AB: Oh, wow. Amazing.

Dr BD: My assistant is here. She will tell you, we are really… and I think almost every day we are here to help people. And also, people are not expecting that, to see that with many things and little attention and control and self-esteem, you can help them with many things. So you are here asking me… I’m sorry, I can’t talk very well today.

AB: No, you talk beautifully. I love your accent.

Dr BD: Ask me something more specific. I’m going to talk about something that I talked about a few weeks ago and many people have talked about this concern. And I love this situation. That is a typical situation where people have the concern of breast cancer when they came and I say, you have two situations. One, they don’t want to see any more medical [experts], they don’t want to have pain.

AB: Yes.

Dr BD: And I understand.

AB: Absolutely.

Dr BD: So I say, okay. And you have also they want to forget it, they want to forget and to feel like a woman again, to seduce, to be sexy, to be attractive and to go in the light and to be active. And the problem when you have breast cancer, you have two things; touching your boobs and the boob is associated with femininity, and you’re touching your hair. So it’s very difficult for a woman after chemotherapy. And also your problem, because you are facing a lot of problem of vaginal, problem of [vaginal] dryness and all that stuff. Well, you don’t feel so well with yourself, you want to have a normal life but you don’t feel so well. And at this moment we can do many things.

AB: Right?

Dr BD: We can help them with the face, with the skin, because that’s how you can lose the skin [health]. Many times…

AB: After chemo, it gets very dry, doesn’t it? In some cases [it’s] got blackened as well.

Dr BD: Yeah, it’s very dry. You have all pigmentation concerns. You are losing many weights. So you can have, some time face will look tired, Also it depends on the age. But if you lose your lips, also it’s important to open the lips. I’m not crazy about [doing work on] lips, but in this case, I think it’s important because they want to feel woman again.

AB: Absolutely.

Dr BD: Well, first thing, I told you many [people have] problems of vaginal laser because they have dryness and they can’t take hormones. So we can help them with their sexuality because it’s important also for everybody, I think, to feel well, in your body. So in this case we are helping them. And I think it’s quite pleasant.

AB: Lovely, lovely. So you’re making people more beautiful and more confident, as you said.

Dr BD: It’s not that. Beautiful, I don’t know what is beautiful.

AB: But beauty is on the inside, right? If you feel confident, you’re beautiful.

Dr BD: No. People will say that beauty… I love this definition… is three things. Beauty is three points. One, it will be the perfect beauty, the big lips, green eyes…

AB: The classic beauty that they say.

Dr BD: Yes, that will be one. The second one, it will be self-esteem.

AB: It will be self-esteem.

Dr BD: If you have somebody beautiful, yes, and he’s watching his feet all the time and shy, he will not seem so attractive.

AB: So you think of self-confidence.

Dr BD: Very important. And the third thing: authenticity.

AB: Yeah, lovely, lovely. Integrity or authenticity. Absolutely.

Dr BD: And in my world, this is very important for that. When I see people who look fake. You can’t see them as beautiful anymore. So we have to be very careful. It’s a balance. And if you go and you lose this authenticity, you’re not beautiful anymore…

AB: I’ve been hearing things like someone said if you have Botox once, you have to have it all the time. Or if you go for any kind of aesthetic medicine procedure, you can’t stop it. You have to go on forever. Is that one of the common myths? Tell me.

Dr BD: No, the problem. Botox, I tell you, is a great treatment. It’s amazing. It’s not risky. The big problem of Botox – it’s addictive because it stays only six months. And normally you’re better. Normally you are less wrinkled, you look more cool. Of course, it’s nice. So you like it. So you repeat. If you don’t want to repeat, you will be like before. And you will change, nothing. So it’s not an aberration at all.

AB: Tell me some of the other misconceptions or myths that people believe.

Dr BD: I think the Botox, for example, is a treatment that you have to do early because Botox is more a preventive treatment than a corrective treatment. So it’s great when you do it, I think at around 30, for most people. And if you have dry skin or not, if you have line or not, but it’s preventive; you can begin early and you have a chance to not change your expression at all. And it will prevent because your muscle will be less strong.

AB: Okay.

Dr BD: Filler. Filler, if it’s well done, nobody will see it. It’s just compensating what you have. The problem is the excess. The problem when you want to have more and more and more. And also, I think that each time you put some filler, you have some filler which stay in your skin…

AB: So this is the hyaluronic acid we were talking about – the filler.

Dr BD: Yes.

AB: Okay. Which is different from Botox.

Dr BD: Yes, completely.

AB:  Okay. Sorry. I’m learning about this.

Dr BD: Botox is a toxin which paralyzes your muscle. We cut the connection between the nerve and muscle and make the muscle in holidays.

AB:  Okay. So when you… sends the muscle on holidays?

Dr BD: So when you’re in holidays, you are not working, so you are relaxed. So that is quite interesting when you are young, if you begin to do that quite soon, if you do that quite often during two or three years, every six months, your muscle will be in holidays [for] one, three years. What does that mean? If you are on holiday for three years, you become lazy.

AB:  The muscle stops working then. It’s muscle memory. Right.

Dr BD: It’s lazy. And if it’s lazy, it will wrinkle less. So also, normally, the more you do it, the less you need it.

AB: Oh, I see. Okay

Dr BD: If you do at the beginning, quite regularly. So filler is different things; [something] that you inject in your skin. When I see, is very important to be a little arty, because it’s not so much the products that you’re using, it’s which product, because you have different densities and different colour. Also, each product has different nuance, but that’s not where you cut it.

AB: Yeah, absolutely.

Dr BD: It can be completely different from one medical [expert] to another one. That is question of taste, of sculpture…

AB: And you were talking about the tools, so you were talking about rollers, but you said make sure you throw away the rollers. But that’s a good thing, right? The tools that people can use at home.

Dr BD: Yes, there are things that you can use at home, but normally not invasive things. Yes, the roller. I like it, for example. I love it for the stimulation of the hair. It is very efficient.

AB: So what kind of roller is this? What’s it called?

Dr BD: The rollers that you buy.

AB: The rollers for the face, You can use them in the hair.

Dr BD: So any problem at home, you have to be careful because you don’t have a good disinfection. You can’t clean it very well because the skin stays around the dock. So you have to throw it away.

AB: Fine.

Dr BD: But you don’t have to have blood. Take something not so deep.

AB: Okay, so to sum up very quickly, we’re going to do a very quick summary. So what is the best age to start aesthetic medicine?

Dr BD: It depends on your problem. If you have acne at 13, it will be at 13.

AB: And the biggest myth in aesthetic medicine?

Dr BD: Myth… what is myth?

AB: Misconception. The biggest misconception. We talked about it.

Dr BD: To think that you’re going to look like a monster. Like you’re a monster. Normally, no, if it’s well done. I do many men. I do the same percentage of men and women, and they are very frightened. And nobody can see it if it’s well done. Nobody can see it.

AB: And the most favoured aesthetic treatment, the most favoured one, the one that you think is most common and that… or maybe the one you do the most. Because I know you don’t like this question.

Dr BD: Because I don’t have one I do the most. It depends on each person. You can have a day when I’m doing a lot of antiaging, another one I’m going to do a little filler. You have to understand that nothing is for everybody. So the one I’m doing more… I’m sorry. I do many antiaging, I do many filler, I do many treatment of the face, of the skin. Depend on the part of the year, because that you can only to do that in winter for the sun. So I have a problem: I can’t give you an answer.

AB: So I want to leave with these two things: that nothing is for everybody and make sure you don’t lose your look. So go to someone who’s experienced and who’s going to help you keep your own look.

Dr BD: Yes and no. Because is that what you’re thinking? And what I’m thinking? But there are people who want to be different.

AB: Okay.

Dr BD: They will not do that with me.

AB: Right.

Dr BD: But they will find a medical [expert] who will help them to look like that.

AB: Thank you, Dr Dalbos. That was such an informative talk. I have learned a lot. So thank you for that. I’m sure all our listeners have learned something. I hope you enjoyed the talk. I hope you learned something. And this was Anshu Bahanda at Wellness Curated. Until next week. Thank you.