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[Background music]

This is Dr. Robert Frankel. I’m an emergency medicine and anti-aging physician, and welcome to the Modern Man Podcast. In this podcast, we talk about important topics for men, which include male aesthetics, health and wellness. But most importantly, we try to remove the stigma of male aesthetics because I think that it’s important to understand what men can do for aesthetics and how important it is … for their social and psychological well-being. And ultimately just to feel and look good. So take the journey with me. It’s going to be okay. It’s going to be fun. So enjoy it. I think the next episode will be really interesting and informative, so take a listen. Hope you enjoy it. Again, this is Dr. Rob Frankel. Enjoy the episode. Thank you.

So today’s podcast is very exciting. We’re going to be talking about the facial features of the Subtle Action Star, and who better to talk about it with one of the most established movie journalists that I know Zoe Gullicksen, she has spoken to and been … interviewed people like Leonardo DiCaprio, Spielberg, Winona Ryder. 

She has been all over. She’s an established author. She has a very, very exciting book that’s coming out soon. We’re excited to see it. And … we are excited to talk to her because she knows the movie business and she also knows the aesthetic business. We are … she has a very, very interesting background. So we are excited to talk to her. We’re going to talk about the aesthetics part of what makes up the facial features of a subtle Action Star. And we’re gonna talk about like the movie business as well. So it’s kind of a little bit of both. And I thought that who better to speak to about this than Zoe. Because Zoe actually has been on both sides. The reason why we know Zoe so well is because Zoe … knows the business of movies, because like I said, she was a great movie journalist. She’s gone and kind of … had met and interviewed all these movie stars, talked to them, has been a great author. She is a great author, but she also has been in the aesthetic business. She, in her spare time actually … was just happened to be an office manager at a med spa. A med spa that I know pretty well. So let’s introduce and let’s give a very warm welcome to the Modern Man podcast to Zoe Gullicksen. Welcome, Zoe.

Thank you, Dr. Frankel.

So Zoe, … it’s very exciting to have you. It’s going to be a really … interesting podcast and we’re gonna talk a little bit about movies. We’re gonna talk a little bit about facial features. And … so what do you think? What do you think is gonna be the most interesting thing to you that we’re gonna get into?

Well, for one, I love being back here because I’m the one that always kept you on your toes, so I’m glad to be back here doing that, first of all.

Yes, yes. 

Two, I love talking movies with you. It was always one of my favorite parts of this job. And three, you’re completely right. I love seeing … being a part of the movie industry and then also working in the aesthetics industry and seeing how you can tell, … looking at an actor close up and seeing if they’ve had work done, if they’ve looked natural, or if people now will ask me, oh, this person, this actor looks really great. This woman looks great. Oh my God, Jane Fonda, can you believe that she’s 82? And I’m like, well, she’s just had a really great doctor.

That’s the reason why she looks great compared to someone else who might not look as great. And it all comes down to the person they go to, to have their work done. So this is a really fun topic, and I’m so excited to be talking about this with you today.

I know it’s very true because I do remember that … we did have a lot of good times in our … Facebook lives, in our different YouTube videos. You did keep me on my toes. We definitely had some good direction … that you put me in that we made sure that those Facebook lives were a little bit more than the average Facebook Lives. Don’t you think? Like they ..

Oh, absolutely. We know how to have fun here, but also I tend to bully people around, but it’s what everybody needed. So I don’t regret it.

… No, that’s true. That’s true. But don’t you remember that we really kind of … … we really were able to make every, you know, shot … just a little bit, you know, close to almost like a horror movie, I used to think.

Oh, absolutely, very cinematic, made sure all the different angles had good lighting, the music, you know, we’re, we provide all services here at our med spa,

Absolutely. So we’re gonna talk a lot about different facial features. And so you got to meet a lot of these actors … and you got to interview a bunch of them. So we’re going to take a look at some of the features of them … and then you can chime in and let me know, like … does this kind of jive with what you kind of saw when you interviewed them? … And I’m gonna talk a little bit about like what the specific features of, you know, … the most popular, you know, models and some of the more common actors are presenting with currently. Some of the things are really interesting that I learned, actually, that you might be surprised at.

Oh, please. Because I love the inside scoop on the movie industry. In fact, I do have one thing to tell you, that I don’t think I’ve ever told you before … is that … I have to keep my source to myself because, you know, as a good journalist, I can’t reveal my sources. But when Scarlet Johansson did Lost in Translation with Bill Murray directed by Sophia Coppola, which won an Academy Award for best original screenplay. Sophia Coppola only provided the cast with seafood on set, and it was filmed in Japan. And Scarlet Johansson hated seafood and she hated sushi so she only ate McDonald’s. And the next film she did was Girl with a Pearl Earring and she had such bad acne from just eating McDonald’s.  The entire time … during Girl with a Pearl Earring, you see her head scarf slowly get … go further back on her forehead because as filming went on, her acne went away. But it was so bad from the stress and the junk food that even an actress like Scarlett Johansson, Black Widow herself, like can … if you eat poorly …

This is …

This is … it affects your skincare guys. So don’t eat fast food.

There you go, see. Scarlett Johansson eats McDonald’s.

Yep.

Now we know.

Now we know. So even her … Even she cannot avoid the repercussions of eating fast food. But please tell me all of your inside things Dr. Frankel. Because I wanna know what you know about aesthetics and actors in Hollywood.

Yeah, well, I’m gonna tell you, so, I mean, you know, back in the … if you look at some of the movies from the 1950s, and I know you watch a lot of them.

Oh, I do. I love me some TCM Turner Classic Movie Channel Movies.

Yeah. I mean, like, if you look at those actors compared to today’s actors, they look very different, right? Like …

Yes. 

… they all kind of had that, that very kind of …tall … very kind of like particular look compared to today that is very different. And so … but there is some very similar  … there’s some similarities that do kind of continue compared to the 1950s to today. And we’ll talk some of the similarities and then we’ll talk, you know, some of the differences. 

Okay.

Symmetry is always very important. So symmetry in the face is really kind of valuable. Like when you look at everybody’s face … you definitely want to have the face to look very similar on both sides. And we always say that, you know, the two sides of the face are not twins, but brothers or sisters. Right?

Really. That’s really interesting because right now there is a famous filter going on, on Instagram and on TikTok where it’ll show you what your face would look like if your face was symmetrical and everyone looks weird.

If they were symmetrical? Yeah.

Right.

Right. So I mean, that’s the thing, like, so it is interesting because like … but you can’t … you’re not gonna be completely symmetrical, but you have to be pretty close because if you are not close, you think about it like when patients have like … when somebody has a stroke for instance and you could see that they’re not fully symmetrical. They look … they’re not going to look, you know, they’re going to look … you know, their best. Right?

Correct. So that’s when you see a major difference in somebody’s face. So if you have a, a significant difference in one side to another, that’s going to really kind of give you an abnormal look.

Oh, so hence the emphasis on not twins but brothers.

Correct.

Okay.

But I hear that a lot with eyebrows, as a female personally …  that’s always what people have told me without when you’re doing your eyebrows or styling them, that they should be, they should not look the same, but get as close as possible, is that .. is that true for both men and women?

That’s definitely true.

Okay.

Like, you want to have especially, you know, the eyes have to look the same. Like there was, they’re actually speaking of like twins, there was actually a bar in Manhattan that used to be just for twins. Did you ever hear of this bar?

No, I’ve never heard of this.

This is the most interesting place in the world. Like everybody who used to go there were twins. I mean, you could go there if you weren’t a twin, you could just like, you know, be a person who was just like a normal person. 

Oh, you’d be like shunned if you weren’t a twin?

No. You could actually go there and be like a normal person, but you would be like looking at these twins and it would be almost like, you know … I don’t know. … It almost was kind of like voyeurism in a way.

Oh, okay.

Yeah.

No, that’s cool.

But it was called twins … and the whole premise of the bar was that people would go there if they were twins.

Okay.

And so it was kind of interesting because people would go there … that weren’t twins and they would actually look at these twins. But anyway … that, you know, is here nor there. But if you look at … if you look at your eyes, yes, definitely the eyes, the eyebrows, the, you know, looking at somebody’s, you know, the set of their eyes really has, you know, a, a really important way at how the shape of your face is going to, you know, is going to look. So if you have some asymmetry within the lower part of your face, it’s … going to be a little bit more kind of forgiving as opposed to if you have asymmetry in the upper part of your face. So they say that you can have asymmetry maybe … at 5% of the upper portion of your face and asymmetry in the lower portion of your face at 75% of your face. 

What does that mean? So basically what that means is that as you go … higher up in your face, the people who are more kind of the movie stars are going to be more symmetrical as they are closer to their eyes and their foreheads. And as they get lower down, they can be a little bit more … asymmetrical.

So you’re talking … you mentioned before about actors from the fifties and older movies. So I’m thinking of Lauren Bacall and Humphrey Bogart,  or like Katharine Hepburn with her very wide set eyes or … I’m picturing her and I feel like she has very like, symmetrical eyes, I believe.

Mm-hmm.

So what you’re saying is that because if … say she is … she does have symmetrical eyes as she’s going down the face…

Mm-hmm.

She should be more asymmetrical or the opposite.

I mean … you will be more … you can be more asymmetrical as you get down lower on the face. But the point is, is that like, it’s so vitally important to have symmetry in your eyes.

Okay.

Because that’s really the first thing that people are going to look at. And so … when we talk about aesthetics specifically, we’re gonna talk about how to make sure that when we have patients that may have some asymmetry, how we’re going to be able to improve that. You know, you can …

Okay.

… … you could have some more asymmetry in the lower portion of your face. And you know, and most people do, like what I’m saying is that 75% of people have more asymmetry in the lower portion of the face than in the upper portion of the face. And the major reason why that is, is because we chew, like … and usually, we’ll chew on one side of the mouth compared to the other. Right. So …

Okay.

… So when you chew it always, you always kind of chew on one side of your mouth.

Yes. That is very accurate for me. Yes.

So like when you chew, what ends up happening is that muscle, that lower portion of your jaw becomes a little thicker, a little wider. And so that creates the jowl.

Is that the masseter muscle?

Correct.

So … oh, this makes a lot of sense because I always say that because I grind my teeth at night …

Mm-hmm.

… The right side of my face is like … that muscle is like jacked.

Correct. Exactly.

And that my face feels very asymmetrical … because I feel like that side of my face is bigger than the other side.

Exactly.

Because I grind my teeth in my sleep.

Exactly.

Oh, so I’m not … I’m totally right. I’m on the nose. Okay.

You totally make it make perfect sense … and whether it is because you’re grinding your teeth and a lot of people do that …

Mm-hmm.

… and or because the fact that you chew on that side of your mouth, you know, or one side of your mouth compared to another. That’s the reason why people develop these, you know, asymmetry on that, on that side of the jaw and so, or that side of the mouth … or they just get more kind of hanging portion of their, you know, kind of jawline.

Of their jaw or so like their jowls if they have that. Okay.

Exactly.

So then … what do … what is something that I can do to help this problem now that you have affirmed my suspicions?

So yes. … So let’s talk about it. … So I’m gonna talk about, we’re gonna go through the entire face.

Okay.

… We’re gonna try to fix all our problems, our asymmetry, and we’re gonna go and see how we can fix them.

Oh, you mean, so we can fix not just the lower …

Yes.

… part of my face. We can also fix any asymmetry going on at the top of our faces too.

Absolutely.

Of course.

All Right.

Yeah. So because of the fact that we know that, you know, we want to make sure that the very high portion of our face is symmetrical because that is, you know, that has to be, because that is one of the things that is most important to be an Action Star, which we all want to be.

Absolutely. Who doesn’t?

Right? Unless you are Dr. Frankel and you want to be a specifically horror movie action star.

That’s true. That’s true.

What you already are, but you just wanna continue to be.

That’s true. Thank you. Zoe, or Zoe who wants to be … Buzz Lightyear.

Absolutely. Put me in a spacesuit. Let me go out there.

That’s correct. So, okay … so … let’s put it this way. So if you, so if you’re … so … let’s talk about like the, you know the area kind of like in the upper portion of the eyes, for instance. Like … so if you’re sleeping on one side of your head, you know, one side compared to the other, you can develop, you know, very kind of shallow temples, right? The temple area is like that area, like right on the very high portion of your head and it kind of sits like right on the sides of your eye. And … you know that area because they always say don’t get hit with a bat right in your temples.

Oh. And it’s also the place where you usually see like the typical, if someone has a headache or someone is stressing them out, they like rub the sides of their forehead and like they rub their temple areas, right?

Correct.

I’m picturing a man who’s stressed out over work, he’s leaning over his desk and it’s … he’s rubbing his temples. That’s the spot, right?

Correct.

Okay.

And I think like that famous … like that famous statue when the guy was sitting on the toilet, he was holding his temples.

Yes. Yes.

So the temples though, are really important for the integrity of kind of the eye socket or what we call the orbit.

Really. Okay.

Because when you think about it, because of the fact that, you know, there’s a few different places where the eye socket kind of sits. It sits kind of below, kind of like where the cheeks are. …

Mm-hmm.

… it sits kind of like on the sides where the temples are. And it sits kind of right above like where the forehead is now. The forehead kind of has a, you know, like a strong kind of bone that sits there. So that’s usually stays pretty stable. Below where the cheeks are, now that could change and we’ll talk a little bit about that, but if the temples lose integrity, that could change the entire kind of way that the eye kind of sits. And so when the orbit … becomes weak, and a lot of times you’ll see this, all of a sudden what I find is that the eye kind of drifts downward. And you’ll start seeing that instead of having kind of … you kind of always … I always kind of think about it this way. Like … when you’re kind of like smiling, your mouth kind of sits upward, and then when you’re frowning, your mouth goes downward. It’s the same thing with your eyes. Like when your orbit … when your temples start to kind of degrade a little bit, all of a sudden your eyes start to go downward.

Oh, that sounds terrible. I don’t want that happening.

I know. And it’s .. and it kind of makes you look sad.

Oh, that sounds even worse. You can’t be an action star and looking sad all the time.

I know. Exactly. And then also the brow … your brow actually kind of goes downward as well. And so like your eyebrows, so you think about your eyebrows go down… like your eyes kind of like go downwards. So you kind of look sad, your eyebrows go downward. You all of a sudden you’re kind of like tired and it’s all a big kind of, you know, it’s all … you’re kind of like a sad sack. Yeah

You know Keanu Reeves, there’s the meme about sad Keanu Reeves.

Mm-hmm.

But he doesn’t look sad when he’s in all those John Wick movies. He’s kicking some butt.

That’s right.

Like, so … what is … besides the other answer from him being a vampire, what is he doing to make sure that he doesn’t look sad? Because he is been doing, being in a movie star for so long.

He’s got great temples.

So, okay. But how do … how do we make sure that we also have great temples

Well, this is how we do it. So, I mean, basically, the best way to do it is with dermal fillers. And so …

Wait. I’ve been working here with you for how many years? I did not know you could put filler in your temples.

… Well, I mean, you can …

Wow.

… and we do. And so you can, you could put dermal fillers and there’s a few different fillers that we use. We could use Juvederm Voluma, we could use Restylane Lyft, or we can even use, which is newer Restylane Contour. It’s a thicker filler. You, you need to kind of use a filler that’s a little bit thicker that really kind of gets, you know, that volume into that area to be able to kind of take up that space. So that way it’s going to give you that lift. If you do it the right way. It’s a very safe procedure. That’s why you wanna make sure that if you’re getting the filler done, you’re getting it done by experienced hands. Right?

Right. You wanna go to someone where it doesn’t look … where the goal is that you … it looks like you didn’t have any work done.

Correct. That’s one thing. But also, you know, that if you ever touched your temple … Touch your temple, Zoe, for me.

Okay.

What do you feel there?

I feel kind of like a little bit of a hollow dip.

Do you feel like some pounding thing next to there also? 

Yes. Like a … like I can feel my heartbeat.

Right. You feel like this pounding thing?

Yeah.

And that’s like a … that’s called the temporal artery,

So, oh. So, okay. I don’t want filler in an artery that doesn’t sound healthy.

Right. … So there’s a big, nice, big artery there. And that the reason why they always say don’t get, get hit in the temples is because that big artery sits there. So, but the thing is, is that if you have the correct technique done, you’re not going to have the filler done near that artery or anywhere, you know, to the place that that filler is gonna go anywhere near that. You’re going to have it in a way that the filler is gonna go very kind of safely in that area. It’s gonna fill it nicely. But the beautiful thing is that once it goes into the right place, it’s gonna lift the eyes. It’s gonna give you that kind of lift. It’s going to make … your eyes smile and it’s gonna give you that, you know, Keanu Reeves, you know, John Wick appearance.

That sounds awesome.

So that’s the first thing. So that’s, you know, that’s the first thing that you want to kind of give, you know … …

Just a nice subtle difference that a man can make as he’s getting older without looking like he’s walking around sad all the time. Because if you remember in the beginning of those movies, he’s really sad because someone killed his dog and that’s why he went on a full movie rampage. Right. Getting … Avenging his dog. So if you don’t wanna have this sad Keanu Reeves look, make sure you get some filler in your temples.

That’s right.

Wow. All right. Learned stuff already guys. This is great.

Yeah. And so the next thing that I thought was very interesting that, you know, like I always … you know, I always heard that, you know, having thick eyebrows was, you know, sort of maybe not the best thing, but I saw a picture of Tom Cruise with very thin eyebrows, and it was a really not a flattering picture.

Really?

Yeah.

Light eyebrows on Tom Cruise.

Yes.

That doesn’t …

Doesn’t sound good, right?

… No, that doesn’t, I can’t picture him with … How’s that supposed to go well with his aviators?

Exactly. And that’s the point. The point is, is that most, you know, movie stars and models even have very thick eyebrows.

That’s also the trend these days. In the early two thousands, they tricked all the women into getting very skinny eyebrows. But men have always been able to keep their thick eyebrows. And I think it’s the most attractive in men if they have like dark or like dark, thick eyebrows. Again, Humphrey Bogart, Jimmy Stewart, back to the old movie stars. That’s a leading, leading man. Like signature style.

And then of course, I mean, just as an aside, of course, you know, as you know … just to, you know, put a little you know, interest into the podcast. One person who has thick eyebrows who was in a movie, in the podcast …

I mean, that would be you.

Yes.

It would be you.

Yes.

And you are … What  … Do any of the classic horror film icons have skinny eyebrows? Michael Myers does not have skinny light eyebrows.

He does not.

No. He would be less frightening …

He does not.

… if he had light … light skinny eyebrows.

That’s true. But would you tell the podcast audience what movie I was in so that way they would …

… So I, again, as a journalist, I have my integrity secrets. If you wanna keep … if you wanna reveal your own secret, that’s up to you. But I do not reveal.

You will not, you will not do it.

I will not reveal it. That is up to you. … that you are my source and I will not disclose that information.

Okay.

Well maybe we’ll … Maybe we’ll talk about it at some other point in …

You guys have to stay tuned for the next episode if you wanna find that out.

 … Yes. We’ll have to … we’ll have to go. So, I mean, how …

So … if we’re talking about eyebrows, then what, what are guys supposed to do if they are not like you …

Mm-hmm.

… and they don’t … and we’re not graced with thick action star eyebrows. What are they supposed to … how do they fix that?

… So that’s a really interesting question because there is an answer to that question actually. There is a product.

Does it involve needles?

Well, it can.

Okay. I’m looking out for all you kind of squeamish guys out there …

But there …

… I wanna give options for all of you. I see you.

… but … there is a product that you can use that doesn’t … that doesn’t involve needles though too.

Okay. 

So there is a product that use … is used for lashes actually, women use for lashes.

That is true.

And it actually works for eyebrows.

I can, um, attest to that it does. It works very well. I am an individual that wears glasses.

Mm-hmm.

And I had to stop using this product because my lashes were so long that they were brushing up against my glasses …

Mm-hmm.

And it started to annoy the heck out of me. So I stopped using it. But it works very well. And I have heard you’re right, it does work … do wonders on eyebrows.

Yes. And that product would be Latisse. So Latisse actually, when used for eyebrows, it actually adds volume to eyebrows. So if you are somebody who has thin eyebrows and wants to … but right now women who have thinner eyebrows need thicker eyebrows.

Absolutely. It’s back in style. No one is doing the mid two thousands Paris Hilton, skinny, skinny eyebrows anymore. Everyone wants the Hailey Bieber thick eyebrows these days.

That’s right. So losing, you know, the … losing the, you know, the problem of thin eyebrows and the complete farce that, you know, came with it. We’re back to thick eyebrows. We’re all in. And Latisse is definitely one of the ways that we can, we can definitely, um, add to it now.

So I’ve done LAIs for my eyelashes, and I have tried it for my eyebrows, and I was a teenager.

Mm-hmm.

I was in high school in 2004. So I over-plucked my eyebrows like crazy. And Latisse did not do very much for me personally because I took away too many, like too much eyebrow.

Okay.

So what then would you recommend if, as a backup for men and women in this case? If I want … like say if I wanted thicker eyebrows, what would be the next step then?

So the next step then, then you’d have to go into something that would stimulate your hair follicles and the best kind of natural way to do that, um, without doing transplantation, which we don’t advocate for. We always … we always look for the non-surgical, non, you know, most natural way to do things.

If you guys have ever seen videos of hair transplantation, don’t look it up. It is, um, I regret looking it up. So don’t, don’t do it. This is why then this treatment that Dr. Frankel is about to recommend is top-notch and much a much better alternative.

So the thing that we would recommend here is… either PRP or PRF. Now… we are actually do more PRF, which is Platelet Rich Fibrin but you could also do PRP, which is platelets plasma. Now, what is … what are these … What are these products? This is actually your own blood. We take them and we spin it down to your specific cells, your specific platelets. And these platelets have growth factors. They have stem cells, and we’re gonna re-inject it into, you know, the area where the follicles are. And so what that does ultimately is they stimulate the reproduction of these follicles and the ultimate hair growth.

So they kind of take these dormant hair follicles and they just kind of wake ’em back up is what you’re saying.

Essentially.

And starts them to start regrowing hair again.

Exactly. So you could do this obviously on your brows, especially if you have lost a lot of hair in that area and the, you know, and it’s just not, you know, working with the Latisse. And if you have, you know, like especially patches of loss, you know, which I’ve seen patients who’ve had that. Um, you know, it’s definitely a good option, but  … it will work in your scalp, you know, as well. I think, didn’t we have one patient that came in who had it on their, um, mustache?

Absolutely. And I believe that worked out wonderfully. And my fiancé is 100% wanting to come in and get it done for his very patchy beard …

Yes.

… in the upcoming months.

Yeah. So I mean, I think that it is … it’s definitely something that …you know, that I think that is definitely a great option for any type of hair growth, you know, as well as just skincare, as you know, in general. I mean, we talked a lot about this in the past.

We could talk about PRP or PRF for days on how amazing it is and all the wonders it can do for your skin and other treatments. But I love that you brought it up for eyebrows because that’s amazing and it’s such a huge part of … especially for men, when you look at a man’s face like they’re a very defining part of … Can you imagine if Martin Scorsese did not have his signature eyebrows? That would be … I can’t even imagine. Dan Levy, what? Or I’m sorry, what’s his name?

Eugene Levy.

Eugene Levy and his son Dan Levy. If they both did not have those classic eyebrows …

Did you … do you remember when Eugene Levy, uh, did you see the movie? I can’t remember which … I think it was Best in Show when he had two left feet.

Yes. … It would be less funny if he didn’t have those eyebrows.

Yes.

So just across the board, if you’re a comedy star, an action star …

That’s true.

… in your own life. It’s just you need to have those eyebrows or else it’s not gonna work, man.

That’s true. That’s true. That’s very true. But yes. And so there are … there are other things that we will be talking about in the future. I think you’ll be excited to hear about this, Zoe.

Okay.

But … we’ll keep people, you know, on the edge of their seat. This is edge-of-the-seat type stuff actually.

We have cliffhangers here.

Totally I mean.

We’re gonna go full-in on the movie metaphors, man. 

So, yeah. So we are … we have some really interesting stuff that I have been really kind of researching and we are probably gonna be introducing soon. But, I don’t want to … I don’t want to really kind of introduce them yet. So we’ll just like, you know, like, you know Who Shot J.R. type stuff.

Yeah. You’re gonna have to wait for the next episode.

That’s It. That’s it. All right, so then here’s another one here. And this one, I don’t really … I don’t really have a … I don’t know how to fix this, but I thought this was so interesting that I had to bring it up.

Uh oh.

So on my research, they said that … one of the biggest things in modeling that the people need to have, you know, gaps in their front teeth.

What, I mean, it is pretty famous, I guess now for, because they spent so long trying to make models look perfect, like … and Tyra Banks doing America’s Next Top model.

Mm-hmm.

They told a girl that they had to get rid of the gap in the front of her teeth. And there’s a big controversy about that. So now they made all the models look the same. Now they’re trying to find models that don’t look the same. So I do … I would be really interested to hear if they have reverse braces. Is that gonna be a thing now?

Now, these people are like, literally … I was watching this video where they like … this woman was like, they had like a saw, like between her teeth …

Oh.

… and they were trying to … and she was trying to like, create a gap between her two front teeth.

What? That woman goes in the same group as the girls who get like, their toes shortened because they don’t like that their second toe is as long as their big toe. Like, I can’t. That is a whole level of unnecessary that I don’t … I can’t, I don’t agree with.

Yes but …

Oh my gosh.

… I mean, I guess you know, this was very interesting to me. I really kind of like … because the whole, you know, like, you know, like money spending on braces and, you know, everything like that. And now … they’re, you know, completely going on this, you know, backwards, you know, slide and saying you have to have a gap between your teeth. I mean, I think that’s amazing. But, uh, you know, I thought that that was so interesting. I thought you’d be interested in that, so.

Oh my gosh. It’s crazy. Well, that was a nice little tidbit …

Yeah.

… from trying to look perfect. So we’re not, we don’t want you guys to look perfect. So be proud of the gap in your teeth, but please also do not take a saw to your teeth if you have a gap.

Right.

Please enjoy it and be proud of it.

Right and we’re not gonna be doing that. Are we Zoe?

Oh God, no. Oh my gosh. No, no, no, no, no, no.

Okay. All right.

Not here.

Okay. So now sticking to like, you know, like the eyes and like when you look at … like the male actors, right? So like, one of the things is that like the way that their eyes are set though also is that their eyes have to be like, deeply set. You know? Like you cannot, like, you cannot have eyes that are kind of more outward and you can’t have the whites of their eyes, you know, showing more than just a little bit. I mean … you want to have, you know, the setting of their eyes kind of deep, you know, and further in then … you know… than anything else, right?

You think of someone like Sir Patrick Stewart …

Mm-hmm.

… or Michael Fassbender …

Mm-hmm.

… or any of these just leading men of any age.

Right.

They have that you don’t … Also, if you have too much white of your eyes showing, you kind of just look like a crazy person.

Right.

So.

I mean … there was an actor from the early … I think the early eighties, uh I think his name was Marty Feldman. Do you remember Marty Feldman?

Uh, he was in Young Frankenstein, wasn’t he?

Yes. Yes. He was young Frankenstein. He wasn’t an action star, and his eyes were definitely not deeply set. His eyes look very white.

Bulging.

Yes. … And so he was exactly opposite.

It was perfect for that movie.

Right. And he was the exact opposite of what you want to have as an action star. So …

So what do you do if your eyes are bulging then?

So, I mean, the best way to deeply set the eyes is you want to use Botox or Neurotoxin. Because what you’re going to basically do is you’re going to create a lift in the area of the forehead. And so what that does is that creates the lift in the forehead. So that creates the more deeply set area of the orbit. And it’s going to create a little bit kind of further … further outward appearance of the forehead and then around the outside of the crow’s feet. And you can see that the eye itself, the eyeball itself is actually a little bit more deeply set. So you gonna use Botox to actually bring the eye a little bit further in.

Are we … is this a good idea that we’re giving this information out? Because … I feel like serial killers can use this information to conceal their crazy eyes. So …

Well.

… I mean, use this information wisely fellows.

Yes, yes, yes.

Please …

We’re not, we don’t …

… don’t. … If you are a crazy person, do not use this tactic to hide your craziness.

Yes.

Use it to win over the ladies that you’re trying and to charm and wine and dine okay.

Or try to get a part so that way … you can be interviewed by Zoe.

That is true.

Yes, absolutely.

If you’re trying to make it in the movie biz and auditioning for Mr. Spielberg himself.

That’s right. Now the other thing that happens is that sometimes … like you could see like in the lower portion of your eye, what happens is that like the eye becomes like a hollow or you could see the darkness under the eye. And so that also creates less of a deep-set eye as well. And so you really, so you really have to find a way to create volume below the eye. And sometimes that’s the problem that makes the eye not look deeply set. So …

Wow, that’s so fascinating because usually, patients come in complaining about having that really like dark circle sagging under the eyes.

Right, and so the best way to kind of like fix that is … we have it two different ways. I mean, you could do something like put dermal filler in and of course we put very thin filler in that area, like a Belotero. And the reason why we use thin filler, of course, is because that area is, you know, the skin is very thin. And so you want to use something that’s not going to be thick, it’s going to not show a lot underneath the orbit, but it’s going to give you that nice little kind of volume that’s good.

A nice little subtle touch. No one will be able to tell that you had any work done.

Mm-hmm.

I’ll just be enough of a difference. When people say, oh, you look very rested, or you look great, but I can’t put my finger on why. And you can just say to yourself like, oh, I just, I’m drinking more water.

That’s right, you don’t have to tell anybody.

Nope.

And the other thing is … dermal infusion. Now, this is a little less intense. You’ve had this before.

Oh, absolutely. I love this. And it is very, very low intensity. So even for the more squeamish side of our listeners, you will have no problem getting this done. And the results are amazing.

Yeah. So this is … you’re using … very small needles. You have a combination within the bottle of filler, saline and you know, a little bit of Botox. And what it does is … you’re creating a little bit of on the very superficial layer, a little bit of filler, and a little bit of Botox. What the Botox does is it actually is going to … make the pores kind of smaller because it actually is going to affect … the pores and it’s going to affect the hair follicles and it shrinks them right away. So it makes everything smoother and it, uh, creates that kind of darkness and it creates a darkness and that is there and it makes it go away. So it really helps it.

Just a nice little airbrush look to make … give that action movie star look, these are the treatments that these movie stars are doing before they go out and put on their aviators like Tom Cruise and go film something like the new Top Gun film.

That’s right and such …

Which if … Did you know Dr. Frankel that they filmed as much footage for the new Top Gun film as they did for all three Lord the Rings movies?

No, I did not know that.

Because there is no CGI used in the new Top Gun movie.

Wow.

Everything is real footage and it is not in IMAX because the IMAX cameras are too big to fit in the airplanes.

Oh wow.

So everything is real footage.

Wow.

So if … even if you’re not a Top Gun fan, you should go see it in theaters as … I’m not getting paid …

Mm-hmm.

… to say this. 

Okay.

But you should go see it, just to see it on a big screen for that movie magic. And you’ll be able to see, because it’s on the big screen, how very smooth and ageless Tom Cruise looks, with his dark eyebrows in the movie.

Yes. I’m sure he has dark eyebrows and I’m sure he has a lot of filler and you know, that we have to look because he does. He has not aged since, Risky Business, I would say.

No, absolutely not. And unless he did something crazy when he did, Interview with the Vampire …

Mm-hmm.

… and did some method acting there, um, he certainly has had a lot of work done …

Right.

… to make him … to make Maverick look just as good in this Top Gun movie as he did in the first one.

Yes. I’m sure. So, you know … the last portion, you know, that we were gonna talk a little bit about is that … so from the eyes, you know … we talked earlier about the jawline and we kind of went and we discussed about the chewing. We talked about how everything you know, has to be, you know, symmetrical, but how a lot of times that things are not. And so did … I know that, you know, Zoe, you are a big advocate and a big listener of The Modern Man Podcast, and I know you listened to the Superhero episode, one of your favorites.

Yes, I did.

So, and we talked a lot about … how the square of strength, you know, the square of strength, you know, really kind of gives you, the entire kind of area and the lower face that creates the sharp contours of that area. And so, you know, that kind of creates the angles that we really kind of look for. And this is all done again by dermal fillers.

One hundred percent. Because if you think about it, even Bruce Wayne himself, when he puts on the … it covers everything but his lower face. So he has to have that really sharp jawline. And that’s, I mean, he’s wearing a batsuit for Christ’s sake. Like, you need to make this man look menacing somehow. So you gotta have that really strong jawline on him for him to be menacing in 2022. Right. Like he was … character was created almost a hundred years ago. You still need … It’s a lot of difference than the TV show when he was running around in like underpants. The strong draw line is like the defining characteristic of Superman, Batman and everyone across the board in every superhero movie these days.

Absolutely. Although, you know … that TV show was, you know, I think the, you know, the best Batman that there was though.

I mean, I can’t really argue against you.

Yes, I mean …

Adam West, was a fantastic Batman.

… He definitely was, and I mean, I think that some of the, you know, traps that were there were iconic, you know, honestly.

And those stunts and everything. I mean …

Absolutely.

… better than Ben Affleck.

No doubt.

Do you know what I’m saying?

Oh, no doubt. So I mean, honestly, like all aesthetics should be a perfect combination of enhancement of the area and, you know … and defining and sharpening the angles, you know, the sharp jaw, the nice cheek … you know, our idea of the square strength is really the best way to achieve the final piece of the Action Star. You know, with all the action stars we create, you know, more of the movies that some of them will star in.

Well that’s, you know, that’s why we’re having such a boom with all the influx of all the new Marvel properties, all the movies, the TV shows, all the new Star Wars movies and TV shows that are coming out. I mean, Ewan McGregor just reprising his role as Obi-Wan Kenobi, that TV show … has been such a massive hit lately. And he looks just as good as he did when the prequels came out, which we don’t really talk about. But when they came out in 1999, so these guys wouldn’t still be able to be these superheroes if it wasn’t for all these subtle touches that male actors, these aesthetic treatments that they have to get because everybody ages, even though men do age better than women, but they still need, some help …

I don’t know if that’s true.

… as well.

I don’t know that’s true. But … I think that … it is true that, you know, the nice thing about these days is for both men and women that, you know, there is a real great option of, you know, the ability to contour, you know, our face in a more subtle way than the old surgeon … the old surgeries that were, I think more clunky, more kind of obvious. And, you know, when you used to see somebody who was getting like … surgery, and even today, I mean, you see a lot of patients who get surgery that it’s an obvious, you know, fact and so … 

Uh, talk about Top Gun Val Kilmer. Have you googled what he looks like lately? That guy is the epitome of someone who had a bad doctor.

Well, I mean, I thought he was on the, you know, I didn’t even know he was alive actually.

Yeah. I mean, you look at him, he wouldn’t be able to tell he is either so.

Okay. Well, there you go. I’m gonna have to Google that now. But yeah, so … and some of the times that you, you know, I’ve watched some of the movies and it’s very hard to watch some of the movies because you get so distracted by some of the bad, you know, like cosmetic … plastics work that some of the actors and actresses had that you can’t even watch the movies. They look so different. So you want a subtle change. I mean, that’s really the … that’s really the best approach.

Absolutely.

Yeah.

Nothing too drastic. You wanna go something or you can still age gracefully and have treatments that make it look natural.

Right … and that’s really what we advocate for here. So, um, so anyway, this was a lot of fun, Zoe. I mean, I think that this … I think we really were able to hone in on what the, you know, action stars really, you know, really kind of had and really look like and …

How you can also go home, you …  listening at home or in your car to and from work, wherever you are listening, that you can also look like an action star too.

Yeah.

And it’s very popular and it’s what people, your friends may not be talking about it, but they might be getting it done too. So listen, Dr. Frankel, and thank you so much for having me as a guest on your podcast. I love listening to it. You have such a great voice for a podcast and listen to a lot of podcasts. So you know me, I wouldn’t lie to you. I’d be very straight and upfront with you.

Oh, I know Zoe, I know. Well, thank you for being on the podcast. I hope you come on and, you know, visit more. I mean, you’re a great co-host and you know … you definitely add a lot to the show and …

Absolutely.

… I’m sure that, I’m gonna get a lot of comments saying that, you know, bring Zoe back.

Absolutely. Anytime.

So I will be back soon, guys.

All right. And thank you for … your listenership. So again, like, share, and comment on anything you want about the podcast. I appreciate your listenership and we’ll see you again soon. Thank you again.

[Background music]

This is Dr. Rob Frankel. I am an emergency medicine and Anti-aging Physician and welcome to the Modern Man Podcast. We are entering this space where we are going to be talking about male … male aesthetics, male health, male wellness, and it’s going to be a fun experience for all of us. Things that many of us are maybe uncomfortable, maybe there’s a stigma to it, um, but things that we want to, as we get older, really understand and really know. So, it’s gonna be a cool experience for everyone. We’re gonna be talking about all different topics. There’s gonna be heavy on aesthetics. We’re gonna be talking about injectables, we’re gonna be talking about Botox, we’re gonna be talking about all different, you know, skincare. But also we are gonna be talking about health and wellness hormone, hormone therapy, as well as we’re gonna be talking about, um, you know, health, and fitness IV therapy. So, take the journey with me, it’s gonna be lots of fun. Today’s … episode should be lots of fun, so enjoy it, and welcome to the podcast.

[background music]

So, in this episode, we’re gonna talk a little bit about what we call Brotox. Now, Brotox is the accepted way that we, as guys discuss using Botox. Botox for a lot of guys, um, they are a little uncomfortable with, there’s a little bit of a stigma, but actually, Botox is a really helpful tool for guys.  A lot of times when I talk to guys about, using Botox, they’ll think that they don’t wanna look plastic, they don’t want to look like the late Joan Rivers. But the reality is that as we age, we want to get to the point where we don’t want to see the lines around our eyes. Those lines, we affectionately call crow’s feet in the aesthetic world. We don’t wanna see the lines between our eyes, those lines we call the elevens and the forehead lines as well.

Now you can have these lines still present and they could just be softened.  So, you can still have a more youthful appearance and still be rugged, … as a guy. Or you can completely get rid of these lines and have a more smooth appearance. There is … there are different ways to do Botox so that way you don’t always have a completely plastic appearance. And most of my patients will tell you that I always create a more natural appearance, for my patients. And that’s our goal…is to always look natural. Because that’s really what you want to do. You want to have something where somebody looks at you and says they’re not sure what you did, but you just look more refreshed. You look more awake. You look younger, you look, just look better. And that’s really the whole point of it.

You go get haircuts, you go get, you go to the gym, you go to …  places just to take care of yourself. And Botox is just that type of thing that … we should be doing as well. So, it really is something that everyone should kind of consider. And I’ll talk a little bit about it. If you do, you know… if guys have it done correctly, Botox is, is very different than when women get it done. Now, when women get it done, the things that they want to have done is they want their eyebrows very high. Um, a lot of times, and, and some guys like this too, but for the most part they don’t. And they want kind of … just flattened appearance of their forehead. Where for guys, you know, we want a more kind of just refreshed look, definitely smoothness around your eyes because that kind of gives you that … kind of awake appearance, kind of that, you know, more youthful appearance and just, you know, more of… a more happy appearance.

One of the things that you find that as we get older … just as our mouth actually starts to turn downwards, which I’ll talk about in some later episodes, which is really interesting. A … lot of the things on our faces start to change and kind of turn downwards… and it gives us kind of a … unhappy look or just, you know, … just not like our cheerful self. Our eyes also start to turn downwards as well. And when that happens, it also gives us that appearance of maybe not only being more awake or more youthful but it also kind of gives you kind of a less happy appearance. And when you do something like Botox, what it does is it gives you that appearance that the eyes actually come … to a more neutral place.

And if I had the, you know, the ruler and I’d be able to show you. But it’s basically your eyes would be coming, you know, more to a neutral area, and … you’re not having that downward appearance. And so what that does is it doesn’t give you that kind of, that more sad look or more tired look or, you know, more kind of worn down look. It gives you more kind of that youthful kind of awake and more happy look. And so that’s what really, part of the appeal of getting Botox around the eyes is. Now around the area … between the eyes. Now, this is an interesting, uh, look because a lot of times when people have that kind of furrow around the eyes, like in between the eyes, they call it the elevens. So the elevens is that line that’s created between, the eyebrows.

And you could see if you take a look and you kind of make a, you know, scrunchy face in the mirror, you’ll see that the … you’ll make an 11 with it, right? So if you have that, more often than not, … a lot of times it gives you the appearance that you’re angry. And one of the funny things is that a lot of my patients, both my male and female patients that come see me,.. they say that when they do get Botox, a lot of times their kids don’t know that they’re angry at them anymore. I don’t know if that’s a good or bad thing, … but the point is that, when you’re presenting yourself, you don’t want to present yourself as somebody who’s angry, right? You want to present yourself as somebody who’s more, appealing, more kind of approachable for whatever it is. Whether you’re talking about your just day-to-day or day-to-day life, whether it is in, you know, work or whether it is in any, you know, like social setting. You wanna be more approachable. And so, helping to make the elevens a little less noticeable, or actually … with Botox, they essentially go away for the period of time that the Botox is there. You actually don’t have that appearance of kind of that angered appearance or your like, hmm, pensive appearance I guess you would say. So, you can easily get rid of that with a little Botox.

And then the last thing that we work with guys is their forehead. And a lot of times you notice that you have, you know, just from whether worry lines or just kinda every day to day, you develop these kinds of creases in your forehead and, sometimes they give you that,… appearance of being, you know, … your long experience or… the long days of, you know, work that you’ve done. But, you know, it does kind of age you as well. So, you can also kind of lighten the… appearance of those lines as well with Botox.

So, you can do Botox without looking fake. That’s the first kind of lesson that I’m going to tell you. When my guys come in to see me, I tell them that, look, we’re not going to make you look plastic. We’re not going to look… you’re not gonna look fake. You’re going to just look more refreshed, you’re going to look happier. And it’s, most of the people that see you won’t even realize you had it done. And so… that’s really the goal of what you want to do when you do Botox.

[background music]

So I know that a lot of you think that if you do this and you would try Botox, you’d be the only one. I could tell you the reality is, is that over the last four to five years that in practice, that our practice probably started, it was about 25 to 30% of men that were coming to get injectables and aesthetics. Now that number has kind of reached up to 40 to 45%. And my goal is to have even a larger percentage of male patients because I think that you realize that once you start doing it… the guys that do it are really happy and it’s just kind of the first time that you do it, that’s … the kind of the fun thing. Now, a lot of times … the first time we have patients, it’s their partner who is doing it and they’re sitting in the chair and I’ll kind of coax them and I’m like …try it and they will.

And then next thing you know… they’re coming back for their two-week follow-up and they’ll like, wow, I didn’t expect this. This looks really nice and I was getting compliments from my coworkers. And then from there on all of a sudden, it becomes part of their life. And that’s kind of what happens. It just becomes part of your life. Now, how long does it last? Like I said, Botox only lasts for three to four months. Some… for some people they’ll do it every three, four months. Some people do it every six months. And it’s really up to you. I mean, once it wears off, it goes back to where you started, to a degree. You will have some degree of that weakness there, meaning that you won’t have the full, you know, areas of wrinkles, that you wore initially. So it’s probably not as bad as it was when you started. Now some people… a lot of people ask me like, well, I’ve heard that when you do Botox and you stop doing it, you get so much worse. Well, that’s not true. When you do it and you stop, a lot of times you’ll go back to where you started and just like anything else, you don’t remember what you looked like before you started, and then all of a sudden you’re like, wow, this is not what I like because you kind of got used to what you look like with Botox.

So that’s kind of more the reality. And then of course, look, I mean, we all age, we’re all gonna keep aging. And so yeah, you will change as you get older too. Um, so people can come in every three to four months, every six months.

Some people come in and wait a year. So really it kind of depends upon you. There’s no like I said, it’s not going to… be a situation where, oh, if I don’t do it, then something catastrophic is going to happen to me.

So when you get it done, a lot of people ask, well … they sit in a chair and they’re like, well, I still have the wrinkles. Well, Botox takes about seven to ten days. Now, there are a couple of different types of toxin. There’s something called Dysport, there’s something called Xeomin. Those are the kind of the three main toxins that are out there. There are a few others, but I’m gonna focus on those three. So Dysport, that actually kicks in about three days, and it lasts about three to four months. Botox kicks in about seven to ten days, and that lasts about three to four months. Xeomin kicks in about seven to ten days also, and that lasts about two and a half months in reality.

So… when you finish the Botox, … you’re not gonna see the results for about a week at least. So usually, you do your follow-up visit in two weeks. That’s usually the peak of when the results happen. And so that’s when I’ll usually see my patients to have them come back in two weeks, … and we’ll be able to see, hey, …  this is where you’re at. And then we’ll say, I’ll see you in three or four months. And, you know, and… that’s basically what it is. So really, the reality is that I hope this gave you a little bit of information about Botox, neurotoxin, Dysport, Xeomin, all the different toxins, they’re all the same, in that they help weaken muscle to create a cosmetic effect. And what you’re really only trying to do is you’re trying to create that cosmetic effect that just helps you look more refreshed, not fake, not plastic.

You should never be getting toxin to have a fake appearance, even if you want to, even if you want to have no movement in any of your muscles of your, say forehead. And I have a lot of male patients who want that. And definitely, a lot of female patients want that as well. You should never look fake. And that’s … I firmly believe that in every injectable experience, like you should never look fake because of the fact that you want to have the experience that you should look like yourself, except you should have the appearance that something looks different. You might not know what it is, but you look improved, a more awake, more refreshed, a little bit more youthful… whatever it is that you’re trying to achieve, that’s what the look should be. And that’s really it.

And it’s not a scary experience. Now, does it hurt? The needles that we use are tiny little needles, insulin syringes, if you’ve ever seen them. They’re tiny, small needles…And so you’ll read online or somebody will tell you, well, I had to get 40 units of Botox to do my face. So that’s true. Most average, … On average, patients are gonna get somewhere between 30 and 50 units to do Botox. But that doesn’t mean you get 40 injections. Each muscle is going to have a different number of units that you need to get. There are some muscles on the face that you need to use five units in just one muscle. So the average number of injections are somewhere between … five to ten injections you’ll have in, you know, one visit. And usually, … by the time I get started and done, you know, most patients are like, when are you starting?

So it’s a pretty mild experience compared to what you might think. Sure, you’re getting needles in your face, you know, there’s always some pinches, but for the most part, it’s not painful at all. So I hope this … helped out. I hope this gave you some kind of information, if you were interested or thinking about doing some type of neurotoxin Botox, you could definitely comment below.

Every episode, I’m going to be talking about these different things for guys, because of the fact that a lot of times there is just not enough information or, you know, guys just don’t want to venture into this space. And so we’re going to venture in the space together. I’m going to give you the information. You’re going to have to take this information. I’m going to give it to you, so you’re gonna have to listen and so it’ll be fun. You’ll enjoy it.

And I’ll give it to you straight. I’m not going to bang it over your head, but for the most part, I’m going to give it to you straight and… we’re gonna talk about… we’ll have some guests on for certain things. And besides, for aesthetics, we are gonna talk about some hormone health. We’re gonna talk about some exercise, we’re gonna have different guests on as well, IV therapy. So we’re gonna have some pretty cool topics that I’m going to be discussing with you. So I hope you enjoy this podcast. I hope you join us. I hope you, will continue to like and share. And again, I appreciate you following us. And if you like this content, please like the podcast and follow us for our next installment.

This, again, is Dr. Rob Frankel, and this is the Modern Man.

[background music]

Our first episode is going to be on men’s health and how your hormonal changes affect your overall health. Many people hear about testosterone affecting your lean body mass, energy, sexual function. But what makes me most interested in testosterone and hormone replacement in men is the incredible positive medical and medical and health effects that testosterone has. Many of the studies that have been done in Harvard University and Baylor University have found that things such as Alzheimer’s disease, heart disease, blood pressure, and diabetes, are all affected positively … by taking testosterone. Testosterone is a hormone that’s created within the testes. It’s controlled by the pituitary gland in the brain. The important effects of testosterone are as follows: In the brain, it’s linked … Alzheimer’s disease is linked to low testosterone. Increased muscle size and strength are all affected positively by testosterone. Testosterone also reduces body fat and mostly in the gut. It also prevents osteoporosis, and it has a decreased risk of heart disease when people are on testosterone.

Andropause, andropause is what we call male menopause. Some people call it ‘manopause’. It does exist. It affects approximately 25 million men between the ages of 35 to 55, and andropause is caused by low testosterone levels. The effects, as you can see on the slide, include increased belly fat, decreased mental sharpness, low libido, depression, sleep problems, irritability, muscle loss, and erectile dysfunction. This slide linked to estrogen is a very important slide because we have to understand that testosterone, which of course is the male hormone, is greatly linked to estrogen in the male body. So men do have estrogen in their system, and the fact is, is that sometimes your testosterone will lower and you will increase your estrogen levels. So as you could see, things such as on this list, belly fat, low vitamin D, alcohol, stress, increase stress hormone, and high insulin can all convert your testosterone into estrogen.

And the reason why this is important is that when you have elevated estrogen levels, and sometimes estrogen levels are caused by abdominal fat, which often is caused originally by low testosterone. When you have low testosterone, you … increase your abdominal fat because you decrease your lean body mass. So when you have abdominal fat, you increase estrogen. And what we’re finding now in the current research is that estrogen is actually the cause of prostate cancer and not testosterone. And we’re gonna talk a lot about that … in the upcoming slides. But if you have increased abdominal fat, you’re actually increasing your estrogen, which is even lowering your testosterone even more. So this is a vicious cycle. The vicious cycle is when you have low testosterone, it’s going to increase your body fat, which decreases your muscle mass, which in turn produces more estrogen. And when you have more estrogen, it’s going to ultimately, again, decrease your testosterone even more. So this cycle produces more and more problems. But more importantly, when you have high estrogen levels, again, you’re increasing your risk of diabetes, cancer, and heart disease. And lower testosterone does …

Alzheimer’s disease was studied in the University of Hong Kong. What they found is they found 153 men who were … were diagnosed as pre-Alzheimer’s disease, meaning that they were not fully … had the disease, but they were about to. So with these men, they also found that these men also had low testosterone. What they did was they gave all of these men testosterone. And out of the 153 that got testosterone, only 10 developed full-blown Alzheimer’s disease. Another study was done in Wayne State University in 2004, and what they found is that there’s a 26% decrease in development of Alzheimer’s disease with a 50% increase in testosterone. Meaning that if you increase your testosterone by 50%, the risk of developing Alzheimer’s disease goes down almost 26%, which is an amazing study.

And now we want to talk a little bit about something that you might have heard about, and some of your doctors might even talk about prostate cancer and testosterone. Often the dogma that was produced in medical school, in fact, was that testosterone causes prostate cancer. So if you take testosterone, you are putting yourself at a higher risk of prostate cancer. A Harvard urologist looked into this study and what he did was he found men who actually had latent prostate cancer, prostate cancer that it wasn’t gonna treat, but just enough to be aware of it. And he told the people that he was concerned because of the fact that testosterone causes prostate cancer or so to speak. So he started giving these men testosterone and doing biopsies every few months. And what he found is that the cancer cells actually remitted, went down, and none of them developed prostate cancer. So he decided to go into the research and try to sort out where the research shows the link between prostate cancer and testosterone.

So the number of studies that were produced that he found that link prostate cancer and testosterone equaled zero. There was not a single study that linked prostate cancer, an elevated testosterone. The reason why this whole dogma came about was in the 1940s, a man who was castrated received testosterone, a single patient. And at that time, there weren’t advanced testings. He had developed, prostate cancer, which metastasized. Now we don’t know if he had that prior, but the entire dogma of prostate cancer and testosterone is based on a single patient in 1940. No other studies have ever linked the two. And in fact, when you think about it, who develops prostate cancer? Older people with low testosterone.

And so Dr. Morgentaler, who’s a Harvard urologist, decided to look at patients who were having prostate cancer. And what he found is that the men who norm, who are having prostate cancer actually have lower testosterone. His research is not done, but all the …  all the research points, at this point, that prostate cancer is not caused by testosterone, but in fact protective. So basically, this slide shows that there was no increased risk of cancer with testosterone. And there was one study that showed that  … that only, that one study showed that the patient who had low testosterone had an increased risk of cancer, was by that single patient.

So what the conclusions are, as you could see, that there is now a greater link to an increase in estrogen in men to prostate cancer, than testosterone, which makes total sense. What we talked about is when men decrease their testosterone, they increase their estrogen, which is actually the link to prostate cancer. Next slide, we’re gonna talk about heart health and cardiovascular health.

There were two studies … recent studies that were done. And in 2011, there was a study done that was published in the Journal of Cardiology. And they found that men who had received testosterone replacement had a decreased risk of cardiac death. A Rotterdam study showed that there was the highest percentage of heart plaques occur in men with low testosterone. And the third study showed that testosterone gel actually reduced angina in men. So there has been now multiple … more studies that are proving that low testosterone is greatly related to heart disease and cardiac.

This is just a fun slide, and what a lot of people talk about is the negative connotations in a lot of the sports media about testosterone, steroids, things like that. Now, testosterone is a steroid, but the steroids you hear about on the news media about the baseball players taking is much different. They’re designer steroids. They’re at four … They’re at 20 times the potency of what we would give as a normal testosterone dose. So … when you hear about the steroids that baseball players and football players take, this is not what we’re discussing. We’re discussing natural testosterone replacement, something your body is missing that we’re replacing.

So it’s vital that we know the levels … of your testosterone, and when we start hormone replacement, it’s important that we know your levels and we track them on a regular basis to make sure that you are getting the right dose and you’re getting the amount that is going to be protective of all things like heart disease, Alzheimer’s disease, but also gives you the positive benefits … of all the benefits of testosterone. So common preparations with testosterone include injections, creams, and then there’s other types of therapies that is not testosterone, but they actually produce testosterone.

These preparations include HCG and Clomid. Every patient is specifically evaluated for what is best for them. … No one gets the same treatment because everybody’s different, every individual we have to look at on a regular basis. So the testosterone benefits, as you can see, increased libido, increased lean body mass, increased erection time and intensity, reduces belly fat, increases mental clarity and memory, improves your sense of wellbeing and competitive edge. Most of my patients say they have a much better memory, they feel better about themselves and they now are performing.

[background music]

Dr. Frankel: Okay, guys, welcome to the podcast today. It’s very exciting. It’s a great topic actually. I’ve been excited to do this topic for a long time. And we’re here to do the topic and … the topic is gonna be on hair restoration. I waited to do this topic for a few reasons. Not to grow back hair, that was not what… the reason. But, the main reason is to… get the most research that we can because there’s a lot of things that happen over the last, you know, few years with hair restoration, the newest kind of cutting edge data. And so, I wanted to try to get the best kind of research, the things that are working the best, the things that are not working as well. And so I’m going to… I’m gonna put it out to you, in as best fashion as I can. Give you the best data, the research that shows that things that are working, things that are not working, and things that are kind of, you know, are less consistent than others. So, I think we’ve got a pretty good handle on what we’re gonna be dealing with today. So, of course, I have my, trustee co-host again with me today, Zoe. Welcome back, Zoe.

Zoe: Thank you for having me. It’s a pleasure as always and we’re getting the full treatment today here at the Modern Man Podcast. Our assistant producer, Joanne, she’s our camera girl. She also hooked me up with an IV…

Dr. Frankel: Oh wow. 

Zoe: For vitamin therapy, because I’m nursing a migraine. So shout out to her. Make sure if you also need … if you’re feeling dehydrated or if you’re just getting over cold or, like me, I struggle with migraines, come to Simply.Aesthetics, so you can get an IV.

Dr. Frankel: Oh yes. Absolutely

Zoe: So shout out to her.

Dr. Frankel: Yes, thank you. Our producer because she helps us in so many ways and she helps the podcast go on because it’ll probably be hard… for you to go on with this podcast … with your migraine. So it’s a good thing

Zoe: Absolutely. Yeah. So shout out to Joanne.

Dr. Frankel: Shout out Joanne. Good job

Zoe: Maybe we’ll get her to come on the podcast one day. 

Dr. Frankel: Yes.

Zoe: We’ll see. We’ll, we’ve been trying for a while.

Dr. Frankel: Yes. We’ll have to twist her arm but we’ll see. 

Zoe: But yeah, I’m really excited about today’s topic. This is the technology in the last couple of years has really advanced in hair restoration. And I know this is a topic that you care a lot about and I’m excited that we’re finally getting to talk about it.

Dr. Frankel: Yeah, I think a lot of people in the community have, you know, The Modern Man Community have kind of asked me about it. You know… a lot of people talk about it. It has been something that a lot of people, both men and women have discussed. So, you know, I think that it’s something that is really timely. You know, just to go back to, you know, like as far as, you know, our… we always go to our, you know, like our cultural icons. And, I think the first icon who was, you know, had no hair on TV was, Telly Savalas, right? 

Zoe: As he played … Yes, as Kojak.

Dr. Frankel: Yes. 

Zoe: The detective.

Dr. Frankel: Yes

Zoe: Before that… Since him, the only leading men that I can think of are like Bruce Willis. 

Dr. Frankel: Yes. 

Zoe: And Sean Connery. But nobody… not everyone can pull off the Bruce Willis look.

Dr. Frankel: Yes. I think Ving Rhames, I mean, he’s done a couple of movies where he was.

Zoe: That’s true. 

Dr. Frankel: Yeah. But yes, it’s true. Like… But Telly Savalas was like, I think the first, but interestingly enough, in the research I did for the podcast, there was a lot of, pictures where Telly Savalas had hair.  

Zoe: Do you think it was a hairpiece?

Dr. Frankel: I don’t know.

[laughter]

Dr. Frankel: That’s a good question

Zoe: Well, if you are someone that has to wear a hairpiece like a toupee –

Dr. Frankel: Yes. 

Zoe: – and you don’t like doing it, I think you’ll learn some useful information today, in today’s episode.

Dr. Frankel: I think so. So, yeah. So … let’s talk a little bit about the different types of … so … this is gonna be a pretty comprehensive podcast. We’ll see if we could make it in one podcast. We might have to break it up to two. I don’t know. We’ll see.

Zoe: There’s a lot of information.

Dr. Frankel: There’s a lot of information and, we’ll do our best to see what we do. But we’re … I’m not gonna… cheat you guys. So we’re going to… I’m gonna give you all the information and if I have to do it in two separate shows, we’ll do it in two separate shows. So we’ll decide once we get to that point.

 Zoe: All right. Let’s get into it.

Dr. Frankel: Yeah. So, the first thing we gotta know is that it is really important to understand that the earlier that you get to and, and find the, you know, the find the hair loss and kind of … work on it, the better. And, this is because of the fact that there actually is two different types of hair loss and they break it… The categories that are broken down are called scarring and non-scarring. And when the follicles are scarred, it essentially means that the follicle is pretty much non-salvageable. And, you know, that is not gonna come back no matter what. 

The non-scarring follicles, these are follicles that can come back and they are, you know, recently, you know, recently lost. They’re recently kind of, you know… had the ability to come back. And these are the ones that we really gonna focus on. So, you know, if you have, you know, a decent amount of loss and it’s been for a while, it’s gonna be hard to kinda work on. Secret that we’ll talk about today is that our producer actually did a PRP treatment on me.

Zoe: That was earlier this week. How did that feel?

Dr. Frankel: It actually was not too bad. She really enjoyed it because we didn’t … she didn’t numb me.

Zoe: Oh no. So our producers getting back at you for all the time, all the mischief you cause –

Dr. Frankel: Yes. 

Zoe: – and the shenanigans in our office.

Dr. Frankel: That’s true. That’s true. But yes, I mean, and so we focused on the areas that we felt that were most likely viable because of the fact that, you know, there are probably areas that are probably scarred. Because, you know, at the time that, you know, that I was losing my hair, that, I didn’t have all this information and you know, it wasn’t as important to me at the time cause I was too busy studying and I guess it just wasn’t really important. But, you know, now kind of I’m interested in it. And so I’m gonna try a lot of these treatments that we’re gonna talk about today and we’ll see, we’ll see what comes out of it. 

But for, for most people, if you start seeing… if you are somebody who you know has, you know, like a decent amount of hair and then all of a sudden you notice that, hey, I feel like, I’m starting to lose my hair. Do you know how much hair you’ve probably lost by that point?

Zoe: No. How much hair?

Dr. Frankel: About 50% of your hair by that point.

Zoe: Wait, so because everyone sheds hair normally, right? 

Dr. Frankel: Right. 

Zoe: You get in the shower or you brush your hair. … The dead hair you lose … is normal?  

Dr. Frankel: Correct. 

Zoe: But by the time that we notice ourselves that, oh, I think I’m losing hair, this feels like more hair than normal, that’s 50%?

Dr. Frankel: Correct. So when you start seeing, like –

Zoe: That’s so scary.

Dr. Frankel: I see like a, you know, I see a spot, I see an area that seems like really thin. Most people have lost about 50% of their hair by that time. So that’s a significant amount. And so you would like to try to stay away from that kind of area. So, it was really kind of shocking to me when I did this research to find out that that’s the case. That by the time you kind of see a spot on your scalp that you’ve probably lost up to 50% of your hair by then.

Zoe: But that’s not too late … to start getting treatment done right?

Dr. Frankel: That’s correct. 

Zoe: Okay. 

Dr. Frankel: Yeah. So that by that point, you know you still… probably have a good amount of non-scarred follicles because of the fact that, you know, like you are shedding and you’re, you know, in a certain phase. But you know, the active phase is still… you still have enough follicles that you can get, you know, you can get those follicles reawoken. You know, we’re gonna be talking like… I always stop, you know, I always stop at the point of surgery or… you know, any kind of invasive treatments on the podcast because we don’t, you know, we just don’t talk about that stuff. We talk about more natural kind of approaches. … So we’re not talking about hair transplants, so we’re gonna talk about all the cutting edge things that you can do up to transplant. We’re not gonna be going into transplant. 

Zoe: Right. Cause transplants can be a little scary. It’s a little intimidating. 

Dr. Frankel: Yeah, quite expensive too.

Zoe: Correct. So I have a question. What’s the difference between a dead or scarred hair follicle?

Dr. Frankel: So essentially, they’re very… it’s a very similar kind of process. Like essentially,  the nomenclature, I would say is probably the same. I mean, a scarred follicle’s meaning, is a damaged follicle. A dead follicle is a non-functional follicle.

Zoe: Gotcha. Okay. So that makes more sense that there’s been trauma of any kind or of any level.

Dr. Frankel: Correct. And we’re gonna talk about certain things that you might be surprised that actually can scar a follicle.

Zoe: Oh, alright.

Dr. Frankel: And we’re gonna get into that and we’re gonna be… It’s gonna be really interesting. And so, and one of the things I said earlier was that maybe you even kind of might be hearing Zoe, that … like there’s a lot more people out there that have talked to us about, you know, the fact that they’re having thinner hair. That it seems like their hair is not as thick or thinner, both men and women. Of course, you know, this is The Modern Man Podcast, but we always talk about women too.

Zoe: Right. So, I mean, if you’re the modern man and you can give a special lady in your life some advice –

Dr. Frankel: Yes. 

Zoe: -This is always… they’re gonna really appreciate it. 

Dr. Frankel: Right. 

Zoe: So good for all you guys out there to know this as well. 

Dr. Frankel: Yes. 

Zoe: But yeah, people have definitely been talking more. I know that I feel like I’ve been more stressed than normal –

Dr. Frankel: Yes. 

Zoe: – from the last couple of years. 

Dr. Frankel: Yes. 

Zoe: I’ve also heard that you can have hair loss as a part of a… like post covid result. Is that something that you’ve heard or people talk about?

Dr. Frankel: Yes. I mean, I think that that has been, you know, pretty apparent that since, you know, since Covid, there’s been a lot of patients… a lot of people who have found that they have had increased hair loss and whether it has been, you know… a part of a… Yeah, part of a continuum of Covid or just, you know, something that, you know, was… from the virus itself that they had at that initial time. You know, it’s hard to say. 

I mean, … a lot of those things are hard to say, but I have definitely agreed that, you know, there … we are getting a lot more, you know, people come to us and say, look, you know since… this time and since I had covid, you know, I have… I feel like I have, you know, been … my hair has been thinner than it ever has been before. And so you know, it’s definitely true. I mean, I definitely think that there’s a point this these last couple of years and… there might be part of it too that we’ll talk about as well, the stress factor. 

Zoe: Right. 

Dr. Frankel: That might be part of it too, but, we’ll… I mean, so I don’t know what the true answer is, and I don’t think anybody really does. You know, but… the facts are that there’s no doubt that more people are finding that this is becoming an issue

Zoe: Than it was a couple of years ago.

Dr. Frankel: For sure. Yeah. 

Zoe: Right. 

Dr. Frankel: So we’re gonna talk a little bit about like, you know, the science behind it, you know, what ways are the best to prevent it. And so let’s talk about like, what are the things that we could do… to really help and, you know, the reality is, is that, you know … most important that… You know, there is no silver bullet, you know, with hair loss. For anybody who tells you that, they’re lying.

Zoe: There’s not just one… Here’s a quick easy fix. 

Dr. Frankel: Right. 

Zoe: That’s all snake oil, right?

Dr. Frankel: Yes. So… we were talking this morning about this, right? That we…  Back in the early, maybe the early 18 hundreds, maybe the late, late 18 hundreds, the early 19 hundreds, –

Zoe: 18 hundreds, right? 

Dr. Frankel: They used to sell tonic and this tonic, they said cured everything, right? And the tonic… but the tonic used to have like, you know, morphine in it. It would have hallucinogenics in it. 

Zoe: Whoa. 

Dr. Frankel: You know, it would also have, maybe cocaine in it. And the reality is, is that, you know, probably, you know, at the end of the day,… you were, you know, you probably didn’t remember what your problem was to begin with. So yeah.

Zoe: Maybe you did feel better for a little while.

Dr. Frankel:  You definitely, probably felt better and you probably didn’t even remember what your problem was anyway, so it probably cured everything because you didn’t know what the problem was in the first place but…

Zoe: Right? Or if you just, oh, I feel so good. Who cares that my hair hasn’t grown back?

Dr. Frankel:  Right. Exactly.

Zoe: I think it’s safe to say that, a treatment of cocaine, morphine, and hallucinogenics isn’t easily available today.

Dr. Frankel: No, I don’t think you get those anymore. Well, you probably could on street but who knows?
Zoe: Yeah on the street but you know, we don’t know if it’s pure tonic.

Dr. Frankel: I wouldn’t suggest that. Not suggesting that.

Zoe: No, that’s not… yeah, stay away from the street level of hair loss treatment.

Dr. Frankel: Correct. Right. But yes… I think that, you know, they would claim this. And so, but the point is … The point I’m trying to make ultimately is that although a lot of the new technology is very promising, and there’s a lot of really exciting things that have come out, and I think that the most important thing that you can do, is that you can combine, you know, the things that seem like they really do have efficacy together… There’s not one single thing that has been shown to be a hundred percent for every single person… I think you could safely say that there’s certain things that work and then, you know, for that person, it’s a hundred percent for that person. Right? 

Like we were… I was talking to the producer … I was talking to the producer yesterday and I said, you know, for instance, Rogaine, you know, which is a lot of the, you know, a lot of the dermatologists and healthcare professionals, you know, kind of poses like the medical … gold standard. That’s what they say. Like if you… For hair loss, the medical gold standard is Rogaine.

Zoe: And you can just buy that at the supermarket with your groceries. 

Dr. Frankel: Now, do you know what the efficacy of Rogaine is?

Zoe: No, I have no idea.

Dr. Frankel: 40%. That means that 40%. So, and she was saying… she said to me that it only works 40%. Like I said, well, it only works for 40% of the people that it does, but that … the 40% of the people that it does, it works a hundred percent of the time for them. In meaning that, those people, it’s going to work for, it works, but for the rest of the people, it’s not… It’s not gonna give them the results that they want.

Zoe: That’s not reliable. I don’t like those odds.

Dr. Frankel: Well, that’s the point. So that’s what I’m saying. So what I’m saying is that, you know, our approach and our ideas is that if you kind of combine, you know… multiple treatments that have good efficacy, and then you’ll get… better results. So we’re gonna talk about each one. So again, the… first thing that you can do… to help with, you know, with hair loss is prevention.

Zoe: Okay? Right. With all things… like we’ve talked about skincare in previous episodes.

Dr. Frankel: Right.

Zoe: We recommend that you take care of your skin and not wait until it’s too late. 

Dr. Frankel: Correct. 

Zoe: So what would be the prevention for hair loss?

Dr. Frankel: Well, so –

Zoe: I’ve never heard anyone discuss that before.

Dr. Frankel: Right… So that’s a good question and it’s not sunscreen. So Jamie, sit down. Jamie, sit.

Zoe: Sunscreen cures a lot of … or prevents a lot of things, but not hair loss. 

Dr. Frankel: That’s right. 

Zoe: So don’t go rubbing it in your hair, it’ll just make it greasy and probably not… maybe it will make your hair full out. So don’t use SPF

Dr. Frankel: Yes. Yes, right. So the reality though is that the more likely thing is that a lot of things that you’re actually putting into your hair actually might be causing a problem. So what the recommendation is, is that when you’re like shampooing or conditioning your hair, you have to look at what you’re actually putting into your hair. And so things like, you know, certain preservatives that you are using, you know, certain fragrances that you are using, these are actually often toxic to the hair follicles.

Zoe: Oh, they’re not even… So when I buy shampoo, it just says like, no fragrance or no parabens, I thought that was just for the quality of my hair itself. Like the hair that’s already grown. I never thought that –

Dr. Frankel: Right. 

Zoe: -it could affect the hair follicle. 

Dr. Frankel: Correct. Yeah, and also the pH of the shampoo or conditioner also should be balanced, you know, as well. And so if you buy like the 99 cent shampoo often, these things are not going to be the case, and it’s going to be, you know, inexpensive and, you know, cheap and, but it’s potentially… you know, you get the strawberry smell, but that might be actually toxic to, you know, the follicles.

Zoe: Oh. So we should really focus or be more aware of your scalp health.

Dr. Frankel: That’s right.

Zoe: And not just the health of… if your, your hair is shiny or conditioned or, oh, oh my gosh, I’m gonna go home and check the ingredients in all my shampoo now.

Dr. Frankel: Yeah. Yeah. I mean, and there’s certain things that… surfactin is something that is protein that is really actually beneficial for the scalp… It’s actually a protein that, when babies are developing, which is really interesting that they… the surfactin actually develops their lungs and it’s a powerful protein. And it’s often in like… Really good shampoos have surfactin and it actually helps to kind of nourish, you know… nourish the scalp. And so that’s something that’s really helpful, you know, in the shampoos, azelaic acid is another really good… product in a lot of shampoos as well. You know, and as well as, you know, just making sure that in the rest of, you know, the rest of the shampoos, there’s, you know,…  there’s not any preservatives, you know. Aloes and other really good kind of like gentle, you know, gentle kind of product in the shampoo that really is helpful and really does help nourish the scalp. So these are things that you can do that you can really, you know, that can really help. 

Zoe: That’s good to know as preventative hair and scalp treatment. This is… Be careful what chemicals you’re putting right into those follicles.

Dr. Frankel: And so this is a simple, easy, cheap, you know, advice. So that’s one thing.

Zoe: Just be aware of… Okay great.

Dr. Frankel: The other thing is your hairstyle.

Zoe: Your hair hairstyle?

Dr. Frankel: Yes. So you might not think of this, but things like ponytails, things like braids actually, you know, the mechanical stress of hair can actually…  and there’s a study done on this, can actually damage the follicles. And like you said, like you asked before, can scar the follicle.

Zoe:  Oh. So if that… That would count as trauma, continuous trauma to the head is wearing your hair in a tight ponytail. 

Dr. Frankel: Right. 

Zoe: I know the man bun is pretty in trend right now. 

Dr. Frankel: Right. 

Zoe: But even as old school as Steven Seagal.

Dr. Frankel: Yes. 

Zoe: His ponytail. 

Dr. Frankel: Yes. 

Zoe: So, all right. So if all of these modern men, Brooklynites, that are listening, that are wearing your man buns while you’re getting your expensive cup of coffee.

Dr. Frankel: Right? 

Zoe: So just keep in mind that that can be damaging, that can scar the hair follicles.

Dr. Frankel: Right. I mean, it’s very tight… you know… hair type, you know, in that area can, you know, damage. And you wouldn’t think about it. You would think, oh, that’s the, you know, that seems like, you know, but it really is … it really is true. And there has been studies that showed that this is the case. So that’s another thing that you should be thinking about. Excessive heat, something that people don’t think about, you know.

Zoe: Blow dryers.

Dr. Frankel: Yes. Blow dryers. Like, you know, the one… I mean the one movie I think about … you remember this movie? 

Zoe: Are you… I think you’re thinking the same thing I’m thinking. That’s scene in Saturday Night Fever, with John Travolta.

Dr. Frankel: Yes. Yes… I think he’s lost a lot of his hair.

Zoe: Oh. There’s no way his current hair… Nothing on his face is real right now. He’s had so many fillers and facelifts, there is no way that man has not had hair plugs.

Dr. Frankel: Yes. So yes… I think I’ve seen him with his hair … like lost his hair at some point, like yeah. I’m pretty sure

Zoe: Definitely. Because he still wears it in a ponytail right now. Usually, when he goes out, he doesn’t have the luscious hair he had in Pulp Fiction

Dr. Frankel: Right. Yeah, so he definitely, you know, was the poster child for, you know, high heat, you know, blow drying. But, you know, if you go into blow dry, which you certainly could, you know, you don’t want to go out and, you know, catch a cold like your mom would say, you know. But you can turn it down to like cooler, you know, cooler temperature to be able to get, you know, to get the same thing because the high heat will potentially damage the follicle as well. So.

Zoe: All right. So let’s cover the two types of hair loss. And then our producers telling us that, your patients are starting to show up for the day, Dr. Frankel. So we’re gonna have to do a part two, but until then, I think we should cover the two types of hair loss.

Dr. Frankel: Yes, I think we can for sure. So, … like I said, the …  scarring follicle and you know, the scarring is the first one. And like I said, it’s… the damaged follicles. And the second one is the non-scarring. So, you know, that breaks down to Androgenic. And the second one is something called Telogenic Effluvium. I didn’t know if I’d be able to pronounce this, but do you think you could say that Zoe?

Zoe: No.

Dr. Frankel: Telogenic Effluvium. 

Zoe: Okay. I was a writing major and I still don’t… I would not be able to phonetically say that. 

Dr. Frankel: Yeah.

Zoe: So what is it, what is the no … what is the regular?

Dr. Frankel: So Androgenic just means hormonal, right? 

Zoe: Okay. 

Dr. Frankel: So that’s the common, you know, that’s the common one. And that’s, you know, and … that there’s a lot of different things that change…  and that’s both women and male pattern. The male pattern is gonna start kind of in the center… of the scalp and then kind of come forward. Women, actually kind of … their hair loss, you know, which is hormonal, starts kind of like in the part of their hair and it kind of like starts in the…

Zoe: Oh, interesting. 

Dr. Frankel: Yeah.  And it kind of, like goes outwards. So, that’s usually how their hair loss kind of like, you know, develops. So that is really –

Zoe: Where, as opposed to men who see it like have a receding hairline.

Dr. Frankel: Receding hairline, exactly.

Zoe: Or the crown of their head.

Dr. Frankel: And the crown and kind of like comes forward. 

Zoe: Okay.

Dr. Frankel: … So that’s androgenic and that’s, you know, like that is what we really kind of focus on, because that is a lot of what we can do work on can be taken care of. Now, telogenic effluvium now that I could say it –

Zoe: Congratulations, that was great.

Dr. Frankel: I’m gonna say it a lot actually. I’m gonna talk to you about telogenic effluvium all the time.

Zoe: All right. So when … so when you’re talking about it, what does that mean? So I can understand what you’re saying. 

Dr. Frankel: So telogenic effluvium means that basically it’s stress-related hair loss. And so it could be caused by, you know, a few different things. It could be caused by stress, depression could be … changes in weight as well, is something that happens like …  rapid weight gain, or rapid weight loss, you know, hospitalizations, … happens with people, you know, sickness. And so … it often is some type of either metabolic or psychological state that can actually cause people to lose their hair. 

Zoe: Wait a second. My psychological state is very telogenic effluvium. I’m very … look at me. I can say it now too. 

Dr. Frankel: Yeah. 

Zoe: I have very … I don’t manage my stress very well. 

Dr. Frankel: Yeah. 

Zoe: And I think my hair is thinning. … So is that something that can be treated?

Dr. Frankel: Yes. Well, yes. I mean, it can be helped. Usually … Like, it’s depending … So it depends on if the state is transient, you know, it sometimes it could last for up to two years, but if it’s consistent … it could actually trigger the androgenic phase too.

Zoe: Oh, that’s not good.

Dr. Frankel: Right. So that’s the thing, like, that’s the one thing about till telogenic effluvium that you have to be careful with, because sometimes it can start as just, you know, like a transient thing. But it can also trigger the androgenic. So like, the people who, you know, had, you know, gotten sick and were in the hospital, you know, and then you noticed that their hair was thinning and then all of a sudden that their hair continued to thin years later. …  Because … the definition of telogenic effluvium, that should only last for about two years. But you know, it can trigger into like true androgenic, you know, androgenic hair loss. 

Zoe: All right. Well, we don’t want to trigger telogenic effluvium hair loss, but however, we are gonna leave you guys on a cliffhanger –

Dr. Frankel: Yes. 

Zoe: – on how to … what are the treatments … So now that you have a little bit more understanding about the different kinds of hair loss, then in the next episode in our part two, then we’ll tell you how to treat it. Dr. Frankel will give us more details in that. So try not to let it stress you out. Your homework is to check your shampoo and conditioner, see what the ingredients are, make sure that it’s not something that can damage your hair follicles. So that is your homework and until the next episode, we’ll be able to give you the solutions on the different treatments-

Dr. Frankel: Yes. 

Zoe: – if you are already experiencing hair loss.

Dr. Frankel: That’s right. So, yes. … I think this is a good place to, you know, to stop for the week, and we’re going to kind of get into the treatments for the next time. So I think this is a perfect time because, yeah … because we kind of got to the point where we’re, you know, … we discussed like … where are we at,  … where we can get to and now we’re going to the next episode, we’re gonna talk about the treatments.

Zoe: The solutions to your … to the hair loss problem. 

Dr. Frankel: Yeah. So, all right. So please listen to part two next week and we’re excited to have you and I’m excited to talk about it, because I think that that’s going to be really where the excitement is all about. 

Zoe: Absolutely. Dun dun done until next week. 

Dr. Frankel: Okay. 

Zoe: Thank you guys. Remember to like and subscribe wherever you listen to podcasts, and we’ll see you next week.Dr. Frankel: All right. We’ll see you next week, and part two is coming next week, and, we’ll be excited to give you the answers to the question and we’ll see you soon

Zoe: Bye.

Dr. Frankel: Bye.

[Background music]

So welcome back. We are on the third and hopefully final, rendition of Save the Mullet. So, we’re talking about, of course, the science and of course the treatment for hair restoration. And we’re at the … probably the most important kind of pinnacle of the whole podcast. And we’re talking about the really interesting and, you know, most cutting edge treatments of you know, this type of, you know, medicine right now, that we’re gonna get to. So it was worth the wait, don’t you think so?

I totally promise, guys, it’s 100% worth the wait. You guys have learned a lot about the history and the science behind hair loss. So now we’re really gonna get into the solutions.

Yeah. I mean, last time we did talk about some of the, you know, more common treatments. We talked about you know, Minoxidil, we talked about some of the other treatments, Finasteride. We also talked about the low laser light therapy, which has really some pretty good research on it as well. So now we’re gonna talk about Platelet Rich Plasma, which … has really good data and it is one of the new cutting-edge treatments. It’s been out for a good period of time. And we’re gonna talk a little bit about it, and we’re gonna talk about the efficacy, and we’re gonna talk about the science behind it.

And we’re gonna talk about why I think that this is gonna be one of the important treatments that we’re gonna discuss. … We talked a little bit about it before on one of the other podcasts, specifically about skin treatments. But, you know, let’s get into, you know, what the data is behind Platelet Rich Plasma with hair treatments because I think that there’s pretty good data when it comes to hair and Platelet Rich Plasma.

PRP is … we’ve seen a really amazing results at the office.

Yeah, Platelet Rich Plasma. So when you think about with platelet rich plasma, whenever you cut yourself, for instance … what happens is that you have certain cells that come to you. And those cells … one of the most, you know, important cells are platelets. The platelets are those wound-healing cells. They are the cells that come and they’re kind of the first responders. They’re the ones that are there for you that come to kind of help to … just, you know, get the important growth factors to kind of heal the wound, help to get … lay down the tissue that’s gonna be important to help the, you know … new skin, you know, that’s gonna be there … present. So platelets are super important when you have some type of wound present. So that’s the way I kind of think of a Platelet. So … that’s why I think platelets are really important, you know, when it comes to this type of medicine.

I like that you call them the first responders. Let’s see … that really nails it.

Yeah, I mean, I think that they … that kind of gives the … it gives the kind of good … visualization of what, like … platelets are. And so that’s the reason why platelets have been kind of to the forefront of all this type of medicine. Now, platelets have been used in orthopedic medicine very successfully. You know, when you think about the fact that, you know, athletes have been you know, damaging and tearing ligaments and they’ve been putting platelets into their joints … and repairing ligaments with platelets. You think about how significant that is … of the wear and tear of a ligament that platelets can actually repair a ligament. What it could do to delicate tissue like skin and hair. You know, that it … it’s pretty impressive that … it could repair a ligament that you think that it could do some, you know, good things with skin and hair as well. I mean, when you really think about those factors.

So here are the high points when you think about what platelet, you know, like what platelet plasma is gonna do. So the first thing is Angiogenesis a big word means that it brings blood to the area. Is that a good thing?

Sounds like it.

Yeah, of course, because what it does is, it’s gonna bring all the nutrients, like blood is kind of like the, you know … like is the supermarket of the you know … of the skin. So, and of course, in this case to the follicles and of the scalp. So it kind of gives all the nutrients it brings, the oxygen, it gives you … it nourishes, you know, the areas that, you know, were dormant and kind of waiting for, you know, that area to be kind of refilled. So when you have, you know, that dormant kind of cells that are sitting there waiting to go into the, you know, the more growth phase, you need something to kind of precipitate it. So, you know, the first step to … get things moving is … the, you know, the Angiogenesis also reducing inflammation. And I’m gonna talk a little bit about this you know, again.

Inflammation is one of the biggest reasons why … we do go into the phase of hair loss, you know, the catagenic phase where we lose hair. Because of the fact that when we have inflammation in the scalp, and we talked about like when you could produce inflammation by, you know, using traction, by … putting yourself into a ponytails or you know, braids, you know, you cause inflammation into those follicles, you’re gonna be damaging those follicles. But you know, specific inflammation, you know, does damage to the follicles and it could cause you know … the follicles to cause the hair to be … to be lost. So we want anti … inflammatory errors to the scalp.

So, if it’s the area the follicle has been damaged by, you said, like wearing hats a lot or tight scarfs around your head, or like you said, put in a ponytail …

Right.

… … the guy in Pulp Fiction, what’s his name? Why am I blanking? John Travolta …

John Travolta.

… and his pony ponytail…

Right?

… that can cause hair loss.

Right?

So we wanna do … or we wanna reduce inflammation around the follicle.

Exactly. So, and … so that’s really important and it’s an important concept, and we’re gonna talk about that a little bit later when we get into the final conclusions to the podcast. And then also one of the important things that the PRP does is it stimulates the … Follicle Papillae, remember we talked about, this is the trigger to the cells going into the growth … phase of … the hair cycle. Remember, it needs a trigger. The follicle papillae is the trigger. It’s the spot that you say like, okay, this is where we’re going from the dormant phase, the telogenic phase into the androgenic phase, and this is the trigger. So it needs this to be able to do that. So the PRP does help this to go more into the growth phase, which is super important. And then it also remodels the … root, you know, and of course, this is super important, and we know that platelets do this because of the fact that they’re the first responders. They’re the guys that are … coming in, and they are, you know, there to help … when damage is done.

So, you know … PRP is kind of the … you know … are the cells that are there, you know, they’re the growth factors, the stem cells, they’re present there to really help. So here are some of the really interesting studies that have been done. There was a study done in Barcelona … and there was it was in 2021, which so not that long ago.  And they … and what they did was they had patients doing six PRP sessions. And so there were … it was a man … they had … men doing the study and females doing … female doing the study and men doing the study. And of course they always, with these studies, they had, you know, people getting the treatments and then they had people getting placebo. And so of course placebo, you know, they would, you know, probably … take the blood and then put some type of, you know, product on the scalp that was something other than PRP.

So when they do these studies, what is the treatment that they’re doing? So the PRP, you draw their … a patient’s blood …

Right.

… and you spin it down … to get the Platelet Rich Plasma … separated, and then you inject that back into the damaged hair follicles.

Correct.

Okay. So you’re injecting it into the scalp, and then you’re injecting it into the specific areas that you find, you know, the cells are or the follicles are, you know, are likely … are mostly in either the catagenic phase or the telogenic phase.  … the areas that are gonna be most likely, you know, dormant or, you know, are going through the phase where … you’re losing, you know, you’re losing hair. So …

So what was the result of the Barcelona study then?

So, you know, what they did is they … … they have interesting kind of metrics on how they do this. What they do is they have, you know, hair density metrics. So they, they put a certain number of hair, you know, like … you know, hair like … so you can’t really count hair, right? But you … but they take, you know, like hair density, you know on your scalp. And then they, you know, put this ruler essentially what it is, and they kind of like, you know … they used this as a metric to see how dense the hair is over a period of time.

And so after six treatments, they, you know, wanted to see, you know, was this, you know, successfully increase in hair growth for, you know, men or females. And what they found is that, you know, for the men, they had a successful, you know, group of treatments. What they found is, you know … an improvement of hair growth for these men and almost … 70% of the respondents that actually did this. And for the females, 73%, so that they …

That’s amazing.

Yeah. Twenty percent of the respondents said that they felt like it was about the same but almost 70% of both the men and women felt like they had significant change in growth.

As opposed to Rogaine was 40% of patients. It worked a hundred percent of the time. So this is 40%.

That’s right. That’s right. That’s right. Right. So 70% of the hundred percent. Exactly. So, but yeah, so I mean, you know, so that is … so that’s a significant finding because of the fact that these people went through a series of six treatments, and usually the way that these treatments will go is you will treat the person every four to six weeks and you’ll inject them, you know, with the PRP, which is their own, you know, blood sample. So you’re not taking it from somebody else. You usually take their own blood, you spin it down, and you’ll use their own blood cells and you’ll inject it back in. So, you know, they found that they had, you know, really an excellent … you know, a really good, you know, really good findings. You know … … in this study.

So there was another study that we kind of looked at, and this was in the Journal of Dermatology in 2017. And … this was a study where … they did five PRP treatments again … there was, you know, the patients were … again placebo versus … placebo versus … the people who got treated. They did a series of five treatments again every four to six weeks. And they were checking for the outcomes they were looking for is the density and the diameter ratio, which means that the diameter of, you know, the amount of hair that was grown within you know … that was grown into … these patients. And so this was kind of an interesting study because of the fact that they were looking to see whether, you know, the hair was not only, you know, present, but was the hair actually thicker and was the hair actually longer?

Which is something that, you know, a lot of times when you look at some of these studies and some of the outcomes, you say, okay, well you grew baby hair. You know, is that enough of what you really wanted to achieve? So this study actually, in the Journal of Dermatology, they were looking at longer and thicker hair, and they found that, you know, in a … large percentage of the, you know, respondents after five treatments of the PRP, they not only had hair that was grown but they found that they had a large diameter and much longer hair that was grown than even their hair that they had on their original scalp, … that was there prior, not even, you know not the hair … obviously the hair that was lost, but the hair that was there before that was present.

That’s amazing. So they had thin hair before …

Right.

… or it was starting to go gray than it was darker and thicker than it was before.

That’s correct.

That’s amazing.

Yeah.

So there was another study. Now this was in the Journal of Molecular Science in 2020, and this was a study that was done against Minoxidil. So this is … we love these head-to-head studies because … we always love the competition right?

And Minoxidil is Rogaine, right?

That’s right.

Okay.

… So this study, was interesting because of the fact that you know … this study kind of, you know, looked at … so this study looked at the Minoxidil, you know, grew … versus … This was a PRP versus Minoxidil. And so this study kind of looked at both, and we were looking at like, okay, like, which was going to have a better density, which group was going to have a, you know, better density group and more dense hair, and which was gonna grow quicker and longer? … So this was a 2020 study … this is a journal of Molecular Science. What they found was that the study … and they had three groups. They had one group that had Minoxidil alone, one study that had Minoxidil with PRP and one study that had just PRP and they found that the study that had PRP with Minoxidil actually had the best respondings. That had the largest thickest, you know, most dense hair in the group.

… The group that only had Minoxidil, did have the, you know … the thinnest, you know … the thinnest group. … So these studies were really interesting because I think that one of the important points that we kind of should look at is the fact that, you know, it’s important to really understand that, you know, alone these, you know, these different types of modalities have … … some really good, you know, like efficacy, but even better is the fact that they will actually have, you know, some really good modalities even together. And together is really kind of … the combination therapy is even better than, you know, just alone.

That sounds like a magical elixir.

Yes. So, we’re gonna go into the next grouping, but we’re gonna take a quick break and then we’re gonna get ready to talk about the next grouping, and then we’re gonna get into the final conclusion. So we’re gonna take a quick break and, just give us a couple of minutes and we’re gonna go right into it. So hold on.

Okay. So now that we discussed the Platelet Rich Plasma, which is one of the really exciting, you know, topics of hair replacement, I mean, I find that Platelet Rich Plasma is really kind of … there’s a lot of studies, there’s been a lot of data, and … I think that there’s been, you know, like good, you know, good results. We’ve seen good results.  … Just like everything else though, I think that, you know, doing things in combination is really kind of the best kind of strategy. But I think Platelet Rich Plasma has shown really good data. So I think … that is, you know, that’s definitely something that … is high on the list of positive results that we’ve been seeing.

We’re gonna go into the next topic, which is something called Exosomes. So Exosomes is kind of the new kid on the block.

Okay. So what is … how new?

So exosomes have been around, I mean, exosomes I guess have been around since the you know … the dawn of time actually.

Okay.

But use of Exosomes have not been … since the dawn of times. … It’s been around only since recently that they’ve been realized that … you can use … these specialized cells in the body and actually use them for your benefit. So you kind of think of Exosomes. What they are, are these little cells that move … within … from inside our cells from one part of the cell to another. And so they’re kind of like the little postman that could.

Okay.

Yeah.

All right.

And so the cool thing about … The cool thing about exosomes is that they have a little kind of lipid bilayer, which is kind of like a little fat bilayer and it moves around and it’s kind of like it … a lot of times it messages things, like it sends messages from one part of the cell to another and it kind of says, Hey, you need to do this and you need to do that. Like for nerve cells, exosomes are really good at saying, hey, you need to create this message so that way, you know, an arm can move, a leg can move. So it has some pretty good functions. It could have a genetic material in it. It could have waste in it, you know, it’s … when the cell wants to get rid of stuff. So exosomes are pretty … are pretty effective materials within the cells, but now they’re figuring out, hey, we can use these exosomes for our benefit.

Or what’s an example?

Okay. So I was hoping that you would ask.

So, you know, what exosomes are being used for now is that if we have material such as growth factor stem cells, that we can place in these exosomes or these exosomes are, you know, from materials that are new, say placenta cells. You know, placentas, all brand new cells, right?

Okay.

And so they’re waiting to … waiting to kind of build new cells because they’re, you know, from a fetus for instance. They’re waiting to kind of get in there and kind of like build all brand new cells and kind of repair things and just, you know, be great advocates to build structure. And you use these cells to go into cells that were damaged or dormant or things like that. You could, you could really have some really beneficial results with these types of cells. So if you can harvest these cells and because the exosomes have a protective bilayer, you could actually inject those exosomes directly into, say a scalp and use those cells to actually repair some of those damaged cells.

That sounds amazing.

Yeah. So that’s exactly what we’re talking about now. Like, you could use it in the skin, you could use it in the scalp, you could use it in multiple places. Now the exosomes could come from different places. They can come from the placenta, they can come from the bone marrow, they can come from … sometimes platelets even. And there’s lots of different research … that’s going on right now. There’s research at the Mayo Clinic where they’re harvesting platelets and they’re taking the exosomes from these platelets, and they’re kind of seeing … since, you know, we talked about how platelets are the, you know, first responders, right? And they’re using these exosomes to actually, you know, affect change, you know, for kind of damaged wound, you know, scarring and, you know, and they could use it for, you know, scalp as well. So it’s pretty incredible idea, you know, it’s pretty incredible stuff. And so it’s… it’s pretty exciting because of the fact that you are using something that is, you know, fresh, something that is … has the ability to last longer because of the fact that you have the protective bilayer of these exosomes and it’s got regenerative material. 

Now, wouldn’t it be even more amazing if you could put something in these exosomes, like say, you know, genetic material to say, you need to kind of wake up, you know, this dormant cell and … deliver it right to the scalp.

Wait, does … can we do that?

Not yet.

Okay.

But they’re working on it.

That sounds amazing.

Yeah. So that’s really kind of the next … that’s kind of the next level of what the exosomes kind of … are working with. So that’s …

Super exciting.

It is super exciting. So it is really kind of like next-level cutting-edge stuff. I mean, but really … kind of the research … you know research out there for exosomes are, you know, are new. So, I mean, there’s not a lot of research. I mean, we have to be very kind of cautious with … all research that you look at. Look … people, you know, like if you Google things, you know, online, you could find things that will make your case … or you know, you could find things that will go against your case all the time. Because looking at … scientific research articles is very hard if you’re not a scientist. So you don’t understand scientific data.

Right.

And that’s really the thing that I warn people greatly about because of the fact that … trust me, sitting in those classes trying to learn how to read a scientific article, and the worst part is waking up at six o’clock in the morning, going to Journal Club in medical school and having to sit through these articles and then having to comment on the article at nine o’clock, three hours later, when they would say, Dr. Frankel, Dr. Frankel, what do you think of this article and the efficacy of the research? It wasn’t so easy. Trust me.

I believe you.

… Being somebody who’s never had the ability to, or never had this training and never had the, you know … never had the education on how to do this and never had the pain of waking up at six o’clock in the morning and sitting through Journal Club, it’s really difficult to kind of weed through … this data. So …

I appreciate you going through it for us and …

You’re welcome. You’re very welcome.

… translating it for us on the Modern Man podcast.

… You’re very … your appreciation is well taken, but there are a few studies that I’ll talk about. And again, you know, you have to take these with, you know … you have to take these … they’re small studies. … there’s not a ton of studies. But there was a study done in the Journal of the Cell in October of 2021 … and it was looking at the Dermal Papillae and it was exosomes versus placebo, which means that exosomes versus, you know, they put some type of material that, you know, had the same consistency of exosomes and they injected it. And they did find that, you know, that with the exosomes, you know, looking at like under fluoroscopy, which means that they looked under like a special light under the scalp. They saw that, you know, the activity of the scalp was two to three times greater than … you know than with the exosomes versus not.

So I mean … that’s pretty significant finding that the scalp was more active, meaning like there was more you know, there’s more vessels growing, there’s more activity, you know, and so that is gonna show that … there’s … more activity. There was a second study back in 2020 that was exosomes versus Minoxidil. And … then there was a study that … then Exosomes plus Minoxidil, and they … they did kind of look at … and this was a study done with mice again, and they found that, you know, looking at the different phases of the mice in the hair cycles that the mice were in, that the mice that were in the Exosomes plus the Minoxidil were at a two-times greater, times that they were in the Anagenic phase versus … either the placebo versus the exosomes alone.

Oh, that is impressive.

Yeah.

So again, the hairy mice, you know … are out there. I mean, you probably could find them … but … they’re definitely present. And so there’s, you know … there’s plenty of, you know, research set to come and, you know, here, you know, at the Modern Man Podcast and at Simply.Aesthetics, we’re doing our own research because we are very excited about this topic.

We can’t tell, we’re very passionate about this topic.

Yeah.

And we want to bring great results to everyone.

That’s right. So we find that, you know, the only way to really kind of get the best results though is to kind of take all the, you know … take all of the most impressive or, you know, … the different types of treatments that have efficacy and combine them. I mean, why not? Right? Why not?

Absolutely.

Right? Like, why would you do anything less? So I mean … here’s some of the things, the bullet points that we’re going to kind of, kind of break down and from, you know, this three-day journey of the podcasts. And thanks for kind of … sticking with us. But let’s get to the high points of … what we said.

Let’s do it.

So again, the most important thing is … the most important thing is to start early. Because what did we say? By the time you actually notice that you have some type of hair changes, how far along are you?

You’re already damaged … you already have damaged follicles at minimum, right?

And you’re probably at what percentage would you say?

Ooh, 50%.

Yeah. Almost at 50% hair loss.

Wow.

Yeah. So I mean, that’s a significant amount. So we want people before they get to that point, but even if they do get to that point, they’re not too far gone. You know, that’s definitely the time to make a phone call. So, you know, start early … and you know, if you start noticing changes, if you start noticing thinning, you know, that’s the time to start working, you know, start working on it. Prevention of course is the first kind of easy step to stop, you know, stop everything. And prevention means, A. you know, don’t do the things that are going to kind of cause hair loss. Don’t, you know, add to your problem by, you know, using harsh shampoos and conditioners, things that have preservatives in them. You know, use things that are nourishing, not things that are caustic to the hair.

That makes sense.

Don’t, you know, use hairstyles that are going to create traction to the follicles that can actually scar them and permanently cause damage to the follicles.

And I imagine avoiding heat, so tools like a hair straightener, dryer…

Right.

… curling iron, those things can all … can be detrimental.

So you gotta be super careful and if you’re gonna use these things, you have to be, you know, you have to be … wary of the fact that you might be damaging and you could just turn down, you know, the temperature, you know, to that one level that’s a little bit less than where it was before. Right. So, you know, the other thing is that, you know, with hair loss, you know, there is definitely a certain … there’s certain … medical conditions that can cause hair loss. So it’s always important to … for sure make sure … that you’re not having one of these conditions that could be treated. But also, you know, there’s two types of specific hair loss that we’ll be talking about, the androgenic hair loss and the telogenic effluvium. The telogenic effluvium, which is more transitory due to stress but what we said is that this can become more permanent.

Absolutely. So even if it’s stress hair loss can cause damaged or scarred follicles.

That’s right. And it could end up turning into more permanent problems. So if you’re noticing that you’re having issues, then like we said, make sure you get right on it and you know … get evaluated and see is this a medical condition or is this something that I need to kind of take care of right away? So I mean, all other different products, you know, and different efficacies, you know, the best … way to kind of go through this is, you know the efficacy of, you know, single products are, you know … there’s definitely good results for each one. And like I said, you know, as we talked to on the first day, so that for instance, Minoxidil has a 40% efficacy, which …

Which is Rogaine for everyone’s still …

Correct.

… tagging along.

And so that doesn’t mean that it only works 40% of the time … like it only works on 40% of your head. What that means is that for 40% of the people, it works a hundred percent of the time.

Right. It doesn’t work for everyone. Just 40%.

Correct. … And that’s true for a lot of these different products, but …. there is no true silver bullet. There’s no true, you know, problem that, you know, there’s no true solution that works all the time. And even with transplantation, there are issues and there’s not … you know, there’s not permanency for all of these conditions. There’s, you know, rejection, there’s infection, you know, and there is, you know, there’s also, you know, problems with certain transplantation as well. So, you know, you have to understand that, you know, there is no silver bullet with this problem, but we can get, you know, to better efficacy with combination therapy … as much as we can. And I think that that is the approach that we take here, and that’s the approach that I think is the best kind of way to go forward. So Minoxidil alone, like I said, or Rogaine has a 40% efficacy. Now, if we had a … if we had ability … to enhance those results, would we do it?

I would hope so.

Of course, we would. So for instance here, at Simply.Aesthetic, in combination with Modern Men, we decided that we were going to increase the efficacy by adding things that not only are going to help the hair growth phase, which, you know, Minoxidil does, but also decrease the hair loss phase. And some of the things that we do … are helping that by decreasing the inflammation in that phase by, for instance adding … Retin-A, Azelaic Acid … Hydrocortisone. So there are things that we add within our formula that actually help to increase the efficacy of our own Minoxidil or Rogaine formula. So it’s not really called Rogaine in that phase because of the fact that we …

Are adding something else to enhance the Minoxidil.

Correct.

Okay.

So we have better efficacy than just, you know, just Minoxidil over the counter because we’re taking, we’re taking the Minoxidil, we’re using the additives, so that way we enhance the results.

That sounds amazing.

… So that’s the first thing. So I think that you know, Minoxidil … the Minoxidil plus formula that we use is a good start for sure. The low-level light therapy as well, I think … has really good efficacy. We talked about … we talked about the low-level light therapy. What it does is low-level light therapy, red light therapy, cold laser, whatever you want to call it, laser cap, all these types of things. What it does basically is it heats up the scalp to a certain point, but not too much that’s going to increase the vascularity of the scalp. And what it’s ultimately doing is it’s increasing the blood supply, it’s going to increase the flow, it’s going to increase the ability or the trigger for the Dermal Papillae to trigger the dormant follicles to produce more … hair growth. And the efficacy in many research articles has shown up to 80% increase in follicle growth.

Wow. So that … and that’s just the red light laser-like caps and, but you have to do that several times a week.

Right?

So, I mean, there’s a protocol for it. And you know, …so like here we have patients come in and we have them come in and they do it here, you know, … we have them … come in, you know, three times a week.

Right.

They pop in for a few minutes, you know … a few minutes a week and six to 12 minutes. And, you know, they pop in, they pop out, say, Hey Zoe, I’m coming in for my … red laser. And, you know, and they get there, you know, they get there a little bit of light and … they walk out and they…

That’s amazing.

… And their follicles are being stimulated. So that’s a second, you know, that’s a second phase of the light. PRP, of course, we talked about you know at length here … and other podcasts. You know, PRP essentially, Platelet Rich Plasma, what you’re doing is you are taking the blood cells, you’re spinning it down to the Rich Platelets and you’re re-injecting it back into the scalp. We usually will numb the scalp before we do this. Of course, we talked about the last time … the first PRP treatment I had a few weeks ago, Miss producer thought it was a good idea that I didn’t need my scalp numbed.

So I did okay.

I think you were still a good sport about it.

I was, yes, I was. But … she said that I would be fine and just started injecting me. … So … but we usually do give you some numbing before we do that. but even still, I could tell you that even without the numbing, it wasn’t really that bad. Especially if Joanne injects you, because she’ll … if you do wine, she’ll yell at you. So it’s …

It’s no big deal.

No big deal. So it usually helps to kind of not feel those bad about it. And so what this is doing is, it’s taking the PRP, bathing your follicles with these growth factor stem cells. It’s creating the depth of the Dermal Papillae growing them, allowing the … follicles to be in, you know, enhanced as well as helping the phase of the … the energetic phase to be elevated and … decrease the range to go into the catagenic phase. So I think it’s, you know, there’s been tons of studies on it. I mean, we’ve seen great results and PRP is definitely, you know, doing it. … And we’re … we’ve kind of come to the thought that, you know, four to six PRP treatments, kind of that range, the research is showing has been kind of range that we’re kind of like going to … doing every four to six weeks is usually the best kind of course of action.

You know, in conjunction with doing the Minoxidil, the red light therapy, you know, adding also biotin. Biotin, which is … which we talked about as well. Great vitamin doing injectable biotin, getting … … the best type of absorption, by doing injectable biotin, you’ll get the best chance to get, you know, good biotin absorption. So if biotin’s going to give you that effect, that positive effect, you want to get the best results because, you know, most water-soluble vitamins that you take orally, a lot of it, you’re going to end up excreting out,

Right? You don’t absorb all of it.

Right? So that yellow, that dark yellow pee that you see when you take a large B vitamin, that’s most of the B vitamin that you just ingested. So the … injectable biotin, you get a really much better result.

Passes the GI system.

Right. So it goes past that and you take it in and finally Exosomes, new kid on the block. And … we’re definitely doing some research with Exosomes. You know, the downside with exosomes is that it’s a little bit more expensive because of the fact that with PRP … you bring your own blood and … we extract your own blood and kind of you know, will harvest that. With exosomes, you know … we get the exosomes from other suppliers. And so the exosomes are definitely a little bit more pricey and the research is still awaiting … a waiting game. But I mean, the science is definitely very promising, very exciting. We did amniotic fluid facials back about five years ago. I don’t know, do you remember them?

I do remember those.

Yeah. So …

A little weird to me to wrap my so brain around.

… Yeah. The amniotic fluid facials, the results were out outrageously good. The problem with that was that like the handling. The amniotic fluid was hard because it was so delicate. Like you literally had to get the amniotic fluid on ice and you had to open it and it could only be good for like 30 minutes because of the fact that it, you know, … as soon as it defrosted you had to use it, right? The positive thing with Exosomes is because it has that lipid bilayer, you have more time to be able to use it, so it’s more stable.

Alright, that sounds good.

Yeah, so … that’s kind of the interesting thing. So, you know, like my feeling, you know, and our feeling is that combination therapy, because of the fact that, you know, everything kind of works best when you … you know, work together is best for this type of … is this type of problem. Minoxidil, Biotin, Laser Light, and advanced treatments, whether it be PRP or even Exosomes at this point will give you the … best results. And t… that’s what we’re, you know, going with. That’s what we are … That’s what we are advocating for and that’s what we feel are going to give the best medical results for … hair loss. And you know, that’s our protocol for hair restoration here at Simply.Aesthetic.

Fantastic.

Yeah. So it is the end of our series.

A three-part saga, but there’s so much to talk about that we wanted to make sure that we packed all this great information in.

I mean, that was almost, you know, two hours plus of podcasting.

It was worth it. I learned a lot.

Yes, it was exciting. But I think that for the most part, you know, I think it was important information and I’m happy that we got to give that to you. So … if you … if this information is important to you, please like, share and … you know, comment and if you have questions, please send the questions to us. Zoe will answer.

Yes, I will.

And next week we have a very exciting podcast.

Even more exciting than treating hair loss.

You think so?

I don’t know. We’ll see. Dun dun dun.

Yes. Well, I think I really wanted to get the … I wanted to get the next podcast in before October ended, but I think it’s fine.

I think it’s … oh, it’s a topic that’s always relevant.

Yes. But I think that it’s gonna be a lot of fun. I really think that … it’s gonna be a visual topic. I think that the last patient we saw yesterday, I’m gonna use some of the visuals from the last patient we saw yesterday …

Oh boy. Can’t wait.

… for that topic, because … it might be relevant to …

… It’s a good one, guys.

It’s really good. It’s really good. And … it’s gonna be very thought-provoking and it’s gonna be a little lighter than, you know, the PRP … treatments, but still gonna be very important I think in the, you know, the big scheme of things. Big scheme of life.

Absolutely.

Yeah.

Thanks for listening.

Yes.

For the last … for all three episodes and for always listening …

Yes.

… to the Modern Man Podcast.

Yes. So thanks again and we will see you next week.

Bye, guys.

Bye.

[Background music]

This is Dr. Robert Frankel. I’m an emergency medicine and anti-aging physician and welcome to the Modern Man Podcast. In this podcast, we talk about important topics for men, which include male aesthetics, health and wellness. But most importantly, we try to remove the stigma of male aesthetics because I think that it’s important to understand what men can do for aesthetics and how important it is … for their social and psychological well-being, and ultimately just to feel and look good. So, take the journey with me. It’s going to be okay. It’s going to be fun. So enjoy it. I think the next episode will be really interesting and informative, so take a listen, hope you enjoy it. Again, this is Dr. Rob Frankel. Enjoy the episode. Thank you.

So, today’s topic, we’re gonna be talking about medical skin treatments for men. This is a pretty important topic, and I talked to a bunch of my male patients and we discussed like, what are the most important things that we worry about as men as far as what things bother you? And so I picked out five different problems that occur, and I’m gonna list them out. And then we’re gonna talk about these problems. We’re gonna talk a little bit about skin. We’re gonna talk about why things work and why things don’t work. We’re gonna talk about the medical approach to skincare because it is different than things that you’re going to pick up at the pharmacy, things that you’re going to see on tv, things that you’re gonna see on the infomercials late at night because of the fact that, to create true change, a lot of times you have to work on the permanent area of skin. And so that’s what we’re gonna talk about today.

So, the five things that … in skin that most patients were worried about were, one was scarring and acne scarring. And so this was, you know, years later, you could still have, you know, scarring or acne scarring. Pore size and this happens later in life. You notice that your pore has become enlarged. Texture of your skin and this creates fine lines and even wrinkles, which is also, you know, with age. And we’re gonna talk a little bit about the different cells and collagen that change … that cause this. The tone of the skin, which means that … so as we get older, the tone of the skin is very important because you start to feel that the skin might sag. You might not be as fit, you know, in …. on your face. Just like … as we go to the gym, we notice that we’re not … having that six-pack, if we ever did have that six-pack in our mid-section. But we’re not having that tautness around our jawline, around our cheeks, around their eyes and so all those things occur and the reason why they occur is a couple of reasons.

The first thing is that you can develop collagen damage. Now, collagen, I’m gonna talk a little bit about, and we’re not gonna go, you know, deep into a skin lecture here, because that will take hours but I’m gonna go through some of the kind of important things to understand, but we will discuss it. So you can just from, you know, environmental issues, sun, if you know, smoked in the past, even excess, you know, taking sugar in, caffeine, all these things can increase your risk of having collagen damage and also elastin. Which is another cell, and elastin actually creates the … just like what it says, the elasticity of the skin. So the ability for your skin to kind of snap back is really important as well, because this gives you the ability … your skin, the ability to have that kind of tautness that we start to lose over time. And so the tone of your skin also … is important to a lot of patients and pigment. Now pigment means that you can over time develop uneven pigment in your skin. So regardless of what your skin tone is you can have often hyperpigmentation changes in pigments, browns and reds. Meaning like, you can develop, you know, brown spots, darker spots where you have hyper melanin, regardless of your skin tone. You can develop extra melanin in, you know, specific areas and so it creates an unevenness in your skin. And this of course is going to create, you know, something that is not what, you know, not what patients want. And so there are ways to improve this as well.

As well as, you know, broken blood vessels, which you can see as reds or you know, sun damage is … another problem that happens over time. So these … issues are all kind of the major kind of five problems that I’m going to target when we talk about skincare for men. And of course, they transcend to women as well. But we’re gonna focus on guys because this is the Modern Man odcast. So and a lot of times guys are going to be less diligent about what they do with their skin. You know, I’ve had talk … I’ve had discussions with some of my patients and they’ve told me that, ivory soap does really well for them and so we’ll discuss. We’ll discuss, we’ll go through it, we’ll get you where you need to be. So why are the things that you see on late-night TV or at the pharmacy, not the best things or not… are wasteful? As far as like I … I saw this on tv, I saw this advertising, they said it’s great, it’s gonna get rid of all my lines, and it’s not. And so why does that happen?

So we didn’t go through kind of like some of the basics of skin and it’s important to kind of understand because if you understand that, then you understand why a lot of the things that you might do might not actually work. So skin has, you know, three kind of important layers, that we’re gonna kind of discuss. The first is the outer layer, and it’s called the epidermis. It’s the outermost layer. So the epidermis sheds usually every 28 days. Now, the fact is actually as we get older, it can take longer for it to shed. Now, as we’re much younger, it actually sheds sooner. It could shed up to 14 days. But for some patients over 50, it could take up to 80 days for the epidermis to shed. So that’s why when we talk about things called peels they’re useful because of the fact to get rid of that outer layer of skin, some of that dead skin, and you know, that outer layer is useful.

But the reason is, is that the epidermis, like when you use a lot of the lotions and potions that you see on TV or at the pharmacy, those materials that you’re putting on your skin are being placed on the epidermis and they’re being sloughed off, you know, over that period of time. Meaning that they’re not making permanent change on your skin because whatever you’re putting on the surface of your skin at some point, eventually is going to be … is going to eventually be sloughed off. Now, if you’re doing it every day, then you can develop change, you know, you’re going to see changes, because there is melanin in your epidermis. So things like retina and tretinoin, which we’ll discuss a little bit here. I mean, a lot of what we’re gonna talk about today is kind of a more of a general idea of skin.

I’m going to go, you know, over the length of these podcasts into specific issues. And we’re going to kind of focus in on, you know, more kind of specific ways that you can fix problems, because I realize that like you can … I could sit here for three, four hours and I don’t know if anybody’s gonna wanna listen to me for that long. So instead we’re gonna break it up into … more general kind of approach to just looking at skin today. So, the epidermis, the size of the epidermis is 1.5 to two millimeters. Now, why is that important? The reason why that’s important is that when you have … you could buy things online that say that they pierce the skin that are less than two millimeters, and that is, you know, that is kind of the kind of FDA approved, you know, purchasing. Then anything below that is only going to be in the epidermis. So that means that you’re not going to get into the second layer of the skin, which is what we call the dermis.

Now, the dermis is a more permanent part of the tissue now. So the reason why, like, we have tattoos that never go away, because the fact is that when they put the ink into the skin, they’re putting it into a deeper layer, the dermis. So every time that the epidermis is sloughed off, it doesn’t affect the ink that’s already in the dermis or scarring that’s in the dermis. So the scars stay there, you know, because of the fact that it’s in the deeper layer. And so this is really important.

So if you want to affect change, you have to get into the dermal layer of the skin. And so … this is the whole idea behind medical skincare and skin treatments. And I explain this to my patients all the time, that most of the treatments that we do have the same philosophy, and I’ll explain it to you, that you have to get into the deep layer of skin to be able to actually affect permanent change. If you don’t, you’re not going to be able to affect this type of change. And the third layer of the skin is deeper, and that’s the subcutaneous tissue, and that’s deeper than a dermis. And this has the connective tissue and the fat layer. And … this layer is deeper than a dermis and so, you know, a lot of times when people are, you know, gaining weight, you know, then they’ll see in their skin there’s more sag. And that’s because, you know, in that area, they create what’s called fat pads and they’ll see that … they’re creating the skin to become more enlarged because of the subcutaneous tissue behind it. So … that is the, you know, first kind of understanding that, you know, using many of the surface materials that we have don’t really do much permanently unless you do it every single day and you’re kind of focused on what you’re trying to achieve, the epidermis is going to eventually going to be sloughed off. So to create permanent change, you need to actually get to the point where … the epidermis is sloughed off, but the dermis is affected. So you need to get into the dermis, which is at least … we say at least three millimeters into the skin is where the dermis lies. And that’s where we have to pierce the skin to be able to get to.

So the next idea is collagen. So what is collagen? So collagen, elastin, these are the cells that are created and collagen is kind of the structure … creates the structure of the skin. It’s kind of the scaffold of the skin. And so as we get older, the amount of collagen that we produce decreases. Now, elastin is also cells that are produced, and this creates the elasticity of the skin. Remember like the snap back, like the rubber band cells of our skin. And so as these cells decrease, the skin becomes drier, less elastic, thinner. And so these create the lines, the wrinkles, you know, the fine lines and just the …the less, you know, attractive, you know, areas of the skin that we … want to improve.

Why does collagen decrease? You know, there’s different reasons why collagen can decrease at a more rapid rate, and obviously environmental factors, smoking, UV light, lack of sleep, excessive sugar, all these things can increase the … rapid decline of collagen production. And so any of these things that you do are going to cause less collagen to be produced. And so that’s the first idea. So, we’ll … I’ll talk about a couple of natural things you could do to improve this for sure. And so … so when we want to increase our collagen, why do we want to increase our collagen? Because if we increase our collagen, then we’re able to increase the ability for our skin to be more elastic. You’re able to see, you know, the lines improve, the scarring improve, you know, so you’re able to see repair of the skin. And so this is why we want to try to improve and increase the production of collagen.

So how do we do that? So the best way that we found in the medical terms to actually increase the production of collagen is to cause a wound within the deep layer of the skin or the dermis. And so what does this mean? So when you cut your skin, for instance, let’s say that you damage the skin by, you know, you cut on a piece of glass. All of a sudden you’ll see … a day goes by and you’ll start seeing all this kind of scarring occur. And so these cells are collagen cells, elastin cells, these are the wound healing cells. These are the cells actually we want. The problem is, is that these cells are of being affected on a, you know, single area of the skin that is often irregular and so it doesn’t look attractive. So you would think like, why would I want to, you know, wound my skin, cause a wound response on my skin? Well, the point is, is that you want a deep wound, first of all, and you want a uniform wound, second of all. So both of these things are going to create a wound response that doesn’t look abnormal, does not look jagged … or cause an abnormal response. But instead, you’re going to be producing these collagen, elastin, these cells that we want to produce. And so, … that’s where we want to approach. So everything that we do in the medical field when it comes to skin is the idea of producing more collagen, producing more elastin, and producing it in a way that’s going to create more permanent change.

So the idea really is, create a wound that’s a uniform that’s going to be in the permanent layer of the skin. And so if we can do that, then we can create more collagen. And there’s so many different ways that we can do this, and I’m gonna go over some of them now. There’s lots of different ways that we do this actually. I’m not gonna go through every one of them. I’m going to go over certain things that … I’m going to go over certain things that kind of lay out from the original outline of the things that we focused on, the five problems that we looked at. So first of all, if you wanna do some natural things to get started, to make sure that you can increase your collagen, you could certainly, increase your sleep, vitamin C is very helpful cause vitamin C does help the production of collagen, decrease your sun exposure.

And that could be by simply, you know, putting sunblock on because you don’t want to damage your collagen, you know, any of the collagen that’s present as it is, obviously smoking. And you can do things like increase your protein intake. You know, there are, you know, collagen supplements, bone broth, these things are helpful. They’re going to give, you know, some improvement. Again, there’s only gonna be so much improvement that you’re going to get. I mean, I have a lot of patients who come to me and tell me that they have taken these collagen drinks and they take it every day and … not sure that they’re getting much results. And look, … you on some cellular level there probably is some benefit to it. But I mean the reality is, is that you’re going to have, you know, just so much change because of the fact that your ultimate goal is to create the collagen in specific areas that you’re trying to improve. And so we’re talking about, you know, in the face specifically, and since we’re … talking about the face, I mean, there other areas we could talk about too, but that’s why you want the wound response to a occur there.

So, the first medical treatment that I’m gonna discuss is something called microneedling. So microneedling is something that we use very often. It’s very small needles that usually you could use it … we use it on a pen. Some places, you could use on a roller. They used to actually do these tiny little needles either way. What the microneedling does is that, that creates an organized injury to the dermal layer. You know, the microneedling needles will go deep enough into the skin to cause this organized injury into the dermis. So that’s causing the wound response. Now, what you’re putting on the microneedling, on the skin does help because of the fact that often we’ll put something like, like hyaluronic acid, you could put vitamin C. We are going to talk about Platelet-Rich Plasma or PRP in another podcast because I was originally going to add that to this podcast. But I think it’s such an interesting and important topic. I’m going to leave it for its own podcast. So … but Platelet-Rich Plasma, which is, you know, spinning down your platelets … to their own platelets and as growth factors and even, you know, evidence of stem cells that are present in those … platelets that are added to the skin, which creates amazing results. The reason is, is that when you’re adding these products to the collagen, it’s not only causing the collagen response, but it’s also helping to repair any of the collagen damage that occurred. So Platelet-Rich Plasma has the added benefit with microneedling to actually not only increases the wound response to produce new collagen, produce new elastin, but it also helps to repair old collagen cells that were damaged. And so when the body starts to … you know, regenerate it creates, you know, these new cells that are, you know, are incredible. So, that’s one … technique that we use which is really helpful, you know, for the skin. So, microneedling in general.

Now, microneedling, another procedure that we use which helps is microneedling with radio frequency. It’s a newer technique. It’s has been around for five, six years or so. But I mean, the nice thing about this technique is actually the combination of radio frequency, which is … Radio frequency, is basically increasing the heat of the tissue and so what that does is that will affect the subcutaneous tissue. And when that happens, that creates … that helps the … heats up that subcutaneous tissue and that will decrease the skin laxity and that area. And so what that does is that, not only helps the texture and texture of the skin, but also that’s gonna create an improvement in the tone of the skin right away because it’s actually lifting because … you’re helping the sagginess of the skin because of the fact that you are getting into the even deeper layer of the skin, which is the subcutaneous tissue.

So microneedling with radiofrequency gives the benefit of having patients receive the wound response of microneedling on top of the subcutaneous tissue being affected by the radiofrequency, by being heated up and actually decreasing the skin laxity and actually tightening the skin at the same time, which is an incredible thing.

Now, different type of lasers. The two types of lasers that you know, are often talked about are ablative and non-ablative lasers. So ablative means that any type of ablative laser technology. So this is heating the skin, also creating a wound response. So this is creating with lasers intense heat, creating this wound response where microneedling is creating, creating the wound response by, you know, the small needles that actually cause the damage to the dermis. The lasers create the damage with heat. And so the ablative technology actually literally will, remove the entire layer of the epidermis essentially.

Excuse me. So you’re getting rid of the entire layer of the skin, and that’s essentially causing the wound response into the dermal layer. And so you are getting … so you’re getting rid of a lot of the imperfections in the epidermis, you know, which you do get, you know, it does give you a nice response in that vein. Plus you’re getting the permanent change by causing the wound response in the dermal layer.

Non-ablative lasers also create a wound response by creating large amounts of heat, but they don’t completely remove the epidermal layer of the skin at the time of the treatment. I mean, the major difference as far as benefits, you know, for this treatment is that ablative type of lasers, you definitely have a downtime, meaning like you’re going to have to not be able to leave your house for a few days to maybe a week, depending upon how significant the laser is. Where non-ablative lasers, you probably still will have downtime, but it will be less. And so we talk a lot about, you know, with treatments like what downtime is, with microneedling, the downtime is usually 24 hours, maybe 48, depending upon the sensitivity of your skin. And so, you know, that is one of the things that, you know, people don’t have the time for … time for downtime. And so we kind of … we feel that gearing your treatments to … your ability to downtime is really important.

Now another technique is what we call Intradermal Infusion. So intradermal infusion is, we use very small needles very similar to microneedling, but these needles … are hollow and so you are able to infuse different products in. So things like, neurotoxin, things like vitamin C can all be placed into the bottles that go … that are attached to these intradermal infusion mechanisms. And so … what is nice about these are that they do create a wound response. Intradermal infusion, … ever heard of something called Aquagold. This is … kind of the brand name of it. You know, I try not to kind of promote the, you know, Q-tip of the … you know, the procedures because that’s what they are. But I … meaning like Botox is, you know, Botox is like the Q-tip of neurotoxin because of the fact that it is just the brand name of a company of their brand. Because there’s all different types of neurotoxins. But, so Aquagold is kind of the commonly known Intradermal Infusion Technique.

And so what what it does is that you can place, because the needles are hollow, you can put vitamin C, you can put neurotoxin into these areas. And so the great thing about this, is that it actually creates, for pore size, it’s very effective to improve, as well as you can get deep enough into the skin that it will create a wound response, affect the texture tone, the fine lines, wrinkles. So Intradermal Infusion is another excellent technique that is going to improve skin, but also the nice thing about it is that it does give you the benefit of improving pore size. And so that’s another thing that we look at.

Now, as far as pigment … one of the things that we, go to is something called IPL. IPL is not a laser … it’s what we call Intense Pulse Light. Intense Pulse Light essentially creates wavelengths. It’s a high-out … it’s basically a high output flashlight … flash lamp I should say. And so what happens is, is that it creates these high heat energies that’s created at certain wavelengths. And so at certain wavelengths, depending upon the pigment, those pigments will be picked up by these wavelengths. And so those wavelength … So those pigments will be damaged by that heat wavelength where the non pigmented cells won’t be affected at all. So … it’s a pretty effective tool because of the fact that you … want to help improve things like brown spots, for instance. If you had like a sunspot, if you had a red spot, you know, from, you know … some, you know, damage to a blood vessel, any type of other condition where you’re developing excessive hyperpigmentation and, you know, specific reds and browns, and I’m not gonna go through all the different conditions cuz there are a lot of them.

But what you’re kind of looking at is, they effectively change the … they effectively work on these cells and get into the deep layer of the skin. And so that creates the damage to those pigmented cells and those pigmented cells, once they’re damaged, then they eventually will be sloughed off. And so the IPL is excellent for hyperpigmentation and depending upon, and there’s some … there’s another device called BBL, which has also different types of wavelengths. So your pigment, depending upon what the problem is and what the pigment is, you’re … the device is going to, you know, best kind of suit what, you know, you’re trying to achieve. So intense pulse light is really the best kind of procedure for that.

Also peels, peels are different depth. Peels, what they do are usually chemical in nature. And again, what you’re doing is you’re getting into kind of the, you know, the most superficial layer of the skin and you are creating the change. And it also affects, you know … in the superficial layer, it also is going to affect the melanin and some of the pigmentation as well. So peels, depending upon the depth of the peel, there could be downtime. All peels are a little bit different. There are superficial peels, there … are deeper peels. I think I’ll go a little bit deeper into, you know, peels because they’re, it’s a little bit of a broad topic at a … another podcast. But, they’re another way to help hyperpigmentation and kind of clarity of skin and that’s another kind of approach to it.

And another thing I’m gonna just briefly discuss is, IV hydration … when it comes to skin as well. Vitamin C is really important for the clarity of your skin, it’s an antioxidant. It also helps produce collagen. And so the best way to always get nutrients into your body is through IV hydration, because it’s going directly … it’s surpassing your gut. So a lot of our patients will do IV hydration for the skin. The other procedure … the other amino acid that we use is glutathione. The glutathione is the strongest antioxidant in the entire body. You cannot get it orally, anything that you take that says glutathione orally will be destroyed in your GI tract. So don’t waste your money. You can only take really … Glutathione as the studies only really show that glutathione is effective, either IV or nebulized. Meaning like inhaled you. There’s no studies that even show that you can take it intermuscular or that it’s effective.

So glutathione does two things besides for the fact that is the strongest antioxidant there is. It also suppresses melanin. And so for patients that have hyperpigmentation issues, the glutathione actually is going to help suppress melanin in general. And so those areas that are most hyperpigmented are going to be affected the most because of the fact that that’s where the most melanin is, you know, affected. And so that being said, that, you know, taking IV glutathione actually does help suppress, you know, the hyperpigmentation. So that’s another approach that some of our patients have gone to as well. So there’s a lot of different ways to skin a cat, no pun intended, talking about skin. But reality is, is that, you know, this is a very long topic and I really kind of, you know, pared it down to kind of the basics.

You know, things like I said, I’m going to kind of just break down just the bullet points and I’m gonna go kind of in depth into a lot of these issues into future podcasts so we can kind of discuss further. So acne scarring, you want to think about things like peels is an excellent choice for acne scarring and microneedling pore size, dermal infusion is an excellent, excellent choice and either ablative or, non-ablative lasers. For texture tone, microneedling, microneedling with PRP, Intradermal Infusion, these are really kind of the top, you know, as far as … I’m concerned, you know, getting … these areas improved. And then pigment for sure, IPL, and then I could just talk about, … you can go to things like IV therapy, you can go to peels as well.

Tone, tone goes into a lot of different things that I didn’t talk about, you know, even, you can do, like I said microneedling with radio frequency is an excellent choice. There’s ultrasound technology, there’s other things out there. Tone also will talk a lot about tone when we get to the ideas of fillers. And you can … do tone with skincare, but you can also use dermal fillers as your … go-to, to improve tone, because sometimes that’s the best way to improve tone. And with dermal fillers, which we’re gonna talk a lot about in the … next coming podcast, I’m gonna discuss how we do that. So we will get into all of that, but I think this was a pretty productive podcast. I hope you guys enjoyed it. I know it was a lot of information.

And, I’m going to, like I said, try to kind of break down some of the other topics and if you have, you know, questions and if you have other things that you want to have discussed, just leave a comment below. I will discuss them and we’ll get deeper into it because I plan on discussing the ideas a little bit deeper. So this was great and I appreciate the time and we will see you the next time on the Modern Man Podcast. Thank you again. This is Dr. Robert Frankel.

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This is Dr. Robert Frankel. I’m an emergency medicine and anti-aging physician and welcome to the Modern Man Podcast. In this podcast, we talk about important topics for men, which include male aesthetics, health and wellness. But most importantly, we try to remove the stigma of male aesthetics because I think that it’s important to understand what men can do for aesthetics and how important it is for their social and psychological well-being, and ultimately just to feel and look good. So take the journey with me. It’s going to be okay. It’s going to be fun. So enjoy it. I think the next episode will be really interesting and informative. So, take a listen, hope you enjoy it. Again, this is Dr. Rob Frankel. Enjoy the episode. Thank you.

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So today we’re gonna be talking about the jaw and how the jawline creates balance in our face and how important it is. In my opinion, the jawline actually is the center of gravity of the entire face. Now, what do I mean by that? So when you look at … As we age, certain things become apparent. The one thing that a lot of people look at, they see that under their chin and around their neck area, they’ll see things like … that they recognize as kind of sagginess in the neck, which they call like a double chin or a bull neck, or even, a turkey neck. They’ll see something around the jaw, which they call the jowls, which I’ll talk a little bit more about. And then around the mouth, there’s also lines that are created from a weak jawline. So jawlines do project strength, especially in men, and it does affect our youthfulness.

So I’m gonna do a little exercise kinda later in the podcast with you so we can kind of discuss this a little bit further. But it is really important to kind of think about the fact that when you look at your jaw and the jawline and how it looks today compared to how it did, maybe, you know, years ago, you could see that around the jaw, above and below, … it may look very different. And a lot of the things that have changed have created that difference. And a lot of the things that bother you, possibly, like I said, around the neck, around the mouth, things that we feel that age us or even they feel that we carry weight in certain areas of our face are because of the fact that our jawline has become weaker and not as kind of defined.

So I’m gonna talk a little bit about like, how do we define our jawline? Like how do we get that strength back? And there are different ways that we can do it. I’m gonna talk and discuss the different methods in medical aesthetics that you can achieve this. So the first thing is that we look at, again, the strength of the face. And the strength of the face, you know, starts with the jawline. Now, I go back to when I was in college, we used to play this video game, and this will age me a little bit. It was a Mike Tyson game, if any of you guys remember this, that the first boxer was the guy named Glass Joe. And he used to have a glass jaw. Thus the weakness of the jaw was the kind of prominent feature of this weak…weak boxer. That being said, Mike Tyson, who I actually did meet once, when I was in upstate New York in college, definitely did not have a weak jaw. He had a very high soprano voice, but definitely not a weak jaw.

That being said, he … You want to look at… kind of above and below the jawline. And that’s how a lot of people kind of focus their attention, because they don’t really think about like, well … so what is my problem? It’s my neck. It’s around, above that area, around my mouth, around my chin. These are the things that we look at and kind of seem to think that these are the biggest problems. But I’m here to tell you that actually if you improve your jawline and strengthen it, a lot of those problems will improve.

So let’s talk about the things that we commonly think of when we talk about fixing the area around the jawline. So, you can do things that will improve the neck area, which will lift the neck. One of the things that we talked about in the last podcast was radiofrequency, Radiofrequency with Microneedling, is even better because of the fact that you’re actually increasing the texture tone of the… of the skin.  Of course, you remember that when we talk about the texture and tone, you need to get into the deep layers of the skin to improve and to tighten. So, Radiofrequency improves this by getting into the subcutaneous tissue where this fat and connective tissue. And so that is going to cause the ability for the tightening of the … subcutaneous tissue, which creates the lift. The Microneedling, which is going to work in the dermal layer, that’s going to create the organized injury that we talked about in podcast number two. That creates the improvement of the collagen and elastin. So, the elastin really does help to make the skin more … elastic. And this is important because I’m gonna talk about a couple of procedures, and … I’ve had some patients that have had certain things done that didn’t work out for them, and they came to see me. And I’m gonna tell you why it didn’t work out because you have to realize that when certain things are fixed, certain other problems can be caused.

So we need to kind of make sure that when we’re improving one thing, we’re not causing another problem somewhere else. So radio frequency and microneedling is an excellent choice because of the fact that what it does, is it actually helps the neck area improve because you’re lifting that region, but it’s also creating the texture and tone and elasticity of the skin that you’re gonna need when you’re tightening the area under … the neck and under the jawline essentially. So, you’re not actually improving the jawline per se, … it is creating a more defined jawline in a way because of the fact that you’re not seeing that kind of weakness … under the jawline anymore because of the fact that the, skin is tighter around that. So that’s one idea.

Now another, another procedure that a lot of people do, and I’m gonna talk a little bit about that, and for some people, it works great is deoxycholic acid. So, deoxycholic acid … is essentially a bile salt. It’s something that dissolves fat. And so for patients who have… like a large area of fat underneath their neck, this is, you know, possibly a great option for them. Now, what I’m gonna tell you about this is that you know, this is a procedure where you’re going to inject the area, where the fat is, it’s gonna cause, you know, a dissolving of the fat.

Now, with that, there’s definitely some downtime because the area is going to swell. … It becomes painful because of the fact that you’re essentially having an enzymatic reaction where you’re breaking down this fat underneath the skin. For some people, this is a great option, and I’m not gonna mention the specific products. The one that’s FDA-`approved, I guess it’s Kybella, but there’s … other people have used, Mesotherapy. That’s been out there for years but Kybella is the one product that’s been FDA-approved. The one issue with this, and you have to kind of think about it, is that when you dissolve the fat, then it’s not going to affect the skin around it. And for some people that is going to become an issue, because of the fact that if the fat is dissolved, then you’re going to lose that fat.

It’s going to become smaller, but the skin around it is not gonna be affected by dissolving that fat. And so what happens for some patients, and I’m not saying this is for all. And this is why it’s so important for you to talk to your practitioner and make sure that whatever you’re doing is right for you. Because of the fact that there are so many patients that I’ve spoken to that come in and say, well, I saw this on an ad, I read about this, this is what I want, and I’ll sit down with them and … I will have to talk them down from the ledge [laughter] and tell them, this is why this is not right for you because this is what’s going to be the end result. And so I’m not saying that … the Kybella is not a good procedure, but what I’m saying is it’s not right for everybody because of the fact that once you dissolve that fat, if that’s not the major issue that’s caused there, then it’s going to become an issue with as far as the skins become lax.

Similar to … if you have liposuction, think about it in that vein. If you take the fat away, then … the skin is gonna be sitting there without that fat that was stretched out and you’re gonna have the same kind of issue. And unless you do a second procedure, then you’re going to end up having that weak skin. And I’ve had some patients who have come to me that have had just that problem, and I could tell you that procedure was the absolute …  and I told them this afterward when they came to me … afterwards when they had it done by, you know, another practitioner … it probably was the wrong procedure for you because now you have a much bigger problem because now the skin is weak. You have … you don’t have that platform anymore and now it’s gonna be harder to strengthen that skin around it.

So, you know, it’s important to understand that. In the same vein, cool sculpting is another procedure if you have fat underneath the jaw, on the neck, this is, you know, potentially another good procedure. You can do cool sculpting in the neck area. And what that does is that cool sculpting is …  it’s a cool technology, it’s cool science, and I’m always a fan of like really cool science. What cool sculpting does is they figured out a way to freeze fat cells to the point where you kill the fat cells without damaging normal cells. And you know, the original kind of story that they tell about how they figured this out was that you know, kids that were eating a lot of popsicles would get dimples on their chin and apparently, the kids were eating these popsicles, they were killing their fat cells right in their chin. They created these dimples and they realized that there’s a certain temperature at which you can kill fat without damaging regular cells. And so that’s the whole concept behind cool sculpting. And again, it’s a similar type of idea as Kybella that you’re targeting just the fat underneath the skin.

Again, there’s not any real tightening that occurs with cool sculpting. Similarly to Kybella, you’re just targeting that area of the fat. And this is, you know, this is going to be another, you know, procedure where you are going to have to be the right person for this procedure. And for some people it’s great. It’s perfect. But again, this is … we’re talking about underneath the jawline and not the jawline itself, but a lot of times that when you’re … when you improve the neck area or underneath the jaw or underneath the chin, you have essentially redefined the jawline in that way because of the fact that now … you are seeing the jawline in a much stronger way. So it does improve it in that vein. And this is the reason why I’m going through all this is because these are the common things that people think about when they think of jawline. But I’m gonna talk, you know, further in about the way that I think of jawline and the way that I think that it is best improved.

Another procedure that you can do is something called, Ultrasound Technology. The most common technology out there is Ultherapy. Ultherapy, also a really interesting technology. Ultherapy does give you the advantage of being able to go above and below the jawline. You’re actually creating injury… Again, that whole idea behind creating an organized injury into the deep layer. And you can get deeper because you’re dealing with ultrasound and it has the advantage of … because it’s ultrasound, the waves are going deeper. So, the energy that you create with Ultherapy is different than laser.

So with laser, the initial energy that’s created is energy on the surface of the skin. And so a lot of that energy is lost because you’re losing the epidermal layer. Where Ultherapy, a lot of the energy starts deeper, because you start with the ultrasound waves going deeper, and then they actually start deep and they radiate, you know, actually towards the surface of the skin. So with Ultherapy, again, it’s a good procedure. It has … you have to be the right patient again. Because again, you need a certain amount of tautness to be able to get the … results that you want. You do get a lift from it. You can lift from … above the jawline as well as below the jawline, which is the other advantage of ultherapy because of the fact that when you do the procedure, you’re actually doing the ultrasound waves above the jawline and below the jawline. So you do get a lift and the ultrasound waves do help, you know, in that vein.

So there is some, and it’s not, you know, it’s not documented in what they talk about, but there’s no doubt that you do lose fat and ultrasound technology like ultherapy. Because a lot of the patients that have had it done that we’ve … performed it on, you could tell that there’s no doubt … that with the heat that’s created by the sound waves, that they’re going to lose fat in that procedure. So you do get the advantage of losing fat, it does give you a lift, but again, it has to be the right patient and you’re again going below the jawline in the neck area and above the jawline which does help, you know, in that area as well.

So these are some of the most common ways that you’ll hear about kind of working in the lower face around the jawline. And it’s mostly the neck area, below the neck. Also, another thing I’m gonna just mention is PDO Threading. Threads are a pretty popular procedure as well. Threads are basically,… you place the threads in, you know, either the neck area again, you could place the threads around the jaw as well above it or below. The threads do improve by lifting. The issue with the threads that I feel is that you know, you … definitely get an initial lift. My biggest concern with it is that after three months the threads are dissolved and … there is collagen that does come and regenerate in those areas.

Now the long-lasting ability of threads is, you know, the hard thing to say for sure. For some patients it works great, it lasts long, for other patients, you know, they have, you know, less effectiveness. So it’s hard to say because of the fact that the threads will only last for three months and they will dissolve underneath the skin. It’s a good procedure. Again, you are working around the jawline, you’re working in the neck area, you’re working above the jaw, you’re working from the cheek usually, to the jawline where you’re creating a lift. You can create just an injury to create collagen, and elastin production around the neck area as well. So these are some of the major kind of ideas that we have right now that kind of affect the production and the help that a lot of patients kind of go to right now to affect their jawline.

But how do you really kind of non-invasively improve your jawline … the jawline itself? And to me, the best and most effective way to improve your jawline is with dermal fillers. And so we’re going to… go into the first… look into dermal fillers because dermal fillers are going to be a pretty popular topic that we’re gonna be talking about over the series of these podcasts because I think they’re a really useful tool overall for the aesthetic procedures. And you have to really kind of understand that the dermal fillers are really effective when it comes to, you know, producing the effect that you want. Now, just like I talked about Brotox at the beginning of the series, fillers are definitely another stigma that is created for guys. If you think that it’s hard enough to get guys to get Brotox, wait till you bring up fillers to them. And I’m here to tell you that they’re definitely harder to even get them to understand how important they are. But I’m telling you that there is nothing more effective than to create a strong jawline than with fillers themselves.

So let’s talk about it. Let’s talk about what fillers are. And first of all, so a lot of people think fillers and Botox are the same thing. They’re not. They’re not even close. Like I said, Botox, Neurotoxin, Dysport, those things are essentially … what they cause is a neuromodulation of the muscle. They cause a weakening of the muscle that creates effect of muscles of movement. So when certain lines are created by movement, that’s what neurotoxin affects only. It only affects the lines that are created by movement. It does nothing else, there’s really nothing else that it creates. So it’s effectively weakening muscle, and that’s all it does. But if you do neurotoxin in the right place, you’re going to create an excellent aesthetic effect because of the fact that you’re gonna create the aesthetic effect that you really want. Because the lines … A lot of the lines that we worry about are the lines that are created by movement. Like I always tell my patients, your mom was right. If you keep making that face, it’s gonna stay like that. And that’s actually very true. So, the neurotoxin actually is going to improve that by helping those lines that are created by expression.

Filler, on the other hand, is a solid project … It’s a solid product. It’s not a … it’s what we call a semi-solid. It’s kind of liquid and solid …and depending upon the filler, some of them are more liquid than solid, and some of them are more solid than liquid. It’s important to know that because of the fact that not all fillers are the same. Most of the fillers that we’re gonna be talking about are made of the same material though,… most of the fillers that we use are something called hyaluronic acid. Hyaluronic acid is found in your joints, your eyes. It’s the cushion. It’s like protein in your joints and eyes and it’s the liquid kind of material that kind of cushions the joints. It’s also very hydrophilic which means that it takes up water and it’s, you know, it’s naturally occurring in your body. So most people don’t have many issues as far as like allergic reactions because it’s something that naturally occurs in your body.

So hyaluronic acid is a pretty, you know, natural thing as far as something that your body is used to. The other thing about hyaluronic acid that is great is that there’s an enzyme that is called hyaluronidase. Now, what this enzyme does is that you can take that enzyme and inject that enzyme into hyaluronic acid and it could break it down. And so why is that important? Well, that’s important because of the fact that if you ever had an issue with where you put the filler or how the filler looks, or if you didn’t want the filler there, then you can inject that hyaluronidase, and then you can dissolve it. Now, that is a great improvement to the fillers that we used to have years ago when they used to use collagen fillers and fillers that were not able to … dissolve. And there’s still some fillers out there that we’ll talk about in some other podcasts that you don’t … are much harder to get rid of and it last longer.

But for now, we’re gonna just talk about the hyaluronic acid fillers. I think that, you know, for safety-wise, hyaluronic acid fillers are the right way to go, because of the fact that, you know, if God forbid, you needed to get rid of that filler for some reason, you can. You could easily inject it and you can dissolve it. Because you’re create… you’re putting a, you know, a semi-solid object into the area and if you need to… it will become more solid as it gets under the skin and, there will be liquid taken up by it and so it will become thicker. So it’s important that you… that you have something that you can dissolve if you need it to. So those are kind of the important kind of facts about what filler really is.

And so there’s different types of what we use filler for. So a lot of times people think of filler as that you have a big hole somewhere and you’ve just filled it, right? I mean, that sounds like what, you know, filler would be, right? You have a hole, you put a … you know, you put a filler in it. That’s it, right? And so that is actually… for some fillers that’s actually true.  For instance, if you had some deficiency underneath your eyes, you could put filler underneath your eyes and you can get a better result. And so, like we do for a lot of patients, the dark circles underneath your eyes are actually created because of the fact that you lose a little fat underneath your eyes. And so when light hits underneath your eyes, you … the light that reflects off the skin because the skin is so thin, is only seeing that deficiency. And that’s the reason why you see the darkness underneath the eyes. You’re not really seeing the… you’re seeing the reflection of the darkness. So once you put a solid object behind the skin, all of a sudden when that light hits it, then the darkness goes away. So filler underneath the eyes is a great tool. If it’s done right, it’s an amazing … you get an amazing result with it. And it’s really easy. It’s nice.

So you can definitely do fillers that fill a hole, but there’s also fillers that actually help to create new structure. And what I mean by that is that sometimes what happens is that for some reason the skin becomes more lax, the bone structure recedes, meaning, like it actually is going to  … decrease, you know, or get further away from the skin. And so when that happens, you could put filler directly on the bone itself to create a new platform for the skin. And so this type of filler is really effective because of the fact that what it does is it actually is going to work as a new platform for where the skin is going to hold onto. And so that creates a new tautness of that skin. And then all of a sudden now you have tightness where you didn’t have before. And so what do I mean by that? So like, just think about it this way. So let’s say you had a trampoline and all of a sudden time went on and like the edges of that trampoline started to get closer together. And then you’d have like the middle of the trampoline would start to kind of sag in the middle, right? Simple idea. If you start pulling that edges further apart because you put a rock or something in, you know, in that area, so that way it pulls the trampoline apart, all of a sudden the lining would start to become more taut and tight. And that’s essentially what some of the filler actually does. So we’re actually … what we’re trying to do is we’re creating a new platform on the bone itself, so that way when the skin catches hold of it, it’s going to either lift or tighten around it. And then a lot of times it does both. And if it does that, then it actually affects a lot of different places.

And this is exactly what we’re gonna be talking about when it comes to the jawline because this is the way to actually treat the jawline, specifically. Everything I talked about up until this point, we were talking about treating around the jawline, right? We were talking about treating the neck, treating above the jaw and in a lot of ways that, you know, they’re effective on helping to give you new definition, but there’s nothing more effective than actually treating the jawline and making it more defined. And once you do that, all of a sudden everything around the jawline is going to become more taught and tight. And … you know, we could show you, you know, example after example of once the jawline becomes taught and tight, all of a sudden you have not only that straight angulated jaw that you had when you were younger, but also that neck that was hanging is all of a sudden not hanging anymore because it’s now it’s pulled up and it’s tight and it’s taut. And everything around the mouth that was  … those lines that are created, all of that is now all of a sudden, you know, strengthened as well.

So, some of the fillers that I’m gonna just discuss, we’ll give you a couple of things to look up. The first one is Juvederm Voluma, it’s one of the more common products that we use. I definitely like this product. It helps to kind of tack the angle of the mandible, like the angle … Like, so when you look at your  … if you go from your ear … all the way down to your neck and then go across, think about that angle that’s created, go across like your jaw. Think about that angle that’s created. So, the first thing that we will do to recreate the jawline is that we will inject right at that angle, right at the juncture of the angle. And my goal for guys is to create a new 90-degree angle from going from the ear all the way to the jawline. So that angle has created a 90-degree angle. For women, we create about a 120-degree angle. It’s a little bit more feminine. It looks really nice as well. It’s really important … for women as well because like I said, the center of gravity for the face is the jawline… for both men and women.

Now I’m gonna talk about the overall kind of how faces age differently in men and women.

You need to be more of a square. You need to get more of a square for a male and more of a triangle for a woman. And I’ll explain that more in a future podcast. And that creates a more youthful appearance for both men and women. But for sure, you want to make sure that you get that 90-degree angle from going … taking a ruler, from going from your ear down and taking that to the jawline all the way down over to the mouth. And so if you don’t have that, if you think that it’s weaker, then that’s the first issue. Now… so these products, Voluma is the first one that’s commonly used. A strong product. Another one, two Restylane products, Restylane Lyft and Restylane Contour. Contour is a little newer product. Restylane Lyft… also a really nice product that I find… as well that’s strong enough to create this angle as well.

Now, what these fillers do, again, when you think about putting filler in, you think, okay, so I’m putting something already on my neck that I think is, or around my jaw that I think is like heavy already. Why would I do that? Well, the reality is, is that as soon as you, as soon as you create the jawline, it’s an incredible thing that you will notice that your face becomes thinner almost immediately. It’s a remarkable thing. You know, we have a lot of fun when we do the jawlines because what I’ll do to patients, cause … you can’t really see, you can’t really see while you’re getting it done, like the side of your face, right? So I’ll literally like, you know, have my assistant like take pictures while I’m doing it. So like over the treatment as I do it, each step by step we’ll stop and I’m gonna show them like, this is how we started, this is where we are. And you could see how the face actually becomes thinner and thinner every time as I’m injecting. And you would think like, how is that possible? How is it possible that you create a jawline that is actually thinner when you’re actually putting a solid object into that space? And the reason is, is because you’re recreating the jaw that is now stronger and it’s pulling everything up. And so what you were seeing  … the weight was that you were looking at is because of the fact that you were seeing a weak jawline. So that’s the first thing. So then the next part of it is… you want to create the straightness of the jaw. So with the straightness of the jaw, you need to inject into the jaw itself. And so a lot of times we’ll do this with something called the Cannula.

And this is the first time I’m gonna talk a little bit about a Cannula. A Cannula is not a needle, it’s more of a plastic catheter we actually use and we will use that catheter that goes into the jaw itself. We’ll inject through the catheter, create the line. And with that, once you’ve created that line, now everything under the neck starts to lift. And you’ve now created an incredible, like, tight jaw. And you should have a 90-degree, you know, a 90-degree angle, a straight jaw, tight neck, and then a thinner face, which is people are amazed by because of the fact that they are wondering how that happened.

Now, the jowls, let’s talk a little bit about the jowls because this is really the most interesting part. Now, what are the jowls? So like, you look at … a lot of patients look at them and they’re like, I hate these jowls, I hate this. And so it’s like the jowls are that area right next to the chin, right? And it’s close to, you know, it’s a little bit, we say lateral to the chin, so it’s a little bit far, you know, a little bit away from the chin and you know, … towards the back of the angle of the jaw. But it’s, it’s relatively close. And so what … what is that? Like? What, why do people get that? And the reason is, because like you chew, right? And so the muscle there. So that is like the … that is the projection of the muscle of mastication, which is the muscle of chewing, right? So the more you chew, the more, and it doesn’t matter. I mean, obviously, if you chew a little bit or a lot, it doesn’t matter.

You’re the … that muscle is going to project stronger than any other muscle. So if the jaw starts to become weaker, all of a sudden, the one thing that starts to project is that area, that jowl. And so if you can take the rest of it, the rest of the jaw and make the rest of … the jaw strong, then look like the equal, you know, shape of that area and straighten it, then you don’t see the jowl anymore. And there’s some great examples of this and you know like I said it’s pretty remarkable when you see it. So I want you to all do an exam … do a little test for me. So I want you to look in the mirror …and I want you to just take a look in the mirror and, you know, look at your profile …and you’re going to take a look. And I want you to just take a look at your profile. Just look at your jaw, look above your jaw, look below your jaw, like just, and look at the line that is created by your jawline.

Like how sharp is your jawline? What’s above it? What’s below it? I mean, what is near your chin … or some of these things that you see, some of the things that bother you. Take a couple of minutes and take a look at this. And I want you to kind of give yourself a, you know, a few minutes. You could turn off the podcast for a minute and take a look and see. But … I hope you … take a look and see. All right. So anyway, so again, the whole point of this is that there are many things that really you can do around the lower face. And I think that it’s really important because, you know, when people worry about certain things in their face, they think about the fact that … they feel like it ages them, they feel like they’re, they’re gaining weight in their face, they feel like they hate their area of the neck. They hate … there’s something around their mouth. They hate their jowls, they hate something that doesn’t look right. They often… reason is, is because of the jaw. And so if you can correct that jawline, a lot of times many of these issues can be improved. And the reality is, is that there’s not a lot of ways to correct the jaw because, think about it this way, you know, a lot of the procedures that are done either use, you know, some type of light energy or you know, like for instance,  … let’s take Ultherapy, which is the ultrasound technology.

Now, if you ever had an ultrasound wave placed on your jawbone, you would never forget that because that energy is incredibly painful. So, you know, the way, honestly, to actually treat the jaw a lot of times is, you know, the kind of the old ways with a lot of technology is to treat above and below. But that didn’t get to the root of the problem because we know now that our center of gravity of our face is the jawline itself. And so by treating the jawline itself, a lot of our issues start to become improved. And a lot of the things that we worry about all of a sudden become improved. And so you still might have to do things and might have to treat, you know, areas of your neck and might have to treat areas of your chin or around your mouth and we’ll talk about these things as well because everybody’s different and everybody has a different way or different, you know, different things that have been created over time. But that being said, but a lot of the issues that I see with guys is that they worry about certain things like the Turkey neck, Jowls, extra weight in their face. And a lot of the issue is the fact that their jawline is not strong and then just strength and masculinity come, does come from their jawline.

Now again, … just as important for women. And it has nothing to do with masculinity. For women, it’s the same thing. When you treat the jawline for women, you’re treating that a little bit differently because you’re not going … the angles are not gonna be as sharp, but you’re going to create a similar type of effect. And a lot of the issues that are created by not having a strong jawline for women are the same as what I’m talking about with men.

I mean, it is like exactly the same. And I mean, the results are phenomenal. And the great thing about filler is that it’s immediate result. A lot of the other procedures that we talk about, the results, you know, are gonna take some time because of the fact that the body has to kind of affect it. Ultherapy, Radiofrequency, these things do take, you know, a couple of weeks and, you know, so it does take a little bit more time. But with filler, you’re gonna see the results right away. And like I said, that’s why, you know, we sit and take pictures while I’m actually injecting. Because I just love to see my patient’s reaction while I’m doing it because it’s really fun and cool to see it.

So that being said, I hope you enjoyed today’s podcast. I want you to all take a look in the mirror, look at your profile, take a look at your jawline and think about it and think about what are the things that are causing you to be dismayed about something. Or maybe not dismayed, but either way. I mean, just to kind of take a look and see, does my jawline look the same as it did back in the day, or am I starting to look like Glass Joe?

So, I hope you really guys enjoyed it. Of course. Just kidding at the end. But, you know, like I said, like, please comment below, you know, like, and share this. You know, we’re going to be doing more of these. Of absolutely … this is the first kind of delving into the filler kind of arena and there’s so much more to talk about because I feel like, you know, we have to really kind of get into, you know, an important kind of … arena. So I hope you enjoyed it and have a good day.

This is Dr. Robert Frankel. I’m an emergency medicine and anti-aging physician, and welcome to the Modern Man Podcast. In this podcast, we talk about important topics for men, which include male aesthetics, health and wellness. But most importantly, we try to remove the stigma of male aesthetics because I think that it’s important to understand what men can do for aesthetics and how important it is … for their social and psychological well-being, and ultimately just to feel and look good. So take the journey with me. It’s going to be okay. It’s going to be fun. So enjoy it. I think the next episode will be really interesting and informative, so take a listen, hope you enjoy it. Again, this is Dr. Rob Frankel, and enjoy the episode. Thank you.

[Background music]

So this is part two of the Modern Man Podcast of Save the Mullet, where we’re going to look at the interesting, exciting treatments for hair restoration. So I think this is gonna be the more interesting, exciting part of the podcast. What do you think, Zoe?

I think so too. This is gonna be amazing because last episode, you got to hear how a hair loss happens, but this episode you get to hear how to fix hair loss.

Yes. And I think that this is going to be a really informative episode. I am looking forward to getting into the information and the research and all kind of what really we found works and what are the downsides to some of the treatments, because I think that is really kind of the most important thing that people want to know.

Yeah, what treatments work, which ones don’t? And that’s always a big debate online and in doctor’s office. So let’s get into it.

Absolutely. Let’s do it. So, the first thing we’re gonna need to do is we’re going to have to go into something that might be heading into the little bit … into the weeds, but … we’re going to try to do it as quickly and, painlessly as possible. We’re gonna need to go into the hair cycle.

Alright

Because of the fact that the only way we’re really going to understand how these treatments work and how the whole idea behind the treatments is to understand a little bit about the hair cycle. Now, we’re not gonna go into, you know, the specific, you know, mechanisms, the biological mechanisms behind it, but we’re going get a … just a brief overview of the hair cycle so that way we can kind of get an idea of like … what’s the really point of this and how does it really work?

Man, after this episode, I’m gonna be able, able to add a science degree to my writing degree.

I think so. I think so. So the first thing is that, so the first phase … I guess the most important phase that we like to talk about is the anagen phase. And so this is rapid hair growth. This is the phase that we all want to be in. This is the phase that we’re trying to achieve because this is the phase where hair is growing. And so … this is the phase that we are looking to achieve. Okay. So in this phase … there is a couple things around the hair follicles that we need to understand. There is something called the Dermal Papilla, say that a few times, fast.

Dermal Papilla.

Yes.

Okay, I’ll do it once.

Okay. And then there’s also a bunch of germ and stem cells around the hair follicles … well that sit around it, that are also there to kind of protect the follicle and also be there to be present and be there to nourish the follicle. And there’s also a receptor that’s there as well that I’m going to mention, it’s called 5-alpha reductase. And just … I want you to be aware of that this exists because of the fact that we’re going to mention it at some other, some other point when we get to it. So we have some of the background material when we talk about hair follicles.

The other phase that we’re gonna talk about is the telogenic phase. … Before I get to the telogenic phase, I’m gonna go back to the catagenic phase. So the catagenic phase is actually when there is loss of hair or the hair follicles are actually are losing, or we’re losing hair, the follicles are leaving the shaft. And so when this happens, the dermal papilla is actually being lost from the follicle. So there is a … … there’s an actual decoupling of the follicle and the dermal papilla.

So that would be something like trauma, or damage that we talked about last episode.

That would be one reason that would … it would happen for sure.

Okay.

Yes, absolutely.

And that’s in the …catagen.

It’s the catagen phase. Correct.

Okay.

Yes. So the cat phase is when we’re moving from the phase where we have rapid hair growth to a phase where we’re losing hair. Now we want the anagen phase to be the phase that … we’re in most of the time. But, you know, there’s times where the catagen phases are going to be a longer phase where we’re actually losing hair. And so we think about the fact that you know, the dermal papilla is lost, you know, at that point where … the two are not close to each other.

Now, the next phase that I’m gonna talk about is the telogenic phase. The telogenic phase is the phase where we’re in rest, meaning like, nothing’s really happening. And … this is a pretty long phase, where the hair follicle … we often talk about is dormant, right? We often talk about that nothing’s really happening, the hair’s not growing, the hair is not losing, it’s not real … Nothing’s really happening. And often, you know, in this phase, you know, there’s nothing really kind of growing, but there’s nothing really being lost as well.

And how much time is between, or how long is each phase?

So it’s a good … It’s an excellent question. And the answer really is depending upon what’s going on with the … person is … variable. Now, the –

Oh, so with like your health, your stress levels, your environment, those will determine how long or how long each phase is and in what phase you’re in.

– Correct.

All right.

And so … and that’s the point. And we want to be obviously more in the rapid growth phase, the anagen phase, but a lot of people, you know, stay stuck in this telogenic phase, or they … worse, they get in, you know, into this catagenic phase where they’re actually actively losing, you know, hair. And so that’s, you know, when we talked about the telogenic effluvium… the patients, when they’re very stressed, they’re actively moving from the anagen phase into that catagenic phase, and they’re quickly losing hair. And that’s a real problem.

Oh, that doesn’t sound good.

No, that’s not good at all. And so we think about the … we think about … what is … what’s happening when we’re in the dormant phase or the telogenic phase and getting into the … the anagenic phase. The major thing that happens is the Dermal Papilla needs to kind of connect with the follicle, and that essentially creates a trigger. And so that’s the trigger, essentially. And so you think about it as like what causes, you know, this to occur. And so there has to be something that triggers that phase to start. And so you could think about it, make it simple for yourself, and think about it that there’s something that triggers that phase to occur. And so that’s really kind of what we want to achieve. Like we want to cause something to create dormant cells to get into the anagenic or the growth phase.

All right? Okay, I got this. I got that science down.

Perfect. And so what we want to avoid is we want to avoid the anagenic phase from going into the catagenic phase, right? So that’s the other trigger that we want to avoid. And that’s when the Dermal Papilla is completely … the Dermal Papilla completely goes away or disengages from the follicle. And so the other mechanism that we want to try to avoid is we want to stay away from the anagen phase going into the catagenic phase, which is rapid hair loss going into … rapid hair … growth going into … rapid hair loss.

Okay? We don’t want that.

We definitely do not want that.

So then … what are treatments? How do we … how do we work with this in all these different phases.

So that’s exactly what we’re gonna talk about. And so now that we have … the whole picture of the hair growth, and we did it in a pretty efficient way, I’d say. We have the picture now, we can talk about it … in an educated way, and how each one of these treatments actually work to prevent these different cycles or gain … to create the goal that we want to reach.

So the first thing that we talk about is that we must make sure that, you know, there’s not a specific diagnosis with hair loss that we’re missing … because of the fact that sometimes there is a medical reason why people are losing their hair, that has nothing to do with these phases of hair loss.

So it’s something that is a skin condition or any other medication that you’re taking. Those would be symptoms or those would be the options that you’re talking about that as opposed to hair trauma or damage to the hair follicle.

Correct.

Okay.

So that would be exactly, or, you know, because of the fact that there’s sometimes those hormonal reasons why, you know, people are losing their hair. And sometimes fixing their hormones will actually, you know, repair, you know … their cycle and, and create … and stop the loss of hair as well. But yes, definitely what you’re saying is skin conditions. There’s … certain types of fungal conditions that are out there that can cause, you know, … loss of, you know, patches of hair that will have nothing to do with any of these things that we’re going to talk about. So anything that you do that … any of these treatments will have no effect on those types of causes of hair loss. So we have to make sure that we distinguish those. And so that’s why it’s important that when we, you know, evaluate, each person … you have to evaluate the person for these types of problems before we even discuss like, is this person a good candidate for helping them? Now, sometimes it’s an easier fix because of the fact that you could help them by treating their specific medical condition.

So not one size fits all.

That’s absolutely true.

All right.

So now we’re gonna talk about each different … some of the most common, and some of the more cutting edge things that you might not have even heard about, treatments for hair loss … then some of the ones that you might have heard of with certain tweaks … that you might not know about that might even make it even better. So let’s talk about these things.

This is exciting. Let’s do it.

All right. So the first thing that you’ve … I’m sure that many of you heard of because they’re … it’s all over the TV, is Minoxidil, which is … the common drug name is Rogaine, right?

Oh, wait, Rogan, Rogaine, right?

Rogan, Rogaine, Rogaine, whatever you want to call it.

Depends on what part of the country you’re in, how you pronounce it, how your accent is.

That’s correct. So, I think in Queens we call it Rogaine or I mean in Midwest, I don’t know how you call it, but I mean, we will figure out. We’ll figure it out at some point. But yes, so Minoxidil actually was a blood pressure medicine.

Really?

Yeah.

Okay.

So the original, and it still is actually a blood pressure medicine, it never changed. It’s still … it actually … Still people use it for blood pressure. But what they found is that when people were taking it for blood pressure, they were growing hair sometimes in places that they wanted to grow hair and sometimes at places they did not want to grow hair.

Whoa. Oh.

Exactly. So, when they realized that, well, the good people at … the good people at … I don’t know who actually makes –

Rogaine.

– Minoxidil. Yeah, but … I don’t know, I forgot which company makes it. But they said, well, hey … this is a winner for us. Just like when Allergan realized that, hey, this headache … this headache injection actually makes people’s wrinkles go away, let’s use it for that instead of headaches, because that’s gonna be much more profitable for us and –

That’s how Botox was created.

That’s right.

It was a headache and a migraine treatment first.

That’s correct.

Oh, I didn’t know that.

Yes.

Well, there you go, there’s the … add that to the list of things I can do to build up my science degree.

That’s right. The history of Botox was that it was FDA approved for headaches and had nothing to do with wrinkles, but –

Oh, interesting.

– but all of a sudden those headaches, the people were having less head pain and they were having less wrinkles too, and so-

And they looked younger. Sounds good to me.

– and all of a sudden, next thing you know … so yes, and so Minoxidil, does work by helping … helping the telogenic phase be triggered into the anagenic phase. So it does help by producing the follicles to move into hair growth. And so you do see, you know, buds of hair growing after you often use it topically. You can actually use it orally as well. There are preparations where you use it orally. The problem with it using orally, it’s harder to control. And again, like they, you know, they did it … you know, they realized early on is that you can grow hair in other places other than your scalp when you take it orally. So, you know, by just putting it on your scalp, it’s going to affect your scalp mostly. And … … that’s where the method of action is going to be present. So that was a good thing. Minoxidil I think we mentioned earlier in the first podcast has about a 40% effective rate. So, you know, as you know … when we talked about that the first week and I told the producer that, her response was, what?

Just like that, that’s just how producer … … What do you mean 40%?

Correct, so –

That’s crazy. They’ve been selling Rogaine at CVS, Target, every drug store across the country and it only has a 40% effective rate.

But you have to understand that what that means is that for 40% of the people, it works a hundred percent of the time. So that means that it doesn’t work for a hundred percent of the people, but for 40% of the people, it works, it works really well.

Okay. So you mean if we give it to a hundred people, it doesn’t work 40% of –

Your head

– of your head for all a hundred people, it works very well for 40% of those a hundred people.

That’s right.

Gotcha. Okay.

Yeah, so that’s what … yeah, that’s what you have to understand. So it’s not like, you know, oh my God, like 40% of my head is great, but the other 60% looks terrible. So, no, but it works. … It works well for 40% of the people, but it … I mean, the efficacy is, you know, like less than  … less than half of the people. But what, you know, … what we found though is that if you can add certain other products and certain other reasons why people have problems with hair loss and even kind of  … decrease, how can we stop people going from the anagenic phase … going from the anagenic phase to the catagenic phase? How would we … how do we do that … would that help the efficacy of the `… minoxidil? What do you think?

I mean, is there something you can add or are you making your own cocktail?

I think that we can, and I think that, you know, if you actually kind of add to the idea behind that minoxidil works really well at producing the rest or dormant follicles from going from dormancy to the … anagenic phase, which is the, you know, hair producing stage. But how can we stop it from going from the hair-producing … phase to the hair-losing phase that would be even better. Because that would make the efficacy work better. And so yeah, you can actually do things within the formula to actually do both. And so things like adding Retin-A and Retin-A is vitamin A, which is really great for, you know, a lot of things, but it’s also … it’s really good for inflammation.

And one of the reasons why we start having problems with hair loss is because of the fact that when the follicle becomes inflamed, it’s going to start to produce … just like damaged, you know, it becomes damaged and it starts to go into the hair-loss cycle. So going from the anagenic to the catagenic phase is because of the fact that it becomes inflamed or damaged. And so by stopping the inflammation, by using things like Azelaic Acid and by using Retin-A and even Hydrocortisone, these are things that actually will prevent it going from Anagenic phase into the Catagenic phase. And it actually increased the efficacy of Minoxidil.

Oh, that’s so interesting. So would you be using these topically as well, or do you take it orally?

… I would say we’d use them topically and I think that we can absolutely, you know, make the efficacy. So, you know, here at Simply.Aesthetics we do … we are working on formulas to increase the efficacy because, you know, our approach always is to say that the best way to really do this, there’s no … silver bullet like we said before. But if you kind of use all the … different approaches and you… You use all the different approaches and you try to, you know increase … each efficacy, you’ll be able to get the best results.

That sounds great. So is that something we’re gonna concoct here at Simply.Aesthetics to offer our patients in the future?

Well, we’re not gonna concoct it right here in this office, but yes, we are. We have a friendly pharmacist who is helping us concoct it.

Shout out to Pharmacist Eihab. He always is great to work with. Comes in really clutch.

Yes, yes. So Pharmacist Eihab in Ann Arbor, Michigan, is really good … a good partner for us. He does help us with all our needs. And … he is working day and night for us to … listen to my rants about what I think is going to be the best way for us to help Minoxidil become more efficient.

That’s amazing. 

Yeah.

That’s so exciting. I can’t wait to see what you guys come up with.

Yeah, so that’s the first kind of idea. The second, the second thing that we’ll talk about is another medication that’s been out there for a long time, and that’s Propecia, Finasteride is the common name. … Propecia is the kind of name that you’ve heard on the TV screens. And so what Propecia does is it blocks the receptor that you’ve heard, 5-alpha reductase. Now I talked about that earlier and that’s one of the receptors that is going to … is going to stop the production of two things. It’s gonna stop the production of DHT, which is Dihydroxytestosterone, but it’s also going to stop the production … the phase of … it’s basically stopping the anagen phase going into the catagen phase, which is a good thing.

So there’s a couple of things about Propecia and Finasteride, it’s effective in the fact that it does decrease … the phasing of going from the, you know … very active hair growth phase into the hair-loss phase, which is great. The problem with Propecia though, it does have some side effects, and so I need to talk about these.

So does it have side effects on men and women?

So first of all … Propecia does not work on women at all.

Oh, okay. So that’s probably why I haven’t heard this. This is not as in circulation that I’m aware of.

Correct.

Okay.

So Finasteride, Propecia is ineffective for women because the receptors are not … I’m not even sure that they are even present in women, but if they are, they’re not a … large part of how the hair cycling occurs in women, so-

Okay. So then what are the side effects for men?

So for men, they essentially are causing low T symptoms. Which, you know, if you’ve heard, you know, our podcast before, we don’t like low T symptoms.

And for those that you don’t know what low T is, it’s Dr. Frankel’s referring to low testosterone.

That’s correct, yes.

Okay.

So it will affect your libido. It will cause breast tenderness. I mean, essentially what it’s doing is it’s increasing your … the effect of estrogen on your body compared to your testosterone. So it’s gonna increase that, it’s going to increase swelling, you know in your hands and feet and it’s also going to … possibly cause you know, a erectile dysfunction as well.

Oh, that is not … those are not things that I want to tell a patient when recommending this treatment. I know a lot of guys that would say, you know what, never mind, I’ll deal with my hair … loss, but I don’t wanna deal with all those other symptoms.

That’s correct. So, I mean, there are definitely lots of doctors who recommend this and actually prescribe it. We are not one of them.

No, we are not.

But … but like I said, you know … it is effective for the reason why it does, you know … it does stop the … hair-growth phase from going into the hair-loss phase. However, with the side effects that are present I don’t … I just feel like it’s not going to be you know … the best course of action.

No, that doesn’t sound like an option route that I would wanna take.

Now for women, since we’re … we are gonna talk about women with hair loss as well.

Happens to all of us.

Absolutely. So with women, you know, one of the reasons why women do lose hair is because of actually … they produce too much testosterone. … you hear about like, the fact that, you know, they … you can grow hair … you know, in certain areas on your face because of high testosterone, but they also can lose hair on their scalp because of high testosterone as well. And so this is can occur because of the fact that there’s a condition out there that’s called, polycystic ovarian syndrome.

So PCOS, I’ve heard, I know a lot of women with that condition.

Now, you could have PCOS without having any ovarian cysts.

Correct.

Even though it’s called polycystic ovarian syndrome. Sounds like a misnomer because of the fact that it’s called polycystic ovarian syndrome.

But you can have the other symptoms without having cysts in your ovaries?

Right, correct.

Okay.

So the major thing is the hormonal changes. And one of the major hormonal changes is that you will have elevated testosterone levels.

Women do not like that.

Right. So one of the major problems with that is that it can create and cause hair loss. So one of the major … major treatments that … some women are put on something called spironolactone. Now spironolactone is a diuretic. … it’s a blood pressure medicine and a diuretic for heart failure actually is used very commonly. And so … but it also does lower testosterone, so it does have the effect of lowering testosterone, but it also has the effect that if you’re not a heart failure patient and you’re not a patient who has high blood pressure, you’re going to have all the effects of, you know, this medication without having this problem. It also raises your potassium as well. So there’s a lot of electrolyte potential imbalances that occur with spironolactone, with the ultimate effect of lowering your testosterone. So it really kind of is  … kind of like a, you know, like a basket half full, basket half empty type of situation because of the fact that it really does have some negative effects. But-

It still doesn’t sound good to me.

Yes, but … So it’s, you know, it is what it is, but … it’s not the best. You could take something like Saw Palmetto, which has less side effects and that also low testosterone, but … these are hard problems to deal with, but Saw Palmetto actually is, and I’ve had patients who’ve had high testosterone that have had some real success with … … giving them Saw Palmetto, which is much less, you know, toxic for them.

… So I think that that, you know, would be a good option as well.

Okay.

So I’m gonna talk a little bit about the next few, which are, we’re gonna get into some, you know, some more, you know … interesting treatments. Biotin is B7, which is a very common thing that you hear about.

Absolutely. Women love taking biotin gummies and supplements for hair and nail growth. I know I’m really rigid about my biotin

Yeah.

My supplement intake.

Yeah. So the interesting thing about biotin is that the studies for biotin are very kind of small and there’s not a … ton of research about biotin.

Oh, no. He’s about to debunk my routine in the morning. All right, go for it.

Sorry. No, I mean, you know, it is true that what the major kind of … the major research that was done was that kids who were on seizure medicine that got depleted, fully depleted in biotin that was losing hair. When given biotin back, actually gained hair back. And so … that was definitely true.

Okay.

… So full deficiency of biotin, will make you lose hair for sure. A hundred percent. But it’s hard to say that without like full deficiency that biotin does much of anything because there’s been very little research done on biotin, you know, like without knowing that the person was deficient or not.

Oh, it could all be psychosomatic then.

It’s possible. But again, like it’s hard to really say because there’s not a lot of research on vitamins in general, and there’s a reason for that. Do you know the reason why?

No, I don’t know why.

Because the pharmaceutical companies don’t make any money on vitamins.

Oh, they can’t, because you can get them naturally or supplements and they’re not creating them in a lab.

That’s correct.

And being able to charge you hundreds or thousands of dollars for it. So no one’s paying the money … to do the research on it.

That’s right.

Well, there you go.

So you learn something new every day right? So it’s hard to really say. I mean, but there’s no doubt that the kids that were deficient in biotin because of the seizure medicines they were on did lose hair. They gained their hair back when they were given biotin, and that’s factual. Other than that, there hasn’t been a lot of great studies that have shown that biotin has been incredibly effective for hair or nails. A lot of it has been more anecdotal. But I mean we’ll, you know … we’ll take it for what it is. And I mean, I think that biotin is, you know … I think for the research that we have, it’s worth taking. It has, there’s no negative effects. It’s a water-soluble vitamin, so it’s impossible to be toxic to your system.

So I can’t OD on biotin.

That’s correct.

All right. That’s good to know.

So I would … I would say that I’ll give it a thumbs up … with an understanding that we don’t have a ton of research on it.

Okay. But it’s also not gonna cause kidney failure in me, so –

That’s correct.

– … I’ll keep taking it.

Perfect.

Just in case.

So … I didn’t completely debunk or destroy your, you know, biotin –

obsession. Okay, great. I’ll take it.

All right. All right. Next we’re gonna talk about some things that do have a lot of research. So the first thing we’re gonna talk about is low-level laser therapy. That’s a handful or mouthful, actually.

Low-level laser therapy.

Yes.

Okay.

So low-level laser therapy is interesting. … I’m gonna show you for the people watching on YouTube … what the device looks like. And so low-level laser therapy … I don’t know if I could turn it.

The hand piece that we have, for those of you listening to it at home, Dr. Frankel’s showing that it looks like a bicycle helmet.

A bicycle helmet. And so basically what we found is that … what they found is that they’ve done a lot of research on this. And so what is the whole point of low … -level laser therapy? And so the idea behind it is that, if you put a laser at a certain temperature, what … is it … will it have a certain effect? And so, you know, Zoe, that whenever I find out about something, I have to know the full historical facts about it.

Yes. That’s one of the best things about conversating with you is that you have a well full of historical details, which as a history nerd, I appreciate it.

Right.

So what is the history behind low-level light laser?

So in the 1960s, a Hungarian physician was looking at … different types of lasers to be able to look at cancer treatments. And he was looking actually to see whether laser actually increases cancer or decreases cancer. And so he was actually putting these lasers on mice. Now the thing about these mice was that they weren’t … losing or gaining cancer, but what they were doing, is they were gaining hair on their back.

Oh, so these little mohawk-looking mice we’re just running around?

Yeah, they were, you know, probably going to the playground and realizing that, Hey, I got a lot of hair on my back.

Oh, they’re probably got made fun of. Oh.

So they … so, of course … you know, the idea now is that, so … how did this whole idea come about? So what they found is that, at a certain wavelength, and what the wavelength that we are going to find that is most common is … 650 nanometers. There’s a certain wavelength that if you put it on the scalp and it can’t be too hot, right? So we talked about when something’s too hot, it could actually damage like the follicle.

Right, we don’t want that.

And if it’s not too hot … so if you … if it’s a certain temperature that’s not too hot, it actually can produce, cause the blood vessels to actually start to, kind of grow. And so this is the whole idea behind the low-level laser light therapy. So at a certain temperature and a certain laser wavelength, you start getting what’s called angiogenesis, which is you start producing blood vessels … at this temperature. And so, there actually has been for patients who had telogenic effluvium, a lot of research with patients who had stress-related hair-loss, and they found they had great results with these patients. They had an increase, you know … so what they did was … they put patients in a group with the … low-level light laser and a just a red light laser. … Just like the red light you see at Halloween, like people are shooting.

Oh, okay. So not … okay, so just a regular red light near the holidays.

Yeah.

So people like, oh, I’m on a red light. I’m like … and they didn’t realize that it was nothing.

Okay.

And the other person … the other patients actually had the laser, they found that the patients who had the laser had almost a 40 to 80% increase in hair growth compared to the people who were in the placebo group.

Oh, that’s even … that sounds like better odds than Rogaine.

Absolutely. So I mean … what they found is that, you know, these people were really kind of did really well with you know … with the low-level light laser. And they really did, you know, they got some really good treatments and they overall had some, you know, excellent results. So, you know, with giving, you know, the laser, you know, adding the laser … to the overall treatment, which is again, very easy. You know, there’s not a lot of downside to adding to the laser. Now … if you have active cancer or anything like that, that’s a contraindication. Because we don’t know what the effects would be. But there’s … other than that, there’s really very little downside to doing the laser every other day. I mean, they found that doing the laser every other day, they’re getting really good results with patients. You know, doing the laser every other day, getting hair growth because of the fact that they’re building … these new blood vessels around that area and they’re getting hair growth.

So if you guys are watching on YouTube or listening on the podcast, this helmet, bicycle helmet-looking device, we just put it over the head for a patient and for 10 to 12 minutes you said every other day?

That’s right.

And it’s very non-evasive. It doesn’t … it doesn’t even touch your scalp and it doesn’t burn your skin, correct?

Correct.

All right. See, that does not scare me. That’s something I would definitely try –

Right.

– for 10 to 12 minutes every other day. One hundred percent.

Yeah. And it’s not for Halloween, it’s for every day.

That’s great. So I think we should leave them on another cliffhanger, Dr. Frankel, and leave the magic treatment for next week.

Really.

I mean, this is really exciting. All the signs that we’re talking about today, –

Okay.

-and the hair growth cycles, I think leaving them off on a really high note with the laser red light therapy, but we still have one trick up our card or … one card up our sleeve –

Okay.

– that I think we should save till next week.

All right. Because we do have, you know, actually, more than one treatment left. And those two treatments are the most cutting-edge part of … the whole thing. So, yes.

So, all right. I think we’re gonna see you guys next week for part three on, Save the Mullet.

Yeah. All right. Excellent. So, well, I appreciate you … we appreciate your listenership and we are almost, you know, at it, but we definitely have the most exciting part coming up in part three. So we’re sorry to leave you on a cliffhanger, but we really need to, you know, get to that most exciting part. But now you have a lot of information and … we’re almost there. So hang on for one more week and we will get it to you.

We take it very seriously here at Simply.Aesthetics. We really wanna help you guys with treating hair loss, so go into much details as possible and we’ll get the next cutting-edge treatments out to you guys next week.

So if you appreciate us, like and subscribe to this video and we will see you next week.

Bye guys.

Yeah.

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