Perfect Skin Is a Lie: Boosters, Fillers & Hidden Risks | Dr Rajat | FO486 Raj Shamani

0:00Skin Booster's stretch marks are broken. It doesn't break any stretch marks. The stretch marks are a scar. It has formed. It will not break. What does Skin Booster happen? Skin Booster is hyaluronic acid. When we add this to the skin, the skin will expand. Hydration will come. It will strengthen, tone, texture. What do you think about Skin Booster? This will change me. That's the biggest misconception. In fact, you do the skin booster for people. I have to do something for skin health. I get hyaluronic acid in the market. Why can't I buy directly? Why do I need to use injection? That's why, because how much cost the treatment of skin booster?

0:4215-18 ,000 rupees is one syringe of a skin booster. When should a skin booster be done? 35 years mark at least. There are complications. Sometimes, a skin booster is put in a vessel. So that's an emergent situation then. You have patients come in. How many percent I have? Maybe it's 70-30. 70 women 30 men. How much money can we get in today's life? In today's time.

1:13We all need healthy skin. That's why we have a special series which we are talking about advancing skin health for every skin story with sensitive skin expert Cetaphil. In this series, we talked about the last episode of the skin care trends. Today, my guest is Dr. Rajat Kandhari, MBBS MD in dermatology, a experienced dermatologist. Today, we will know what the skin boosters are and what effect they have on skin. What age do they need to do? What is painful? How much cost does it? How much cost does it? fillers, skin boosters سے کیسے different ہوتے ہیں اگر آپ boosters لینا چھوڑ دو تو کیا skin اور خراب لگتی ہے stretch marks, dullness dehydrated skin کیا یہ سب solve ہو سکتا ہے اگر آپ healthy glowing skin چاہتے ہو یا صرف اپنی skin کو better سمجھنا چاہتے ہو تو یہ episode آپ کے لئے ہے اسے end تک ضرور دیکھئے اور مجھے comments میں بتائیے کہ آپ نے اس episode سے کیا سیکھا

2:20what do you think about skin boosters? what do you think? because it's injectable device it will change me the biggest misconception is because we inject it it will change me I will start to see weird things and so on and so forth that's the biggest misconception I would say which it's not like that But in fact, you do the skin booster for people who don't want to change. Who don't want to lift a little bit here or my chin is bigger, my lips are bigger. Who don't want to change. And who want to change for skin health. I just want to look nicer, hydrated, supple, glowy skin. That's why it's a skin booster.

3:04So that's a big misconception that they have. Okay. You know, supple is such a dumbass word. My first time dermat says she's not her dermat is supple. Supple means soft, right? Supple means soft. So if I ask you, Raj, what does good skin mean to you? What will be your answer? Glowy, even tone, soft. This is it. Yeah. There's no problem. There's no acne. That's it. So you use three different words. I'd maybe say radiant, hydrated, luminous, so on and so forth. so this whole zone of skin quality skin glow perceptions vary i think what you might think that for me this is a good skin quality someone else might think something else so what you said right that no acne should be done i tell them these are glow detractors so if something is up down on the skin so first of all you have to do it because that is detracting from normal healthy skin then you work on other things so that will sort of detraction but is it all these dermats because you study like that or because of studying you study supple detract radiant as well your dictionary is it or not it should be a little I should say I'm going to sound good that's why I think it just comes to you and you keep hearing people right and you keep seeing today Korean glass skin is another very common word which is being used dewy skin so on and so forth possible is korean glass skin india so i tell my patients ki koreans hai na tabhi unki korean glass skin hai hum indians let's move towards indian glass or glowy skin whatever because they are so glowing skin is a final pathway or a phenotype i call it so you are genetically predisposed tum kya karte ho how you're eating sleeping hydrating all this together leads to that final pathway so obviously indian skin however it might be and i think it's one of the most beautiful in the world if you need glowy skin then we need some work too have you met koreans and with flawless skins I think they generally have a decent skin that's what I meant by saying that genotype genetically their skin is quite good there are not so imperfections there are a lot of things in India many ultra pretty looking people maybe it's it's not like they look like they are filtered it's like that and probably that's why that's why that's why is also so they do a lot of stuff yeah okay so we are talking about skin boosters tell us what is skin booster what is so skin booster hyaluronic acid we say one of the main skin boosters and which was in India around 2014 skin booster hyaluronic acid hyaluronic acid is a sugar when we inject it different concentrations dootie hai.

6:27To skin imagine kuch bhi agar inject kia to skin thoda sa expand ho ga. Jab wo expand hoota hai to humari body ko eek signal malta hai skin ko ki now I need to act. Okay. To humari skin scales renewal karna shuru kar djeti hai. Thodi hydration a jati hai. Collagen stimulation shuru ho jati hai. And it also because hyaluronic acid ka main kaam hai hydration. So it not only hydrates it will strengthen tone, texture and once the hyaluronic acid goes in it expands the skin a bit so the pigment is on top, it looks better it disperses, so imagine a balloon which is not inflated, it looks dark and as soon as you inflate it, it looks smooth and a little translucent, something similar to that which I get in the market, hyaluronic acid why can't I buy directly?

7:21Why do I need to inject it in the injection? why do you need to put a high molecular weight? Yes, very nice question. So, this is why because there are many weights of hyaluronic acid. Now, let's say I have a high molecular weight and a low molecular weight. Big size, small size. Now, if you put a big size, if you put a high molecular weight, it won't penetrate the skin. So, many creams come to claim that hyaluronic acid have some high molecular weight hyaluronic acid. So, they work on top of it and they don't go inside. but it's getting better in the world low molecular weight actually goes in and it has the ability to penetrate the skin barrier so when it goes inside it does the work however when we use a higher concentration of hyaluronic acid and inject it that does a much better job because it goes into the exact plane where it needs so outside it will give smoothness okay and there's glow and when we talk about skin glow we don't have to work but also work because our skin dermis if it's homogenous then the light will reflect very well so it gives that whole glowy look it's not just the upper bumpy road which we were talking about upper thing will get the smoothness but it'll appear nicer if the dermis is also well hydrated and smooth.

8:55Okay. There's good collagen and elastin. So it'll look firmer, taut and hydrated. How do you know if some product will be seen that it's small size or big size? Unfortunately, this is not mentioned in any ingredient list. So if you're thinking about it, you'll think that maybe there's low molecular weight in this. Or at least there's a mixture. Because if the claims are there, after all, every company is not out there to fool you. so they will obviously have some hyaluronic acid which will penetrate also you can look out for terms like sodium hyaluronate many people don't know about this that sodium hyaluronate is a form of hyaluronic acid this is in some moisturizers anti-aging creams this has a better penetration and smaller size so you can look out for this term if it is written in hyaluronic acid written so it can happen that I have two sizes.

9:51Okay. I guarantee that 100 % it is not a guarantee. Yes. So it's a chance is better. Yes, it's better by availability. Got it. And these skin boosters, filler or toxins, which are injected and how do you do it? How do you do it? If you have to have me and say, I have to lift this face. Which is very common. Right? Under the eye, it's a bad word. Like you see my eyes. में देख रहे हो या मेरे lips plump कर दो jawline improve कर दो यह filler का segment है क्योंकि filler has the capacity to stay in a place एक जगा हमने उसको बिठा दिया जैसे I mold a clay in one place for example or and it stays in that place it's cohesive वो रहेगा माँ एक tenting effect दे देगा as compared to a skin booster जो मैं चोटे -चोटे drops डालूँगा और वो बहुत अच्छी beautifully fully merge کر جائے گا تو وہ آپ کے پورے skin کو hydration دے گا let's say so اگر مجھے کسی کی contouring کرنی ہے یا کسی کو lift دینا ہے یا lip enhance کرنا ہے تو میں filler use کروں گا but اگر میں کو skin health پہ کام کرنا ہے even tone texture firmness elasticity تو میں skin booster use کروں گا and lastly your question was that what is you are watching the lines so these are moving lines when I'm laughing here these are the lines of anger feeling sad for these lines to relax the muscle we use something called in a layman term what does skin booster better do in the skin I am going to do it example what will happen to me it will be smooth feel the first thing is Supple feel.

11:39Smooth, supple, hydrated. It's the first thing. And skin booster term is actually premature aging skin. Dehydrated skin. If it's crappy skin somewhere, it helps these things. So maybe a week after you do it, you'll feel my skin is very soft. And someone will come and tell you, Raj, your skin is looking good. that's what a skin booster will do so face change but smooth glow it will be smooth and the other will be good fresh what does it mean? fresh good that sort of thing is it a visible difference? it varies a little in amount and this is why sometimes the patient comes in so it's very important to align his expectation because if you come in and you tell me that I have to do one syringe skin booster that you do it on the whole face so then you should know that the effect will be a little less maybe you will feel smooth but the sound maybe you don't say that it's glowing but as soon as you would love one sitting one syringe it's one one syringe one syringe one ml one ml you can imagine one ml is what nothing so if we do a little more for one face I usually tell my patients at least start with two because that at least you also feel that i did something nice ideal so you can go up to five mil per session but typically i think in clinic we all do two to three as a start that's good enough okay if you're also combining the neck then maybe four and how much do you need to do?

13:24how many sessions, how many times, how many times? if you're a young patient so once in a few months you can do it and typically maintain once in 6 months but protocol says that first 2-3 sessions you do it in 1 month 2 or 3 sessions after that you do it once in 6 months and lifetime no not necessarily if you feel now my skin is looking good you don't have to do it every 6 months you can do it once in a year but if you have to do it then there is no addiction this is a very common question that if I will do it once if I'm going to get hurt then my skin is bad I'm used to get hurt every 6 months if I put it then I'll get hurt but you must realize that this collagen is also working on the collagen so your skin is firm after one time maybe 30 days same with many times same with fillers I think the initial building blocks or the foundation of like we are building a house first we have foundation and then we have interior interiors facade so when everything is done you will add one piece to add for the beauty same way in this it is not much that you maintain so when do skin booster so there is no particular age bracket but I think a good time to start would be anywhere around the 35 year mark at least or and you know this is a segment for a younger person also because if someone is young just wants that skin is good so for that it's good so you can so even if it's a 25 year old they can do a skin booster 18-19 year old should not no can can but then again like you said you you're getting into that zone quite early so i would say for a very young person 18-19 i would suggest first do your skin applications see how you're doing because you're not really really starting the aging process at that time so much right and once you start seeing some changes maybe you can start this is a good starting point so 25 and above this is a good starting point because you don't have to do much more in this it's very safe but what time will I feel when I try to do skin booster or go to do dull dehydrated skin little fine lines are starting to see you know little wrinkles neck little crappiness these are common areas so it's skin boosters are done for premature aging okay that's one of the main indications for it so if you look here my body so sometimes we just give hydration neck neck decolletage area these areas just i mean the chest the decolletage the chest or even in the hands if someone's face is good but they are very old then they do it for them how common is it how common is it how common is it how common is it that people are looking at these things it was not that common but now people do come in on their own for these indications My hand is aged?

16:44What do you think? Your hands are just fine. So are mine till now. So sometimes your hands completely give away your age. When you're getting old man's or old woman's hands, if you're getting old man's or old woman's hands, then in those cases, definitely it can help. Interesting. And then, okay, you talked about skin when someone's feeling prematurely. Did I do it? Yeah. Why would you say so? Because you'll feel better about how your skin is. rate my skin based as a dermate oh that's a trick question 1 to 10 we are very open from every dermate we are going to see everyone's marks I think anywhere between around 7 out of 10 okay you are being kind you have 6 I was gonna say between 6 and 7 but yeah you are right I am being kind you could work a bit on some of the glow detractors and yeah okay tell me top 3 things which you feel which is why you have reduced 4 marks from 10.

17:44I'm seeing some pimples, one or two spots under the eyes. There are slight hollows which are coming in. And of course, you can work on the skin texture and mild unevenness which I see. Okay. And if you had to work with me, what would you suggest in the starting point? First of all, I'll understand from you what you want. Because I think that's very important. because there's a lot of thing going on here also when you're coming in for a consult like this so if you're wanting something then i'll balance my uh you know what i'll be offering you accordingly as well because at the end of the day you should be happy with what you did but initially of course i'd maybe just tell you to give you a simple skincare regimen to work with and leave you with the thought that these are certain procedures which can help you read about them think and come so I asked you question because I don't understand I'm very if I listen to my I don't understand I'm like okay I'm happy I'll start with a sunscreen and I'll start with I'll start with let's say it right I think it's a good way to tell audience to understand what you're thinking what you're watching they'll see from different ways and I'm very open about it very transparent about it so initially I'd work on like I said skincare regimen maybe a simple procedure like a chemical peel or laser toning to work on your pigment and maybe if you're open to the idea i'll work on your under eye dark circles with a filler maybe with a filler so that's skin booster is always a good add-on so i'll add that and offer that to you because that is an easy thing because i don't want to change much because otherwise look good so these areas if i refresh then it'll look great okay maybe if you're just open to the skin booster head say okay let's just do the skin booster that will further just improve this on its own got it under eye improve skin booster okay okay myths skin booster around tell me top three myths first is that change will come to me a lot of change i will feel very weird okay secondly pain in this pain it doesn't happen so skin boosters many of them are with lidocaine lidocaine is an anesthetic okay pain is very manageable I would say if at all how much pain is it?

20:16if you asked me I get it maybe I would get it done without a numbing cream even pain doesn't happen okay for people to do it easy for it small pinch which is a sugar needle something similar something similar exactly if I give one marks that it is one pain so something similar one pain then something very similar yeah okay that was sugar but it's just that there are few pinches how long it takes the procedure will be finished in 10 minutes that whole process sometimes is a bit uncomfortable for anyone but I can't say it's unbearable pain or anything for 10 minutes it will be a pick small small small how many times depends on the size of the face I would have to do it how many times it will be yeah lagalo is at least at least uh if not 20 20 pricks on each side at least okay see in one shot that's just 0.01 mil but in one area we give 0.03 and it's one mil the whole thing so obviously it's it's quite a reasonable spot 30 pricks in that you eventually cover almost this much zone and then this much zone okay, is it painful after that?

21:35no, so post treatment pain it doesn't happen, discomfort at that time will happen, because lidocaine happens, so until it will get affected by it, after that, there can be a little soreness feel on the day and the next day okay, a little bit soreness, means you'll feel something happens on the chest and because this is injectable procedure, you can have little bruises every time, you can have blood will be a little bit of a pin point. We don't put this very deep. So, there's no chance to get more blood. Needle, I've told you, is very small. It can be bruised, which we say, we can study it. It can be used somewhere and it goes off in some time.

22:16After maybe 48 hours, you can conceal it also. 2-3 minutes. Got it. Which types of skin boosters are? In India, mainly, there are hyaluronic acid skin boosters. and this term skin booster came in 2014 okay in the hyaluronic acid domain everyone's hyaluronic acid after that the other hyaluronic acid content varies all of them now there is another segment which we call PDRN polydeoxyribonucleotide its DNA fragments these are derived from salmon fish and then there is one more which is called NCTF skin segment or new cellular treatment factor like this these are also some segments majorly 3 types which is the best?

23:07hyaluronic acid is the most researched and used so I think it's quite a no brainer that if you want to do something which is a lot of research backing you choose hyaluronic acid first also before we go on hyaluronic acid is the most long way because it's two types cross-linked and non-cross-linked Cross-link means it will sustain. And when it gets laid, it will be long. If I ask you, how many times it will take 40-50 years to take it? You'll say, you'll take a little bit. So obviously, you would want something which stays, right? So you tend to choose something which is more sustainable for your patient, obviously.

23:48And some are non-cross-linked. Non-cross-linked will be maybe a little more reasonable. But it'll go off faster. so you'll have to get it repeated again and again cross link how much time will it go? non-cross link 6 months claims are there cross link and non-cross link it goes in a month every month and how much price difference will it be? not much but yes maybe few thousand rupees uptown how much cost skin booster treatment? it will vary from Tibet you put it big big anywhere between 12 to 15-18 thousand rupees is one syringe of a skin booster one syringe means one ml one ml so if one session is two to three ml 36 thousand 35 thousand 40 thousand 30-40 thousand this is cross link non cross link 25 segment and it is not necessary that we will do in syringes all non cross link syringes in the vials also so you can a little bit vary that amount for your patient okay and this price can even go down actually depending on the amount you're doing with the non-cross-linked can be substantially less it can be even you can do one session in let's say 10 ,000 rupees also let's talk about cross-linked you're saying if it's better or better then talk about better people for people correct and that 30-40 ,000 range you charge that much that this standard across so that's why I gave you a range I think it varies from place to place in Delhi Mumbai so this range I think okay I'm saying I think this I know okay 100 % I can't say 100 % it's possible and 30-40 this is the top level brand and everything yeah you will be top notch something comes from this something comes from this maybe someone is offering skin booster somewhere in the posh area somewhere in a fancy clinic and they say my treatment is 1 ,000 ,000 my treatment is 2 ,000 ,000 and I use more good products what do you know what do you know you have to do example because that's how people sell expensive products is there possibility that it can be better product and it can be 1 ,000 ,000 you are not getting a better a product because i'm talking about one of the best products let's say this is what the charge of that segment would be okay maybe you'll get more of an amount maybe you'll get added benefits in the treatment of other combination therapies but if you're being told that i'm going to 1 or 2 lakhs for you i'll do one session skin booster then that's a bit of a cut trap okay then I will go to my okay

26:57I will tell you what techniques without skin booster that is what is happening we call it a micro droplet technique or a napaage technique we put small drops of booster in skin we can do it with syringe if someone's wedding is going to come and that's a week before me that I have to do skin booster so it may be that I will use any other technique in which I will not do so many tricks I will put it from one point in the face one side one point one side there is only a slight flaw that your depth gets deep but it doesn't matter you will get the skin booster and the trauma will be relatively negligible that will not see but the depth deep howzat what do you mean skin there are parts epidermis dermis dermis the bottom part where collagen elastin we have to add a little deep so if we use cannula from one point we don't live in that zone because there is a lot resistance so we go down a little dermis okay but there are innumerable studies which have used cannula and the patients have got a satisfactory outcome so like what you need in urgent one prick is better one prick is better and sometimes like someone's acne scars for example I'd use the one prick technique again because the cannula helps us to help acne scars to lose a little bit we call it subsistion that means we lose them so they are more amenable to any other treatment if someone has only under eye so maybe I'll use again the one prick technique because I don't want to give too many pricks here because skin is thin it will be bruised if it will be bruised then the patient is dissatisfied obviously right and they are not happy with the outcome complications are there?

29:01it happens wrong the most common complication is bruise it's a nail it's a nail and how long have it been? so if someone's skin is very thin lower face so many times 10 days can work and many times 2-3 days can also dissolve and some complications can be a big problem hyaluronic acid per se complications known especially the main which we are the vascular compromise vascular compromise means that if I have hyaluronic acid filler rather than a skin booster booster or skin booster also put in any vessel in a case of the wrong thing so that will give the blood supply to curb it will be close it will be close it will be possibility so that's an emergent situation so that is emergent what does it mean after that so hyaluronic acid is a molecule which I can dissolve so if if I have picked up quickly then I will dissolve it so that I will save the patient's skin if you know if you know someone who knows how to go that you have a problem first of all you will tell me that I have a pain here I have a cold feeling here I have a blanched skin meaning the skin of the skin will change a little compared to normal skin I have this like this, blood comes back to your skin.

30:39In that case, blood will come slowly and slowly until it's set in. These are the most common symptoms. And how many times it goes to know it? One day, two days later, or in that same time? 10-15 minutes. Well, it immediately, sometimes not. Because immediately, patient might complain of pain or discomfort. And because they have lidocaine, then it doesn't pick up easily. pain you don't know because you have anesthesia yeah so more than you know within 24 hours that this is happening and then you will come back and then what do you do when you come then you will call them that because you have to act and now what do you do and then we have a protocol which we follow which we can do which we can do and how much time protocol how much time process so within a few hours okay but it happens yeah, it's painful.

31:37What happens in that? What happens in that? There is an enzyme that helps to dissolve the hyaluronic acid. We call it hyaluronidase. So, you will put injection in? Yes. It needs to be put. And it will be very painful. No, it's not painful. So, we can mix lidocaine in that too. But yes, it doesn't have pleasant for anyone. No doubt. which can be bad. If 24 hours of someone has not been upset and ignored, that's okay tomorrow, tomorrow, tomorrow, tomorrow, what can happen? Like when the skin's blood supply is finished, then the skin's perfusion will be finished, then the skin is a strange necrost, like we call it ischemic.

32:16Like when there was a heart attack, what happens in a heart attack? One part of your heart stops getting blood and it stops working. So the same way the skin will start appearing weird and it'll stop looking like normal skin. Weird means dark. Dark, crusty. First of all, it's an evolution. First of all, pallor. Pallor means that the color changed. After that, mottled appearance. It means that it's a net appearance. After that, there are small-sized pustules. It's like pus is made. Little-lucky-lucky. We call them pustules. And then if you still neglected then it goes down the road of something called necrosis that means you lose the skin in that area then it is not if it's if you're too late then it's not salvageable too late how much is it?

33:09if you're seeing all these signs and you don't act that means you're way too late and how many signs do this? in one day two days five days two days? it depends on the extent of the insult if it's a small insult then it's easy sometimes if one branch compromise there is a hyaluronidase because it's a blind procedure now I don't know I have blocked I have some idea suppose my block is here now here this branch this branch this branch blood vessel here I don't know which one I blocked so I need to take care of all those if I hit in the first go the right one then I'm lucky blood flow back but sometimes because branches and all the anatomy are different when we learn medicine when we open the face if I open the face for learning 10 people's face we can't see 10 people's same artery same exact place this is God's way so if someone's branch is compromised so this is tough tough ہے.

34:17So, you have to have a complication in skin booster? There is not a person who practices aesthetic dermatology where there are complications. Now, in skin booster, there is never a complication in my skin. But yeah, bruising has been. One more common complication with skin boosters is that it can be seen a little bit like neck. A small skin booster feels like it. What do you do? You inject one injection, one drop, it will dissolve in that time. So, if we are seeing that problem here, it is very easy. I didn't see where the problem is. If it's in the vessel, then it's a problem. Okay. So, when you've seen any patient's complication?

34:57This one. Necrosis? Necrosis is not. Thankfully. Or, if someone's in the vasculature, I've seen some cases. Yes. Maybe you've done skin booster. Skin booster has not happened. Never. I'm talking about it. to give you a cream and anti-inflammatory antibacterial cream to put it so that there is no infection and typically oral medication doesn't need but if someone has let's say 4 ml so I'm telling that I'm going to take anti-inflammatory avoid makeup on that day if there are many supplements which are a little blood thinning when you have green tea so I'll tell them to take it easy on that maybe no strenuous exercise on the day and next day and no facial massages etc or facials throughout that week and I can use normal skin boost to normal cleanser or moisturiser tap water I tell the patient to avoid on the day of the procedure but you can clean your face with maybe bottled water or just a cleanser okay and like a gentle sensitive skin cleanser but it's not to put water in it?

36:38it's not necessarily, just clean your face after doing this after moisturizer can you put moisturizer? No. The cream we will give you with moisturizer mix. You can put it in the sun. And can you go to the sun? Yes, can you go to the sun. How many times after? See this is not compromising your upper skin. There is no issue honestly. The sun is going to go. But we typically as as a dermatologist you say after any procedure that if the procedure is very invasive so we say that this week take it easy, don't go out for a picnic let's say but if skin booster is like procedure I mean that day maybe but after that you can safely go out in the sun max is in a very safe zone so it's just one day just like today is done tomorrow will not go to the person can you swim after that not on that day for sure not after any injectable procedure so if you you don't want to swim in tap water so obviously don't go to swimming okay but yeah i would typically say again 48 to 72 hours before you go for a swim three four days and sauna steam no no avoidable again half hour so avoid unnecessary things of course if steam and sauna so there are patients who tell me why don't I can't go steam why don't I can't go sauna it's a part of their life literally so i tell them okay take a two to three day break and then go okay let things see you'll see it let things settle down a bit it doesn't damage the skin there's no side effect side effect is not something special mostly it's mostly good things honestly i mean you're putting hyaluronic acid in so side effects we discussed but other than that it's not damaging your skin in any way honestly okay it's feeding you are insulting the skin and telling it that collagen is made and hydrate that's what it is so anything is not like that there is no damage or something that is something that I am artificially injecting so after a while it will naturally make my skin so that's why I will get addicted to this no so yeah any good thing shouldn't be overdone so yeah what do you mean by overdone so we discussed right that you do it in a particular protocol and maybe maintain it once in 6 months if you're doing it then your body's ability to maybe produce a hyaluronic acid is definitely not affected okay and because you don't have enough of it tabi tum yeh kar rheo so kyunki jo body mein hyaluronic acid bantai wo bade jaldi break down ha jata hai okay so islehe yeh yeh cross linked islehe taak yeh joda raha thoda sa rahe islehe isko aise banaate hai i was reading that ki sone mein dikkat aati hai jav skin booster karaatai iske ya face you can't sleep on the bed like this you have to sleep like this so there is no issue you can sleep like this but because obviously the chest is sore so you might find it a little uncomfortable okay and I can't sleep like this because I'm a little scared yes that's it so if someone is very you know is very complicated then we give anti-inflammatory sometimes we give it that okay for the pain you may take this okay and skin booster stretch mark hurt it helps it I can't say hurt it I can't say hurt let me be quite candid about this stretch mark scar is now it is formed so it will not hurt no treatment can't hurt no it hurt it better it can't look peel laser stretch mark will so So, I'll tell you this too, it will look better.

40:32It will not turn. Is there any treatment that can turn scars? So, yeah. It will be better. Scars can be better. Permanently, anything. No dermatology, no plastic surgery will be done. Any plastic surgeon, if you talk about acne scars, for example, no surgery will not be done for that. Yes, I mean, if there are very deep acne scars, so someone has fat crafted here put a little fat so that scar will look better with that you can combine things but I don't think you need to weigh the benefits and the risks if the risk of surgery is more then it doesn't mean to surgery fair I don't know why I don't know why usually people say flaw is on the face I like that I find it pretty on people men or women if it has a scar or freckles or moles like these things i like which brings me to another line that every scar tells a story see that's it's a good story i think so it's a natural tattoo that you have gotten and it looks beautiful so for some people it may be the the extent of effect mentally of acne is compared to suicide so an acne scar acne so you can imagine sometimes when those scars on a person's face they are very distressed but yes if it's a scar here here here it might look rugged beautiful in a way sure it can be and i wish people would look at it in that direction more because it's a natural imperfection yes so it's fine how often it happens where patients come every very very frequent nowadays every day every second third day you're like why are you here?

42:24yeah and you're right there are some people who may come to your clinic every week that now what can we do? and you're also thinking now what can I do? what's that? you know you're thinking I was taken to an addiction doctor he is one of the top addiction doctors in the country and he talked about addiction very deeply addiction we are talking about western world we have studies that a common addiction in housewives is becoming getting treated by an aesthetic aesthetician addiction it's like it gives them purpose in life that they change something yeah possible imagine and I'm like wow this is going to be clinically people are doing and addiction doctors of the world are marking it as an addiction as an alcohol addiction not that severe but as it is addiction this is also an addiction honestly Raj there have been instances in my clinic when I am doing one of these realm of treatments aesthetic treatments not one time it has been happened and that patient breaks down it feels like I am doing or why am I doing and what is happening to me and so on and so forth.

43:54So the baggage is sometimes huge and I think with experience you start picking it up early but sometimes you just don't and then you realize it later and that's when you realize that this circumstance is also being an art honestly. Fair. And the younger generation body dysmorphia a big issue he is watching you all day on the face that I don't feel since he is completely normal and it affects their lives fair and it's insane sometimes it's bad but I think bad actors good actors society pressured actors these all in every field in every area I think needs to be balanced yeah and celebrities skin boosters definitely I mean not that I'm doing a lot of celebrity skin boosters but yeah at least as far as I know it's a very very common treatment and it's like if they're doing it every month is that a problem then so again if it's someone let's say if it's someone who's in the bracket of 45 to 55 year old and they're getting one ml of skin booster every month nothing will really go wrong i think it's perfectly acceptable every month yeah for let's say six months yeah and then give it a break for some time there's nothing wrong with it because one ml is barely anything and you're just sort of giving your skin a little push okay you know young insan obsessed with that many people are obsessed and obsessed with that one time he saw wow now my skin looks good and every month he comes to you so i think the onus lies with the dermatologist i keep and i reiterate this fact many times i think we should know that when we have to say it because i think we see it all over nowadays that overdone jobs and overdone and that's what people notice yeah i don't think any doctor in their heart wants their patient walking out like that but there's a very thin line at times which you cross.

46:11What is the thin line? Thin line is like lips already look good for example I'm not talking about skin booster now for a second that if lips already look good and patient has a patient that I want to do my lips now in my mind I'm thinking her lips look great but then you think okay maybe a little bit because you want to do your job so that's when you need to tell yourself that you know I think the proportions are right here and i need to tell her it'll look worse so and of course somewhere the skill as well as how much you are into that process matters okay you know and i always say even the best of the best of doctors can sometimes make a mistake they are humans right yeah yeah so that's that's possible so that thin line is ki there's a small line of going wrong overboard and not and once it goes overboard that's when it looks odd in a skin booster domain i think going overboard would mean you're doing way too many syringes in one session okay or if you're doing let's say four syringes of a filler and putting a skin booster on top kai bar ayesha hoti ki over hydrated loko jati hai to thoda puffy lagna lagta hai face over the next few months okay and any person who you recommended is you 2ml and he force that no I want to get more glow so 5 6 7 whatever is that possible so what I tell that would be better that skin 5 6 more so I say that in one session let me assess and let you also see especially if this first timer then I will tell I'll tell you first, see how you're feeling.

48:03If you're feeling good, you can always add a couple of months later. Okay. You see, with any of these things, addition is easy. Deletion and going back becomes a challenge. So take your time and no need to hurry into things. Okay. And then, and you'll get a reasonable feel in 2 to 3 ml. You'll know what it's doing to some extent. You'll feel it. It means you'll yourself feel it. You will feel them. You yourself will definitely feel. Whether others tell you. Sometimes. No, it doesn't happen. I can say this. No, I think what the problem is. Sometimes a lot of people want. That they say to them. Then they feel that I have done something.

48:46Okay. You know, Doc, no one told me. Anything after my booster. That you're not looking nice. There's no glow. There's nothing. But the skin's looking decent. even when the patient comes back. So I think the expectations are for everyone varies. Sometimes they want that that friend should tell them that friend circle that wow man you're looking great. Yeah. And sometimes but you will definitely feel the difference because you can feel it right. Others are not going to feel your skin. They're just seeing what's happening. As a touch. You can perceive it. Skin boost after shaving can you shave the kids?

49:22Yeah. One two days later. Yeah one two days later because a little there'll be slight soreness so maybe you want to do it in a day or two got it tell me men versus women kiski skin zahla kharaab hati hai men ki skin or women ki skin skin mein kuch kuch differences hotte hai jaisi kya sabse pahla to hair right so your hair glands and the oil glands are more active in men okay obviously males mein admiho mein muscle thudhe zahada active होंगे या बलकी होंगे तो अगर कोई treatment कर रहे हो तो कई बार तुमें थोड़ा जादा dose चाहिए एक आदमी के लिए as compared to एक woman के लिए. Skin booster में जादा तर same dose चाहिए होता है बट कई बार क्यूंकि आदमीों की skin कई लोग होते है जिनकी बहुत robust skin is heavy.

50:11If you touch it on top it is leathery. In their case if that person will tell me that I have to do 1 ml then I will say then don't do it. Because there will be nothing feeling and it will feel that I will spend money. So in this case there will be a little vary. In skin booster patient selection is a little crucial because if you come to me your skin is good already so you are a good candidate for skin boost. Because I know that this will be done in the work. Okay. But if someone's skin is very dehydrated, then I have a little expectation that this is a stepping stone. This is how we're doing better your skin framework for your skin.

50:52That's why we're doing more work. God. Before you get to get to a level. So to put it, maybe in layman and scientific balance terms, our skin cells are and they hold a cement. Like a wall is. on the wall there are bricks and cement right cement is holding the bricks same way our skin structure brick and mortar so this cement it strengthens a skin booster so from that perspective I am saying that this framework is good so it will make a setting got it so women it feels less than men I mean if I have to generalize maybe I will say that let's go women it will be a little use and overall in a long period of time also sorry men in a long period of time many times face broader also bigger so many times you should more in one zone same with hands many times when you work on your hands suppose I have a big man if your hands are so big so many times it should more and overall in a long period of time if there are 18 to 50 year olds in this men's skin is worse than women's skin that we start from 18 when both skin is flawless and 50 to 50 years ago, the skin has got a little damage that it's worse than women's skin we can't generalize this, it's your habits mostly lifestyle in fact, in fact, if you look in the literature there are two twins exact same but one's skin is very bad one's skin is very good just because of their habits and let's say the time spent in the sun one used a sunscreen one didn't use a sunscreen so they are showing examples got it so it depends on a much more than just that genetically your skin is so bad but like I said women go through more changes because their hormonal cycles are a lot of changes changes in their body imbalance up and down that's true so maybe maybe from that perspective to some extent but i don't want to generalize generalize this is more like a spin he is a lot of bad but yes hormonal changes do affect the skin sure because it was a Harvard medical study in 2022 where they said that if we talk about aging, then after one age, women are more old than six to eight years.

53:33Then after hyperpigmentation, then after one age, it becomes more than one age. This is usually around menopausal age. Yeah, if you look at the broad picture, maybe yes, I would say men tend to, if I have to, tend to age a little better than women. Sure. And pigmentation also, because sun exposure or lifestyle, It's not because of menopause or periods or PCOS or pregnancy. All of these causes are not in men. Yes, yes, yes. Do you have so many patients? How many percent men and how many percent women? I think the realm of dermatology of seeing patients changed a lot over the past 20 years. Before I had a dermatologist who had a person who had said that I had a problem and I had to do this.

54:21today people come to see me in that domain of course women are now more but men are slowly growing but I would still say maybe a 70-30 70 women 30 men and skin boosters who are more women 70-80 % women yeah more women more women 90-10 actually men don't know many times so they have to tell them Some women know that they come asking that I have to do this. But one thing is that if a man says that this will be your work on top of the top of the top of the top, he says that they will do it now. This is a little easier with him. That okay, if he does work, let's do it now. Because he has time to do it.

55:09So I want to go and I want the result. With women, they sometimes want to know way more. what is, why is it, how will it happen, how much pain will it so on and so forth I have a lot of doctors I have a doctor saying that he will have to do allergy tests or blood tests okay, look now, if you come here, you do it like I went to because I was a chicken gun after chicken gun I have a chance of reverse arthritis and then after that there are a lot of complications complications complications on there right so I had ENTK that he said that I don't see any signs so probably put a camera in and see it and then he will do it so tell me when you are free you have to come in 5-7 minutes and it doesn't take much time but if you are ready I was like do it and he's like I mean do it I was like do it then he was like do it then he was like he was like I'm not going to do it.

56:07I'm going to do it. It's like that attitude is very, I was like, yeah. Look, I'm going to get done. Done with it. Okay. Can a pregnant woman get skin boosts done? No, I would not recommend it. Okay. Pregnancy, lactating, I would. See, no one has done studies on these things. So for obvious reasons, why do you have to do it at that time? so I would say and I think every dermatologist would stay clear of doing anything invasive at all even if it's minimally don't do that at that time so when you're pregnant you don't have to do it after pregnancy because then you actually you're breastfeeding so you should do it there's no problem but again I would say that stay in two times I mean we say relative contraindications that don't do that at that time there's no data there's no problem why do you risk it?