Paula's Personal Cosmetic Surgery Secrets

Airdate: 9/11/12

Paula tells all about her recent cosmetic surgery experiences. Discover the pros and cons of a neck lift, laser treatments, fat injections and more.

Paula Begoun: This is Paula Begoun. I'm part of this team that does BlogTalkRadio keeping you Beautifully Informed with Desiree Stordahl and Bryan Barron.
00:00:27 And it's – god it's been way too long. And I'm excited! I'm excited to be talking again on the radio show and get a chance to talk to our callers and listeners to talk to them and share beautiful information. We do facts and share research with style and aplomb and keeping you beautifully informed is my favorite thing to do. I've been doing it for 35 years with my first book, "Blue Eye Shadow Should Be Illegal." And 19 – actually I think it's 20 books later with the ninth edition? Tenth edition?
Bryan Barron: 9.
Paula Begoun: What edition?
Desiree Stordahl: 9.
Paula Begoun: I can't even count anymore.
00:01:11 It's the ninth. That's because, Bryan, and Desiree, wrote most of it. The ninth edition of "Don't Go to the Cosmetics Counter Without Me." So, we're talking – we got stuff to talk about. So let me jump in because I feel like I could wax nostalgic right now because any time I talk to our fans and our customers and our new listeners I just get emotional.
00:01:36 I got to – so, it's just been that kind of year. So, a quick rant. I don't want to rant too much. Just a quick rant. Got this article in one of the many journals I get about different things on beauty and what's going on in the beauty industry. And there is a new wristband, actually a couple of them that are coming out or already being sold that wrap around your wrist, kind of like when you go to a concert or Disneyland or something, or some kind of event where you need to go in and out and get back in and that looks like you belong, that little wraparound plastic thing.
00:02:19 But this one is such that it's supposed to alert you when it's time to get out of the sun to avoid burning or potentially carcinogenic sun damage. That's what the claim is. What makes it so incredibly bad, just bad to consider, is that sun damage begins within the first minute that the skin sees the sun. And the bad rays of the sun come through windows. I don't even know what this thing is about. I can't think of a bigger waste of money. If anything people would put it on and think that they were being, "Oh wow, now look, something's happening."
00:03:01 Once something started showing up on that wristband you're late. You've already been damaged. Forget it. It's not – yeah. Big problem. Don't buy this.
Bryan Barron: It's almost like putting – oh, I won't say it – but I was thinking in terms of birth control and remembering it after the fact.
Paula Begoun: [laughs] Actually, you're right. We won't go there but I think it's a perfect analogy.
00:03:33 Sun damage – I know, everybody who listens to us knows this one, but that little wristband isn't going to help you take any better care of your skin. Instead you shouldn't get a tan –never change color because of the sun. Wear sunscreen. Seek shade. Okay. And bad rays come through windows. Okay, enough said.
00:03:56 Let me rave about a product. I have a new best friend that actually isn't a Paula's Choice product. It's a product from Victoria's Secret called VS, which stands for Victoria's Secret, Pro Pout FX Fix Lip Primer and Definer. And people think I have long names of my products! So what makes this lip primer so wonderful in comparison to a lot of them that are out there is it goes on silky smooth. I mean silky smooth.
00:04:33 It really does work in a spackle-like manner, but it just doesn't feel thick. I can't account for why it doesn't feel thick, but it doesn't. And it really does prevent lipstick – not greasy lipstick, and not greasy lip gloss, but matte-ish kind of lipstick from bleeding into the lines around the lips. It is my new best friend. I have had problems with bleeding lipstick from very, very young. Very, very young. It's only gotten worse as I've gotten older. And the other thing that's really good about this is that it's thicker, it's more like a fat pencil, which means it works easier to fill in the lines around the mouth.
00:05:19 And it twists up. You don't have to sharpen it! Desiree, what was that product that we rated well except you had to sharpen it? Do you remember the name of that?
Desiree Stordahl: It was Make Up For Ever Lip Line Perfector.
Paula Begoun: Right! It was a Make Up For Ever lip liner.
Bryan Barron: Typically what happens is because, as Paula mentioned, she's had this issue with lines around her mouth from a very young age, and lipstick bleeding into them. And so whenever we come across a pencil or primer type product from a company, I mean, we'll kind of look at it and get a general impression of it, but we always have Paula test it because if it works for her it's almost guaranteed to work for anyone else.
Paula Begoun: So the product from Make Up For Ever that is a similar kind of lip filler kind of product, I mean it works.
00:06:13 There's no question it worked, but it was a pain. It broke. It needed to be sharpened. Any pressure, the tip came off, and you would sharpen it more. I basically used one up in about two weeks. And then it would scratch because the edge would get sharp, the edges around the pencil part would get scratchy around the lips. It was a pain. And this just – thank you Victoria's Secret. We don't love everything you do, but this one you scored and it's only $12. And I had Desiree buy me a whole bunch.
00:06:54 Okay, all right. So let's talk about facelifts. Let's talk my, uh, my little surgery that I've – in fact I just –
Bryan Barron: Yeah. Just a simple outpatient procedure.
Desiree Stordahl: Yeah. I wouldn't quite call it little. There were quite a few things going on there.
Paula Begoun: Yeah, it was – you know, it is amazing that it is an outpatient thing. But, you know, people, they don't want you staying around hospitals or places to get sick, not to get healthy. But let me just remind everybody that they can call in to ask questions at 347-426-3783.
00:07:38 And where else can people as us questions? On Facebook or email?
Desiree Stordahl: Yes, exactly. They can also ask us questions on Facebook and I'll be monitoring that all show long.
Paula Begoun: Okay. So, I did have a facelift. A classic facelift. A classic lower facelift actually; let me put it that way, which is basically cutting and pasting to lift up the skin along the neck, reposition the muscles, and tighten everything up in general. And that is a scar, a very tell-tale scar that goes around the ear and a scar under the chin.
00:08:20 So you lift the skin and muscles of the neck that go straight down from the face up from the chin down gets lifted and tightened. And then the neck skins that kind of fall along your jaw down, and that whole jaw line area gets lifted. The area along the jaw and side of the neck, that's what gets wrapped around the ear. And then the skin that is what some people would call the turkey neck part of your neck gets lifted and tightened with a scar that is tucked along the jaw area.
00:09:00 So that was a major part of what I had done. The other thing that I had done at the same time was a classic CO2 laser. A CO2 laser procedure is a very deep penetrating abrading laser procedure that has risks. Well, everything has risks. The surgery has risks. All cosmetic corrective procedures, even those benign have some risks.
00:09:29 The rule of thumb is the less invasive the procedure the less – no risks and there's not as much benefit. More risks, you get more benefit. Obviously cutting and pasting your neck looks almost back to when you were younger, less (sic) invasive and it just takes longer, but you can have great results. It's just how much results do you want. So I had my neck lifted, my jaw tightened, muscles repositioned.
00:09:59 And then I had the deep laser resurfacing actually almost over my entire face, including my eyes. I did not have a Blepharoplasty. I did not have my eyes done. I don't have – I don't really have sagging heavy skin around my eyes. The other thing I had down though at the same time, so I had the facelift, the deep laser resurfacing over most of face including the eye area, and then I also had fat transplant. It's a type of dermal filler.
00:10:32 And what a fat transplant is is during the procedure they take fat out of, like a liposuction – well, not like a liposuction – a liposuction – and they take fat out from the inside corner of your knee. That' supposed to be the best fat for this kind of procedure. And while you're under the surgery they take this fat out and they process it to then be injected back into your face. And what they do is they inject it around the eye area and along the cheekbone to lift that area up without surgery.
00:11:11 And I would say that of all of the things I had done, the one that I'm not the most – I'm thrilled with the way my neck looks; I'm thrilled with the way my jaw looks; I wish I could still get some feeling back! I have almost feeling, I mean, the feeling around my ears – that was weird. Couldn't feel my ears for the longest time.
00:11:35 It's been 3.5 months by the way. I can feel my ears now. The one part of my face that's still pretty numb is right at the corner of my – the outside corner of my jaw is pretty numb. When my boyfriend kisses me I can't quite feel it, yet. It's a lot better, but I still can't quite feel it. But in terms of appearance and healing, I need to be – I really should be using our scar gel.
00:12:04 I can't, you know, it's like that saying that the shoemaker's children don't have shoes. We have this new scar gel I formulated with Kate, my product development director. I think it's one of the better products I've ever made and I'm just not using it regularly. I don't know why I'm being so…
Desiree Stordahl: And just so people know, that product is not out yet. It's still in development.
Bryan Barron: It's in the final stages of development and if everything goes according to plan, and we expect it will, it will be available next spring.
Paula Begoun: Next spring? Yeah, next spring. Okay.
Bryan Barron: I know you always want to launch everything right now, Paula, but patience is a virtue.
Paula Begoun: Yeah. You're right. Okay, patience.
00:12:57 But the under eye area, to me the fat transplant isn't holding up as well as I had hoped. It's still pretty smooth-looking. I just – I don't know. I'm not as thrilled with it as I am with other aspects of how my skin looks and especially the upper eyelid area. That really did get tighter. But the lower eyelid area just not as thrilled. Don't quite know – you know, I'm going to wait another month. And, I don't know, I'm just wondering what else could be done.
00:13:33 I don't want to get – I don't want to be a facelift, a plastic surgery/cosmetic procedure junkie, but I'm curious if it could look better without looking plastic or overdone. So that's what I had done – I chose the plastic surgeon pretty much like how most women choose plastic surgeons, is I knew somebody who had a facelift that I thought looked incredibly successful.
00:14:07 And the practice – the Naficy Center here in Bellevue, Washington, that's just outside of the Seattle area, had specialists. The doctor who did the face and there was a separate doctor who did the eyes and a separate doctor who did the work from the neck down. I liked the idea that their center specialized. And then I went online and did research and saw what other people were saying about this physician.
00:14:33 He got awards. Just pretty much how everybody should go about looking for a plastic surgeon. I made sure he was accredited. And went with this Dr. Naficy after checking out a few other surgeons. And basically it was because my friend had a great facelift. I chose what I had done – some of it I already knew but I did go with some of the recommendations. The fat transplant, I would not have thought of that. I did go with his suggestion.
00:15:03 I knew I didn't want a Blepharoplasty, an eye tuck, because I knew my eye wasn't that aged. So, I think it all went really well. The one thing I did have done that is unique to the Naficy Center is I had – their eye specialist, their surgeon who does the eyes did a special technique of tightening the back corner of my eye.
00:15:30 You wouldn't have noticed what he did, but because of the way laser – you know how you see some celebrities that have had plastic surgery done and their lower eye looks pulled down?
Desiree Stordahl: Right.
Paula Begoun: Do you get what I'm talking about? You know, somebody is tugging on their lower eye all the time. So, when you have laser resurfacing or some procedures, they can tighten the skin to the point where they actually start pulling down on that eye area which is why you get that look.
00:16:01 So what the Naficy Center does is their surgeon who specializes in ocular surgery did something to prevent that from happening. So, that's some of why I could have the deep laser around the eye and not get that pulled down look. And now I wouldn't have known to opt for that. So those were two of their suggestions. I knew I wanted the deep laser, as long as I was out, why not, and the neck lift, and the tightening of the jaw.
00:16:34 So that was that combination. And then as many of our listeners know, over the years I've done different things – Botox. I have had dermal fillers. I have had Fraxel. Over the years I've done various things. I'm hoping this is the only – I don't want to go through this again! I think I'm done. I don't know that I'm done with Botox , I don't think I'll be done with Botox. And the type of dermal filler I had for the lines around my mouth and between the brow is a semi-permanent filler.
00:17:12 It's called Artefill or Artecoll. And so I've only had that done twice in 11 years. So, as high maintenance as I am, I like to think of myself as being as low maintenance as I can be for being high maintenance. Does that make sense? I don't know if that makes sense.
Desiree Stordahl: That does make sense.
Bryan Barron: You're on the low end of high maintenance.
Paula Begoun: I'm at the low end of high maintenance!
00:17:36 Because the only other thing is that in terms of skincare, I know that – and anytime that I go into a derm office or a plastic surgery office, everybody comments on how good my skin looks. I know that – and it's a shameless plug for Paula's Choice, but I know that a lot of – I definitely do things to my face that are cosmetic corrective procedures.
00:18:04 But I also know that the quality of my skin, and the glow it has, and the smoothness, and the lack of brown spots, and the even skin tone, that that look, that part of my skin appearance is from my products. And the fact that I heal so fast and the health of my skin, now some of it is that I do eat a really good healing diet, you know, anti-inflammatory, antioxidants, omega-6 and fish oils, all that stuff.
00:18:33 And I don't smoke. I stopped drinking two weeks before my procedure, and I didn't drink for at least six weeks afterwards. Slept upright. But in terms of the general smoothness of my skin is because of the exfoliants I use, my BHAs, and the fact that none of my skincare products contain irritants and they're loaded with healing ingredients. That pretty much sums up to have face procedures, and to have great healing, and to have great skincare all the time.
00:19:06 Now you do have to follow what your doctor says. Unfortunately I think some of what they recommend sucks. But, you know, you got to go with your doctor because sometimes they sell you products that are too expensive and not worth it and not all that well-formulated. So I still think you should check out how we review a lot of those products on Beautypedia. But overall I am thrilled with my results. I do think I look younger.
00:19:31 You know, if anybody wants to check out my new face, my BHA9 product that we've launched now is up on our website at PaulasChoice.com and the video I did for it that's up there – actually, did we do that video last month, Desiree? When did I do that video?
Desiree Stordahl: Yeah. It was a little over a month ago. It was back in July.
Paula Begoun: Back in July?
00:20:01 So I look younger. I do look younger! It's cool. So, take a look and Desiree and Bryan, let's take – unless there's another question you guys have.
Bryan Barron: Oh, Paula, you didn't – unless you wanted to not mention, I thought we were going to talk about your recovery?
Paula Begoun: Oh, maybe I just kind of put it out of my mind. Maybe that's why I wanted to go on. It was terrible. It was terrible. It was the worst – oh my gosh.
00:20:37 How do I say this? It was terrible. I don't know what I was thinking, but it was... – For the first two weeks I thought, maybe even the first three weeks, I thought I was crazy. And what had I gotten myself into? I was in pain. I was on three different kinds of pain killers, and Valium, and it was so difficult on my boyfriend.
00:21:08 Really, I should have considered doing it when either he was – sent him out of town, or I was at one of those medical spa hotel things where you can recover outside of your home. The laser procedure in particular, because it's a deep laser, ablative laser procedure, I was red. I mean, Desiree helped take care of me. Desiree, I was red, swollen, and oozy.
Desiree Stordahl: Yeah. And part of it was that we had to keep putting Vaseline on your face after the laser procedure. And so that just kind of made you look goopy even if you weren't naturally doing that. So, yeah, it wasn't a pretty sight, but man you were a trouper. She was calling me by different names and just having a heyday with things. She was in pain, but those pain killers definitely helped.
Paula Begoun: I lost 7 pounds. I couldn't eat. I couldn't get my mouth opened. I couldn't see for three days.
00:22:09 My eyes were swollen shut. I think a lot of that might have also been the goopy Vaseline thing. But I don't remember that so much. It was difficult. Now, obviously some people heal differently; not everybody heals the same way. I'm sure there are people who have had facelifts that are sitting and drinking champagne the next day and having a good old time.
00:22:36 I – yeah, that wasn't my experience. It was very, very difficult. It was very, very difficult. I did get, because it was so difficult, my boyfriend, and Desiree you couldn't live with me. We did bring in a home care person which helped a lot. It took a lot of pressure off my boyfriend to have to take care of me.
Desiree Stordahl: Well, you know, all the directions for the different medications and different instructions for tending to the procedure areas, it was like reading a thesis paper. I mean, it was a big stack of papers. So, it was very wise of you to hire a nurse as well to come in, because that's just a lot to take care of.
Paula Begoun: Because there was lots of medication.
00:23:21 And there was two different kinds of pain killers because you couldn't take – when one stopped working you couldn't take it again that soon, so you had to take another one. Yeah, it was complicated. Now, I didn't know it at the time because I was so out of it. But it took a good month for me to appreciate, for me to actually say that I'm glad I had done it. Because I also looked odd for a period of time. I was swollen. I didn't look like me for about – what would you say, four or five weeks before I started looking?
Bryan Barron: Yeah.
Desiree Stordahl: Yeah. I think it was about the fourth week when it started to look really like you again.
Bryan Barron: I remember, your first appearance at the office after you had the procedures down, I know you kind of prepped everyone because you had to have been thinking, "Are they all just going to look away? Is everyone just not going to make eye contact and just say, ‘Good morning, Paula. Have fun.'"
00:24:27 But you actually looked pretty good. I mean, you could tell that you were still healing and that there was some swollenness, a little bit of discoloration and what not. But honestly you looked better than I thought you would. I was kind of prepared for something worse.
Paula Begoun: Yeah. I'm a little – yes. But I am, I'm thrilled. I do think I look younger. There's no question about it. I think that going, as a woman of almost 60, I'll be 59 in November. I would say that I probably look like a woman in my late 40's now.
Desiree Stordahl: Yeah.
Paula Begoun: As I look at myself objectively. And I think in dim light maybe even early 40's.
Bryan Barron: Paula, I may have spaced on this, but did you talk about how you prepped your skin?
Paula Begoun: Well, basically I know – they talked a lot about what you had to do, but my skincare routine pretty much followed some of what they were saying. And I know even more than what they were saying. Because I already used – actually, they didn't even say anything about fragrance-free products.
00:25:42 But, you know, they wanted you to pare down what you were doing and not used fragranced products, although I don't think doctors really know what a fragrance-free product is, because a lot of plant extracts, even in products they sell can be irritants. So I basically just stayed using the skincare routine I always use. Now I don't use Retin-A or Renova or other tretinoin products. And I don't use benzoyl peroxide for acne. I use my BHA.
00:26:12 So there would be some question about whether or not your should continue using a BHA because it is a salicylic acid product and you're not supposed to take aspirin. I don't think it's the same issue with BHA topically on the skin, but that would always be something you would want to check with your physician. So, no, I just basically stayed doing what I did.
00:26:31 Now I didn't use our Redness Relief Treatment because of the aspirin, because it does contain aspirin. And our BHA is just so much better for a healing process like that because it helps with cell turnover. And part of what's happening as you're injuring the skin, especially for scars and everything, you want to help get the built up dead skin cells off which is why I think I healed so well. I definitely healed.
00:27:00 Well, I do from all the types of procedures I've had, especially Fraxel. So, I do like my products. I do like my products! So let's start with callers. Desiree, first caller.
Desiree Stordahl: We have Nina from New York on the line.
Paula Begoun: Hi Nina.
Nina: Hi, how are you? Thanks for taking my question.
Paula Begoun: I'm glad to be talking to you. What can I do for you?
Nina: So I'm starting to see fine lines around my mouth and eyes. And they tend to be more prominent when I wear makeup versus when I'm bare faced.
00:27:34 So my question is do I need some kind of procedure to prevent and correct them, or am I wearing the wrong kind of makeup?
Paula Begoun: Nine, how old are you?
Nina: I'm 34.
Paula Begoun: You're 34. And have you been a sun baby?
Nina: No, not at all. I actually wear 45 in the summers and 35 in the winters.
Paula Begoun: So I would like – so this is my new little kick when young people are telling me that they're getting lines and wrinkles as young as they are is that I really want to encourage you to take a look at the ingredients in your sunscreen and consider for your face, not from the neck down so much, but from the neck up to make sure that you're sunscreen contains titanium dioxide and zinc oxide.
00:28:22 It's fine to not use it if you have a problem with it. There's nothing wrong with the other sunscreen ingredients, but titanium dioxide and zinc oxide, I don't have a lot of research to back it up, this is more my personal strong feeling that it makes the biggest difference, the biggest impact on reducing problems. In terms of fine lines, depending on how heavy the foundation is, they will look more prominent with certain kinds of foundations. The more coverage, the thicker the foundation, generally the more obvious it will make lines look.
00:28:58 I'm going to send you our Barely There Sheer Matte Tint Foundation. It has a little bit more coverage than some tinted sunscreens have, but it's light. It's sheer. And then I'm also going to send you my Healthy Finish Pressed Powder with SPF 15. So, that way you can layer up your sunscreen. I'm a big believer in layering. Especially with powder you can touch up your makeup and get extra sunscreen at the same time because you're applying the pressed powder with sunscreen.
00:29:35 Now in terms of the lines, when you say fine lines, are you using any exfoliants? Are you using any of our exfoliants?
Nina: I am not currently using any exfoliants. The only thing I use is a baby towel every other day to exfoliate my skin.
Paula Begoun: A baby what?
Nina: Like a towel for babies, like for buffing my skin. It's like a wash cloth ultimately.
Bryan Barron: Basically, Paula, it's a very finely textured wash cloth that you would use on an infant's skin. And they are definitely softer than a traditional cotton washcloth.
Paula Begoun: Okay. So, Nina, give me your skincare routine.
Nina: My skincare routine is I wash my face every morning and every night with the Clean & Clear Sensitive Skin Foaming Face Wash, which I know you are a fan of. And then I don't always use a toner, but when I do I use the pore one that you suggest, the pore perfecting one.
00:30:38 And then I tend not to put on lotion.
Paula Begoun: Nina, is that the one from Neutrogena you're using?
Nina: No, yours. The pore minimizing one that you have.
Paula Begoun: Oh, from the Clear line?
Bryan Barron: No, I think the Skin Balancing. Nina, does that sound right?
Nina: Yes, that's the one. Correct. And then I tend not to put lotions on because my skin tends to be a tiny bit oilier.
00:31:03 So it feels tight for just a second and settles in. In the mornings though I do wear SPF by Oil of Olay.
Paula Begoun: That's your whole routine, right?
Nina: That's my whole routine. And then I use eye cream.
Paula Begoun: Whose eye cream are you using?
Nina: I use the Clinique one. I think it's called All About the Eyes.
Bryan Barron: Yeah, that's definitely a more popular one.
Paula Begoun: Is it a jar, Bryan, or is it a tube?
Bryan Barron: It's in a jar! Yup.
Paula Begoun: Nina, okay, Nina, we're going to help you out here. Guys, everybody listening, listen up: No jars! The only jar should be lip balm. But that's it, no jars. Nina, why shouldn't you use a jar? Tell me, what do you think? Have you been listening to me?
Nina: Absolutely.
Paula Begoun: [Stuff] is going to be wasted in a jar.
Nina: I know. I have to give up that eye cream. I know.
Paula Begoun: Actually, you need to throw it out.
00:32:02 So let me tell you why, just to remind everybody, is because if it's well-formulated. Well, whether it's well-formulated or not, but it should be – let's say it is well-formulated. When good ingredients are in a jar they don't stay stable. All of those wonderful ingredients, and Bryan, is the Clinique eye product, All About Eyes, is that well-formulated?
Bryan Barron: Typically, yeah. And I get why a lot of people like it because it's silicon heavy and it's got that silky cream feel and it has that texture that has a temporary filling effect on lines.
Paula Begoun: Oh, okay.
Bryan Barron: But, yeah, like Clinique moisturizers, they're using a lot of very good ingredients which is why that brand in particular, when they came out with their Super Rescue Moisturizers in a tube, we thought, finally. You know, they're getting away from the jars. And in short order the jars were back.
Paula Begoun: So the problem is that the great ingredients for skin don't stay stable when exposed to air.
00:33:09 It's just that simple. Not to mention, you stick your finger in, that is unsanitary. It transfers bacteria and that further breaks down the good ingredients. It's a problem. The good ingredients – I mean, I'm sure it still feels nice on skin, but the healing ingredients that are working below the skin just would go away once the product was open. They just don't stay stale.
00:33:33 So the Olay, the Oil of Olay sunscreen you said you're using, you said it's an SPF 45?
Nina: No. The 35 in the mornings. It's that one that Oil of Olay, I think it's called DNA Repair or Ageless Repair, something along those lines. It's not the one that comes in the white bottle. It's like a smaller tube.
Paula Begoun: Bryan, would you double check and see if that has titanium dioxide and zinc oxide?
Bryan Barron: If it's the one I'm thinking about it has Avobenzone.
Paula Begoun: Okay, so the problem with using just a baby towel to exfoliate your skin is it's just [unintelligible] exfoliation. You're just rubbing off some very superficial top layers and just because of sun damage and growing up you need a bit more than just that scrubbing action. Even when it's gentle.
00:34:28 And I use a washcloth, too, on my face, but it's just not enough in terms of really getting that even, smooth, dead skin cells off, because it's that build up of dead skin cells that is most responsible for the appearance of those fine lines you're talking about. So I'm going to send you one of my 1% BHA lotions. Actually, let's just do the 2% liquid. Just use a little bit of it and give it a shot just around the areas. Well, wait. Bryan, what do you think?
00:35:06 See, now I'm backtracking. Which BHA should we have Nina try?
Bryan Barron: Nina, are you struggling with breakouts?
Nina: No. Not at all really. My skin is pretty clear.
Bryan Barron: Okay. Paula, I would say either start her with the 1% lotion or the 2% lotion if she wants something more moisturizing.
Nina: So this isn't a scrub? By exfoliant you don't mean scrub, do you? You mean just like a cream?
Paula Begoun: A topical lotion or gel or liquid.
00:35:37 We have three different kinds. One is a lotion; one's a gel; one's a liquid. These are alpha-hydroxy acid or beta-hydroxy acid exfoliants. And they exfoliate the skin chemically. They gently move built up layers of skin. They help skin do what it did when it was young, which is help skin cells un-adhere to skin and jump off the way they do on parts of your body that haven't seen the sun and don't have fine lines, or crepiness, or discoloration because they haven't seen the sun.
00:36:13 So I'm going to – we'll go with the 1% lotion to get you stated. Stay using the Clean & Clear. I think that's fine. Do stay using my Skin Balancing Toner. Add that 1% lotion. I'm going to be sending you my Barely There Sheer Matte Tint with sunscreen and the Pressed Powder with sunscreen. And I think that those fine lines – oh, you know something, let me also send you my Moisture Boost and use that one, my Moisture Boost Moisturizer.
00:36:40 Use that one around your eye. It looks like it's a face moisturizer but it's meant to be used wherever you have dry skin. It can definitely be used around the eyes. And see how you do with that. I think you should have a lot of luck and you'll be happy and I think the fine lines will look much less. And we'll get you going on some better sunscreen. Thanks for calling Nina.
Nina: Thank you so much.
Paula Begoun: Take care, dear.
Desiree Stordahl: Okay, next we have an email question from CD asking, "When does Botox not work? Why does this happen? And is filler the only subsequent option?"
Paula Begoun: No, no, filler doesn't replace Botox because you can't fill the forehead. The major place Botox is used for the lines around the eyes, the crow's feet, and the lines along the forehead.
00:37:32 What they call the 11 lines that are between the brows, those can be filled with dermal fillers, but often they use both because those can be very stubborn lines for some people, even when you shoot with Botox. You can still have those lines, so they often, for the 11, the lines between the brows, use both Botox and dermal fillers. But you can't use dermal filler on the forehead and you can't use dermal filler around the eyes.
00:37:58 So Botox doesn't work for many reasons. Many people would say it's the practitioner, it's the way they're injecting it. They're not injecting enough. They're using old Botox; in other words, once Botox is opened it should be thrown out, not put back in the refrigerator. But for cost-effectiveness sometimes they'll do that. They'll stick it back in the refrigerator and use it again the next day. That, or two days later, or over the weekend, the next Monday. That's always a problem.
00:38:32 There are different reasons why it might not work. However, there is definite research that just shows that some people just – it doesn't work for them. For whatever reason, they don't know why. And then there are other options like there's another type of Botox-like injection called Myobloc. Some people call it Botox B, or Botulinum toxin B, versus Botulinum toxin A which is what Botox is made out of.
00:39:01 And that should be the other option to try if you're looking to deal with the lines on the forehead and the crow's feet around the eyes because there's limited things you can do for that other than Botox. But that's why Botox generally doesn't work. It is really rare that somebody, just it doesn't work for them; for whatever reason their body doesn't react to it. That's considered rare.
00:39:28 Most people would say it's mostly the practitioner not using enough, or using old product, or they don't know what the hell they're doing. So that's some of the issue around Botox. I'd get a second opinion on that if you've gone to a practitioner and they didn't see a difference. I'd give it one more shot before giving up on it or moving and tying Myobloc.
Bryan Barron: What about Dysport, Paula? I don't think Dysport is the same thing as Myobloc.
Paula Begoun: They might be – right, actually I do think they're two different things, but I can't remember right now.
00:40:03 But, right, you would try a different type of nerve muscle – well, it's not really a nerve, but the muscle, the substance that's paralyzing the muscles, that's preventing the muscle that creates the wrinkles. So, yes, instead of Botox you would try Dysport and Myobloc. I forgot about Dysport. I don't know if there is – actually that's a good question.
00:40:28 I don't know if they are the same thing or not, but you would want to try one of them anyways to see if it worked for you, if the Botox didn't. Desiree, next question.
Desiree Stordahl: We have Sandra from California on the line.
Paula Begoun: Hi Sandra.
Sandra: I can't wait to see what you look like because I thought you looked super young already. So when I get home I'm going to look at that video.
Paula Begoun: I do look younger. It's a kick! I love it. I do love it.
Sandra: My question is I've been having like a sting on my skin recently, and I've used the Obagi tretinoin cream at night, like every other day.
00:41:13 And then during the daytime I use your Skin Balancing Antioxidant. But I also exfoliate twice a day. So I'm just wondering am I overdoing it or is it just one of those items that maybe…
Paula Begoun: Sandra, give me your whole routine. What are you using to cleanse your face?
Sandra: I use your Skin Balancing Cleanser and then your Skin Balancing Toner during the day. And then I use your 2% BHA liquid.
Paula Begoun: Twice a day?
Sandra: At night I use your 5% AHA.
Paula Begoun: Okay.
Sandra: And then I use the Skin Balancing…
Paula Begoun: Gel?
Sandra: No.
00:42:08 I use the Moisture Boost cream at night. But I also use your hydroquinone with the 2% salicylic acid. I just spot on my chin.
Paula Begoun: Okay. Okay, we're doing too much. All right. We need to back off. Where are you stinging? Are you stinging all over?
Sandra: Yes, basically over my eyelids and my cheeks. Basically I…
Paula Begoun: What are you putting on your eyelids? Are you putting anything on your eyelids?
Sandra: I use the Skin Balancing, the serum, I just put it all over.
Paula Begoun: All right. There can be several things going on. So, the toner and the Skin Balancing antioxidant – Bryan, correct me if I'm wrong, because you know me, I get my products mixed up.
00:43:04 They all contain niacinamide, right?
Bryan Barron: Yes. Yup, all of those Skin Balancing products contain niacinamide. And then there is also the issue that's she's using tretinoin and products that contain retinol. So she's just doubling up on too many active ingredients.
Paula Begoun: And hydroquinone at the same time. Okay. All right. So, Sandra, here's what I'm going to have you do. I do want you to stay using the Skin Balancing Cleanser. But I'm going to change the Skin Balancing Toner. I don't know this for a fact, but until we figure out what's causing the stinging I don't know that it's such a good idea to use niacinamide with tretinoin.
00:43:50 I'm just very skeptical about that, unless Bryan feels differently. So, I'd like you to stay using the Skin Balancing Cleanser. Are you struggling with breakouts? Is that some of your concern in terms of your skin type, Sandra?
Sandra: Well I get like once a year I get a cystic acne pimple on my chin. And then when it finally goes away it leaves a scar. And that's the only breakout I ever get. But, I don't want to stop using your toner because it really has tightened my pores. Or at least it appears, but I think it's because of that. I love that stuff.
Paula Begoun: No, it does. Yeah, niacinamide restructures the pore. It does. Yeah, I know. I don't want to go without my toner either.
00:44:38 I understand. Okay. All right, let me – this is tricky. Okay. You know, Sandra, I want to figure this out for you. I think that you need to keep the Skin Balancing Antioxidant off of the eye area. I think that's one of the first things I want you to do. And I want you to cut back. I don't want you to use the 5% AHA anymore. I don't think you need tretinoin, BHA... – Even though tretinoin does something very different than the BHA liquid and the 5% AHA to tretinoin, they don't work the same.
00:45:12 AHA and BHAs are exfoliants and tretinoin actually absorbs at the skin and tell skin cells to do different things. It's a very different active ingredient. So I want you to stop using the 5% AHA. Stay using the Skin Balancing Toner. Stop using the Antioxidant concentrate around the eye area.
00:45:34 And instead of using the hydroquinone on your chin, because hydroquinone actually isn't the best ingredient to fade redness from blemishes, I'm going to send you, use the 2% BHA over that area. And then I'm going to send you our new Pure Radiance Skin Brightener because that absolutely with the anti-inflammatories it contains can help also reduce redness as well as improve skin color. I think that should help a lot when you cut back on the AHA, the 5% AHA, stop using that. Definitely stop using the hydroquinone product.
00:46:15 And call our customer service. They'll give you a refund, no questions asked. And I just lost my train of thought, something else I was going to say. I can't remember. Bryan, did I cover everything?
Bryan Barron: I think so.
Paula Begoun: I think so. I think that will go a long way, Sandra. I'm also, our new BHA9 just came out. And I think that when you do get that cystic blemish that drives you crazy, I'd like you to put some of the BHA9 over it. I think you'll get a lot of improvement much faster when that kind of blemish shows up on that beautiful face of yours.
00:46:55 If you have any problems with anything I'm suggesting, in other words the stinging doesn't go away, will you make sure you email or chat with my customer service team and say, "Paula told me to get in touch with you to get me in tough with her. And they'll help you find your way to me. And let me see if I can…
Desiree Stordahl: I'll also be in tough with Sandra via email after the show, so we can get her taken care of. And she'll have my contact info.
Paula Begoun: We'll help you out, Sandra. We'll get this handled. Good luck, dear.
Sandra: Hey, can I just say one more thing? I've been talking to Isabelle in customer service since 2004 and she's really just the best. I just wanted to say that. I don't know her but…
Desiree Stordahl: That is so sweet.
Bryan Barron: Oh, we love Isabelle.
Sandra: I love talking to her and I've been talking to her for years.
Paula Begoun: I will definitely tell her. She's been working with me for over 12 years, or 11 years, something like that. So she will definitely love hearing that. Thank you for saying so. Take care.
Sandra: Thanks. Bye.
Paula Begoun: Bye-bye Sandra. Okay, Desiree, next caller.
Desiree Stordahl: Next we have Shane from Massachusetts.
Paula Begoun: Hi Shane.
Shane: Hi.
Paula Begoun: What can I do for you dear?
Shane: I was wondering about the Fraxel restored treatment that you had done.
Paula Begoun: Yes.
Shane: Like what type of results did you get and how many treatments do you do?
Paula Begoun: Well, I only did one.
Desiree Stordahl: Shane, are you on speaker phone right now?
Shane: No, I'm not.
Desiree Stordahl: Oh, okay, it's causing an echo. But, Paula, go ahead and answer.
Paula Begoun: It is sounding weird. So, Shane…
Desiree Stordahl: I just put him on mute.
00:48:42 So you can go ahead and talk and it won't echo, Paula.
Paula Begoun: Great. So, when I had Fraxel done I definitely crusted up, but using my BHA, because I'm just neurotic about my 2% BHA, it definitely helped get the crusty brown scabbing that happened, get the dead skin cells moving. And I healed actually pretty fast. I thought it was nice. It's nothing like what I've experienced now, and I only did it twice.
00:49:15 The second time I think they didn't use a strong enough dial, a strong enough wavelength, and I didn't quite get the same results as I did the first time. But I think Fraxel and Ulthera, which is – they're not the same but they're both this remodeling, building collagen kind of thing – are definitely something to look into. There are many versions of Fraxel now. There's pixilated, CO2 laser systems; some come with Thermage mixed in.
00:49:48 There are all kinds of versions. I mean, there must be over 100 different, maybe more, maybe 150 different laser machines out there. So, it's hard to compare them. But I think that Fraxel and Ulthera, or the pixilated CO2 machines and Ulthera are probably what most dermatologists and plastic surgeons these days are most excited about in terms of results.
00:50:15 I think Thermage, I don't know, people say it depends on the practitioner. It probably always depends on the practitioner. I'm less excited about Thermage. You don't hear so many people talking about it anymore in comparison to Fraxel or Fraxel and Thermage when it's together in one machine or Ulthera. But, you know, one of the things about growing older and wanting to do something about skin problems that cosmetics/skincare products can't take care of, it takes experimenting.
00:50:46 And along the years, probably starting some time in your 40's, late 30's early 40's, experimenting with things because some of this stuff is preventative, you know, helps maintain your collagen as opposed to waiting till it's all broken down. You know, people said to me when I was looking to have a facelift, they said, "Oh, you don't need a facelift. Why are you getting a facelift?"
00:51:08 And I said, what, am I supposed to wait until you say, "Damn your skin is hanging down! Look at your saggy old thing. You should get a facelift!" Whoever does that to somebody? Nobody says that. That's just the point is it's about, from my perspective, it's before anybody tells you you need to go get something done. It's about preventing looking older, not waiting till your older and then cutting it all away.
00:51:36 So I do think that cost-effectiveness wise that it's good to start a program, if this is something you do consider for yourself, to start it relatively earlier than later. I'm hoping that answers Shane's question. You want to bring Shane back on, see if we don't hear the echo anymore, and just see if I need to answer anything else for him?
Desiree Stordahl: It doesn't look like he's on the switchboard anymore. But I do have a question from Erica.
Erica: Hello?
Paula Begoun: Erica, what can I do for you?
Erica: Hi, Paula, thank you for taking my call; I'm a huge, huge fan. But I'll be quick. Okay, so, and I use your products; I love your products. But I just went to the dermatologist not too long ago.
00:52:21 And I have pretty decent skin and I basically asked her what would you suggest for preventative. I'm 30. I'm good with sun block. I don't have too many issues. I do have dry skin. But she put me on Retin-A, so I've been doing that every night. And I just wanted to know, you know, you've been coming out with a bunch of different products and different things and what would you suggest pairing with that?
00:52:46 And is that what you would suggest, just to get your feedback on someone age for preventative? Actually earlier you said you don't use Retin-A, so…
Paula Begoun: I don't use it not because I don't think it's good. I don't use it because I have a bad reaction to it. I can't even use retinol, my products that contain retinol. My skin just doesn't tolerate retinol very well. I wish it did. Believe me. I think the active ingredient in Retin-A and Renova and all of the tretinoins, the research about them, or retinol in a cosmetic product is pretty darn impressive.
00:53:25 Erica, you said you have dry skin but your dermatologist gave you Retin-A. Is that what you said?
Erica: She did. Yeah. And actually I mentioned that to her, too. I'm afraid of my skin being dry, and she said, "Oh no, it's fine. Just put it on maybe every other day." And I was like, okay.
Paula Begoun: It's just that's so odd. Because it's not terrible, it's just the base for Retin-A and the base for – you know, Retin-A and Renova contain the same active ingredient. It's just that the base for Renova is a little bit more elegant for dry skin than Retin-A skin.
00:54:05 Retin-A actually is a very inelegant, icky feeling. It's not a fun product to put on your face. Renova feels much, much better on the skin. So, and next time you're down in Mexico you can just go buy some Renova and bring it back up with you.
Erica: I'm not too far from there, so it's fine.
Paula Begoun: What?
Erica: I said I'm not too far from there. I'm actually going there this weekend on a little cruise.
Paula Begoun: I'm a big one in bringing drugs back! I mean, not drugs – I mean, prescription drugs.
Desiree Stordahl: Yeah, watch out there.
Paula Begoun: I'm a big one into bringing stuff over from Mexico. But there's no reason to not pick up some Renova. And it's cheap! I mean, it's cheap and it's the same stuff. I mean, you might as well.
00:54:57 I don't think there's anything wrong with finishing up the Retin-A, but you really should be using the Renova for somebody who has dry skin. So that's fine. Are you using my Skin Recovery products or my Resist products?
Erica: I'm using, okay, what do I have? I've used different things. What I'm doing now, now that I'm on the Retin-A, is I'm using your Skin Recovery serum, which I really like that. That feels nice.
Paula Begoun: So you're using that.
Erica: I'm using that.
00:55:27 And then during the day I'm using the Moisture Boost Daily Restoring Complex sun block along also with the Skin Recovery Super Antioxidant. So I'm doing the serum twice a day. And then I have a Clinique moisturizer I use at night also.
Paula Begoun: Which Clinique moisturizer?
Erica: It's Super Rescue Antioxidant Moisturizer.
Paula Begoun: Bryan, how did we rate that?
Bryan Barron: Those were all rated well.
Paula Begoun: Okay, good. So, Erica, for cleanser, what did you say you were using for Cleanser?
Erica: Cleanser, I'm using yours, the Moisture Boost.
Paula Begoun: Okay. That's great.
00:56:05 So I think that, and you're not using an exfoliant?
Erica: No, and I'm not sure. That's kind of why – yeah, I'm not. I didn't know if I should be.
Paula Begoun: Well, I don't know "should" so much. I generally think that skin does best – we need help exfoliating. It's just some of what happens with age and sun damage. So I'm going to send you our 1% BHA lotion. I'd like you to give that a try.
00:56:32 The other thing I'm going to send in terms of sun protection, I love the idea that you can layer up sun protection. I am going to send you my Barely There Sheer Matte Tint Tinted Moisturizer with Sunscreen.
Erica: You know, I've actually used that before, and I find it a little drying for me.
Paula Begoun: That was drying for you?
Erica: Mm-hmm. I think that's the one I have. I think it is because I used it and I never finished it because it doesn't…
Paula Begoun: Well forget that.
Erica: It's the Barely There Sheer Matte Tint.
Paula Begoun: No kidding? So, Bryan, would All Bases Covered be a better option for her?
Bryan Barron: Yeah. It's definitely a more moisturizing formula.
00:57:17 It is a foundation though versus a tint. But, if you're using it to augment the Moisture Boost Sunscreen you're applying, you don't need to apply it as you would a foundation. You can just either spot apply or do a sheer layer of it. Because you're getting the sun protection from the Moisture Boost, so the All Bases Covered would simply be adding a bit more.
Paula Begoun: All right. Let's give that a try, Erica. We're going to add the 1% BHA lotion. I think that will give you a nice, smoother feel to the skin. You would use that on the either opposite day, once every other day, or use it at night and use the tretinoin in the morning, or vice versa – use the 1% BHA in the morning and the tretinoin at night.
00:57:58 And Erica, I've got to run, but I think you're doing great. I'm proud of you. Stay doing the right thing. We have just a couple of minutes left so I want to make sure that – god, I miss doing this show. It's wonderful to talk to everybody. But I want to make sure we mention the upcoming shows. On the 25th, the worst diet myths and what to do instead with nutritional expert Jonathan Bailor. He's author of Smarter Science of Slim.
00:58:28 What he has to say is controversial. It's interesting. And definitely worth thinking about in terms of how you're going to consider taking care of your body for the rest of your life. On the 9th of October, I can't believe we're talking about October, one minute skin rules with dermatologist and author Dr. Debra Jaliman. She is one of our favorites. And I'm going to be doing that interview because I love Dr. Jaliman. She is a [technical difficulty]. Celebrity makeup tips with makeup artist Kimberly Heintzman on the 23rd. This is Paula Begoun. That's me.
00:59:04 I'm here keeping your beautifully informed when I can be here on Tuesdays at 6pm.
Desiree Stordahl: Every other Tuesday.
Paula Begoun: Oh, every other! Oh god, see, what do I know? See, I'm not here enough. Desiree Stordahl and Bryan Barron, the better part of me and the work I do, the work I do with Desiree and Bryan. Until the next time I'll be on, which is with Dr. Jaliman on the 9th of October, keep staying beautifully informed.
00:59:36 Come visit us on PaulasChoice.com. Take a look at our new BHA9 exfoliant to treat stubborn problems. We guarantee it. And also our new Pure Radiance Skin Brightening Treatment. Take care. Talk to you soon. Bye.
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