[MELISSA]: The Bomb Mom podcast is part of the Practice of the Practice Podcast Network, a family of podcasts that are making the world better. You’ll also probably like the Imperfect Thriving podcast, Beta Male Revolution and Empowered and Unapologetic podcast. Check them out at www.practiceofthepractice.com/network. Hey, what’s up everyone, if you’re looking to be inspired, motivated, educated and entertained, you have come to the right place. Welcome to the Bomb Mom podcast, the podcast where we explore your fitness, life mindsets, and actions that help you become unstoppable. You’re worth it and it’s time to finally make changes in your life that will last you the rest of your life. Hey everyone, welcome back to the Bomb Mom podcast and you are listening to part two with Dr. Alex Denes and April Turner. We are continuing the discussion on collagen and how the skin works, and mostly about the CO2 laser resurfacing technique that they perform. So, we get to hear all about that, but we’re gonna learn more about how the skin works, how collagen and elastin is reproduced, and I get to share a little bit about my personal story with this procedure too and tell you guys what that was like. So, let’s get started. Welcome back to the Bomb Mom podcast you guys and it is part two with April Turner and Dr. Denes. If you guys just came from part one, you are definitely gonna want to hear part two because we left off talking about collagen. So, we talked about Botox fillers so if you’re like, “Wait, what? I missed that episode,” go back and listen to it. And we ended talking about the two ways, the number one, the number one and then I say two, the two ways to improve your collagen. April, recap that part for us really, really quick number one was? [APRIL]: Well, I was talking about from, all the way from one spectrum to the other, the topical agent Retin-A is the only FDA proven, and many peer review studies have been done to prove that it actually increases your collagen production and elastin fibers over approximately a 12 month period. And then after 12 months, you’re pretty much at a maintenance where you’re maintaining the production that you achieved. Now that’s like the lightest, easiest way to get collagen. And then on the other end of the spectrum, you can do an ablative laser, which would be a CO2 laser. And that’s like almost immediate collagen stimulation like on a mother lode level. [MELISSA]: Okay, and you guys do this procedure? [APRIL]: Oh yes. [MELISSA]: This is like your jam, right? [APRIL]: Oh gosh, yes, I’ve had six and a half of them. [MELISSA]: And that’s not normal though right, or is it? [APRIL]: Well… no, most patients, most, will get a CO2 maybe every three/four years. I’m a little addicted to it. The downtime can be substantial, a week or two, but the results… there’s nothing that will give you the results of the CO2, nothing. Yeah, your face, for many people, depending on how severe the epidermis and their their skin is, and the elasticity is, you know, your face can turn into a baby’s butt. [MELISSA]: Okay, so what age? And we’ll go into all of this you guys because I know a lot of people are going like what’s the CO2 like, wait, what is this whole thing? First say, what age should people start getting it done, or could they? [APRIL]: You know, it depends. We’ve had some younger, young 20 year old patients, that have unfortunately had a history of severe acne when they were teens and now acne scarring. And we can treat, say just the cheeks or the forehead, you know, for the acne scarring. And then, maybe when you get in your 30s and 40s, 50s, 60s, and you’ve got a lot of skin elasticity or a lot of fine lines that you just can’t seem to eradicate in any other way, or you want to eradicate them very rapidly, then you can do a CO2. Or, if you have severe hyperpigmentation, and you don’t want to take the time to use the Obagi system, which suppresses melanocytes that causes hyperpigmentation. On top of the Retin-A, you want to jumpstart it and get rid of that hyperpigmentation then keep it at bay with the Obagi and Retin-A. You can do the CO2 and then your maintenance with your Obagi and Retin-A. [MELISSA]: Okay. So most of our listeners, I would say on average are like, God, anywhere between like 30s and 40s but I would say average, like, probably 30 to 50, that’s not really an average but around that range, and they can get this done? [APRIL]: Oh absolutely and… [MELISSA]: Prevent? Reverse? [APRIL]: Yes and yes. Preventive in the way that you’re building collagen so you’re gonna naturally, as when were younger, decrease the amount of depth in lines that you’re going to get with dynamic movement of your face because you have more cushion essentially. And then, to eradicate it’s going to, well Alex can explain it better, but decrease the lines or, if not eradicate the lines that you have, the crepiness of the skin, and I have a lot of hyperpigmentation naturally without using my Obagi and Retin-A and getting the CO2s, like from my chest down, I’m a leopard. My face would be like that too if I didn’t do my CO2s, and the obagi and Retin-A, but immediately the number one thing to go is the hyperpigmentation because that’s the most superficial on the layer of the skin. [MELISSA]: Okay, so this is an actual laser, like you’re laying down and like this laser is zapping your face. [APRIL]: Yes. [MELISSA]: Okay. Remember, CO2 for Dummies. [APRIL]: Sorry. It’s not like an IPL laser like an intense pulsed light laser for laser hair removal. This is a complete ablative laser and I think, oh, you know, a wise man named Alex Denes once taught me many years ago, when you have a question, ask an expert so, I think we should ask Alex more about this because he is the expert on CO2 treatments. [MELISSA]: Tell us more Dr. Denes. How does this all work? [DR. DENES]: Well, you know April’s right, CO2 is an absolute godsend. This is a laser and you know, laser differs from, from regular light, the kind of light that we can see in that it’s a cohesive beam. So, it’s a single wavelength that doesn’t scatter. You know, you take regular light like a flashlight, you turn it on and it forms a cone, it scatters. Laser does not. So, when you fire a laser beam, if it’s one millimeter in diameter, when you fire it 10,000 miles away, if it’s traveled that far, it’s still one millimeter in diameter. And that’s important because it gives us an immense amount of control. Lasers are very, very controllable. And so, lasers have been around for a long time. They’re used industrially, they’re used medically in surgeries and so forth and over the past several years, we’ve been able to use them, because they’ve adapted machines to allow to use them in a cosmetic way. So, basically what we’re doing is a laser is a controlled burn. It’s a destructive force, if you will. Now fortunately, obviously the laser has lots of different settings and we can go from very, very light to very, very deep and everything in between, depending on what the patient wants. But what we’re doing with a laser are two things. Number one, we’re resurfacing, which means that we’re, you know, your skin is made up of basically three layers, the epidermis, which is a very, very tough part, and that’s the part that flakes and it’s constantly being rejuvenated. Your epidermis is constantly turning over and right below that you have the dermis, and the dermis is really where all the action is. That’s where your glands are, that’s where your blood vessels are, and that’s where your collagen is. So the first portion of the laser, and I’ll talk about in a second, but what we call the ring portion is an energy beam coming out of the machine that actually vaporizes the upper third to two thirds of the epidermis, the outside layer of the skin. So we’re basically wiping out the top layer of your epidermis. Why do we do that? Because that’s where the aging has occurred. That’s where the degeneration has occurred. And by doing that, we increase turnover. As we age, or as we go on with life, our epidermis is constantly replacing itself and it goes from bottom to top, and the top layer eventually peels off and, and there’s new skin coming. When we’re babies, we regenerate our skin about every two or three weeks. As we age that regeneration gets slower and slower and by the time we’re over 50, we’re only turning over our skin every 45 to 90 days. And that’s one of the reasons that we show signs of aging because we’re not turning over epidermis. By doing a laser, we wipe out the top third to two thirds of the epidermis and force the body to create new what April and I like to call baby butt skin, to come from the bottom layer and come to the top. So that’s the one thing that the laser does is it resurfaces and it peels a layer. The second part of it, is what April talked about, is collagen stimulation. The laser fires, if you could sort of visualize a doughnut. The ring portion of the laser is the portion that hits the epidermis. In the center of the doughnut, we have a spike and that spike goes deeper into the dermis and punches holes in the collagen. That’s that protein layer that April’s talked about in the first segment. That collagen layer is very, very important to us because, I tell people it’s like your skin is a sheet on your bed, and your collagen is a mattress. And you can make the sheet as tight as you want but if the mattress is lumpy, the sheets going to be lumpy. And that’s what the collagen is, the collagen’s the mattress. So, with the laser, we poke holes in this collagen. We purposefully damage it. And why do we do that? Because as our body heals, it contracts. If you ever cut your skin and you watch the scar that develops, the scar pulls the skin in around it, yeah, it’s contraction, and the collagen does exactly the same thing. So, by punching holes in the collagen, as the collagen heals, it contracts and it tightens and it causes the skin to tighten as well. I know that was kind of a long answer to a short question but… [MELISSA]: No but that’s like brilliant! Like I didn’t know that at all, like I’m sitting here like speechless because I’m like, absorbing up. But the way you describe it with the bed and the sheet and like the doughnut and the spike like, it, oh my god, okay, I get it now. [DR. DENES]: Good. I’m glad I got my point across. And you know, the point is, and April mentioned this, we can go anywhere and it’s very patient specific, just like with Botox and fillers. It’s what the patient wants. It’s what the patient, what bothers them. One of the first things I learned… my first Professor when I went into cosmetic surgery was, this is not about you, it’s about your patient. So, when somebody comes in and says to me, “what can you do for me?” I do exactly what April says, I say, “what is it that bothers you?” Because what I see may not be the same thing as what they see and I don’t want to impose my ethics in my judgment on them. I want them to tell me what they want us to fix and their budgetary constraints, or recuperative time constraints for people, some people have to go back to work. So, the point is that we can make the laser anything that people want us to make it. We can go anywhere from the very light feathering, for which we don’t need anesthesia at all, or we just put on a very light layer of a topical anesthetic. They come in, we do it in 15/20 minutes, they go out, and they’re red for two or three days and that’s the end of it, they can go right back to work. Or, we can go to the opposite end of the spectrum, which is a very deep, very heavy treatment where I really crank up the energy on the laser. And of course, you know, you don’t get anything for nothing. The stronger the treatment the more results we get, but the more the injury, the longer the recovery time. So we can customize whatever fits into people’s needs and time constraints and budget. [MELISSA]: Yeah, I was gonna insert my own personal story with this because I’ve had just my eyes done, because I was like, April, what do I do for this? You know? And she’s like CO2 and I’m like, really? I’m like, okay, fuck it, it’s happening, we’re gonna do this. [DR. DENES]: Did you really say that? [MELISSA]: Oh, I’m sure I did. KNowing me, I’m sure I did. Like, this is happening. So I did just the eyes so it was basically all the way up to my eyebrows, my eyelids, you know, like take your hands, make circles around your eyes and that’s where they hit. And I was like, you know, I remember you starting Dr. Denes and they’re like, okay, you know, like, how intense do you want it and like, just give it to me and try that. Okay, yeah, I can handle that. And who was the assistant with me that day? Was it Nicole I think? [DR. DENES]: Might have been. [MELISSA]: I think it was Nicole. And she’s, bless her heart, she sat there with me the whole time and like held my hand because it was painful, but I, pretty sure I was like your third patient with your brand new laser that you had gotten at the time because this was like probably two years ago or a couple years ago now. [DR. DENES]: Right right. We got the fractional laser. [MELISSA]: Yeah. And I was like, you know, one of the first people to get it done but it was intense but I was like, You know what, if I’m doing this, I’ve had three babies, I can do anything and I was just like no, just crank it up, just give it to me. And it was, it was a recovery time you’re right, the harder you go the more you know recovery period there was and I did it over Christmas. I’ve done it twice and the last two times I did it over Christmas because I was like, you know LA is gonna shut down, auditions, acting, you know, not really doing a whole lot. So time it you guys. If you’re thinking, if you’re listening to this and you’re thinking about it, just time it with your life. But he said, they can even do lighter but yeah, I got red, that peeled, like freckles and age spots that I had by my cheekbones and you know that they like literally fell off and they didn’t come back. [DR. DENES]: Right, right. It’s very, very effective for that. Now, I want to point out that we can’t get rid of every single discoloration on your skin, right? It all depends on how deep in the dermis that this coloration is. Many of these, what we call lentigos, or sunspots, or moles, they’re very, very superficial and the laser just, like you said Melissa, the laser just peels them off and when you leave the office, they’re gone and they don’t come back. Unless you get more sun because many of them are sun exposure related. Some of them are deeper and we may not get it the first time around, or we may never get it. I hate to promise people that we’ll get rid of every mole on their face, because we can’t, but we can get rid of a lot of them. [MELISSA]: Right? And how long on average is the recovery time would you say? Like I know my personal experience, but you know, if someone’s like, no, I want to get this done. You know, like really get it done. I want a good, heavy treatment. How long is that recovery time looking? [DR. DENES]: If we go full bore, then probably I would say ten days, ten to fourteen days. [MELISSA]: Ten to fourteen days that you’re hideous and you can’t see anyone? [DR. DENES]: No, no, no, no, no, no, obviously it’s the worst the second or third day, that’s when you’re the worst. You’re very, very red, you’re pealing, you look like you’re ready for Halloween. But once the peeling is gone, and I would say that’s probably five to six days, then you’re just deeply red – erythema, because it’s inflammation because we’ve caused an injury, right? And that erythema slowly goes away, usually in about five to seven days. So, it all depends, you know, a lot of people want to go back to work right away. We’ve had people come in and do a full ablative CO2 and you know, they work in an office where nobody else comes in to see them, they’ll go up, we’ll do them on a Friday, they go back to work on Monday. They don’t care what they look like. And the other thing is right after the treatment, you have to put on a product called Aquaphor, which is sort of a water soluble Vaseline because, remember that we’ve denuded your skin now and by doing that we’ve taken away your primary barrier against infection and against hydration. So, people after CO2, as you probably remember Melissa, are dry. The skin is going to be very very dry and you have no barrier to protect yourself so this aquaphor is an artificial skin barrier until your own skin comes in. So you’re very shiny for several days, because aquaphor is very shiny, and so you kind of look funny, but you know, I tell people if you can, give me ten to fourteen days. [MELISSA]: Okay, okay. And what’s funny too is because after you know you’re, what are we doing? We’re putting the aquaphor on like every hour or something like that? Or, I know it’s a lot and you’re like gobbing it on. [APRIL]: Well, it’s about, you know, I just had one done a week ago today. [MELISSA]: Yeah, April is in recovery phase right now. [APRIL]: Yeah, I got chewed up and spit out and you know, I’ve had six hardcore CO2s in the last 14 years and, 15 years, anyway, every single one is a little bit different, my recovery. And that’s the way you know, we vary every time. This go around was day two, I really started to swell a lot, day four most of swelling had abated, and now I’m already one week in, I’m at the point where I’m only having to reapply my Aquaphor about every eight hours. And when I initially, post-treatment, I was applying it every three to four hours because my skin is awfully thirsty. It absorbs the Aquaphor and you definitely want to keep the skin moist, you don’t want to let it get dried out. [MELISSA]: Right, right. The second one that I had done, again I timed it with Christmas and I knew what more to expect and stuff in the healing, and I literally had to go like get Christmas stuff done for like a Christmas party. I was at my kids school, I’m pretty sure the very next day, which is probably dumb, don’t do what I’m doing, but I had big sunglasses on and I was like helping at a Christmas party at school and I just wore my sunglasses. I kept ’em on the whole time, and no one ever really knew. But I had the Aquaphor, I kept it on and stuff and then I went home and rested. But, it definitely wasn’t something that I wanted to show my face in public without my glasses. [APRIL]: No. [DR. DENES]: Right, exactly. And that’s another thing that is variable about the CO2 is we can do whatever area you know, bothers you. Like you had just the eyes done Melissa, or some people just want the area around the mouth done. And the strength of the procedure also determines how much, if any, anesthetic we give. If we do a full bore, heavy duty laser procedure, then patients are most comfortable asleep because it can, as you know, yeah, as you know, it can be painful. And a lot of that has to do with tolerance, but if we’re going to do a full blown treatment, we usually recommend… it takes about an hour, and people are uncomfortable during that period of time, so we do what’s called moderate sedation or IV sedation where it’s not a general anesthetic. You’re not paralyzed like you are with a general anaesthetic, you’re not intubated, you’re breathing on your own, and we keep you just as deep as we have to keep you comfortable. It’s a much safer form of anesthesia than a general. Usually Michael, April’s husband, is the one that does the anesthesia for us and we monitor people very, very carefully and make sure that they’re safe. And many times, they’re light enough that they can actually talk to us. So we want to keep them as light as possible but we want to take away the pain. On the other hand, many procedures, like the feathering, don’t require any IV sedation at all. We just use a little topical anesthetic. [inaudible] [MELISSA]: I think okay, go, go go. And then I’d be like, okay, just give me a break. And then like, do it again. And you know, eyes are what, 10/15 minutes like maybe I don’t know, I wasn’t under very long at all. So I’m like, I could do anything for 10 or 15 minutes you know but when I do, cos I will do a full face, is it full face and neck or do you pick? [DR. DENES]: You can choose, we can do full face or full face and neck or full face and neck and chest. So we can go down into the decolletage, the V of the neck and follow that down. Because a lot of women have a lot of discoloration there, like April had mentioned, so we’re able to take out a lot of that discoloration. We have to use completely different settings for the neck and chest than we do for the face because the neck and chest are much more sensitive to the laser than the face is. So we have to change our settings. Same with the eyelids by the way, we turn down the power when we’re doing the eyelids because the eyelids are very, very thin and we don’t want to burn through the entire epidermis. [MELISSA]: Right, right. So yeah, I will be put under when I do my whole face. [APRIL]: Oh, you know, they put me under, cos you know, I’m a big baby. But I was pleasantly surprised when I did just the feathering spot treatment CO2 ,that all I had was the TAC on and I did fine. But yeah, they don’t want to deal with me awake, they give me a little IV sedation and you know, I’m kind of nap-ish and I’m well behaved that way. But this go around I, you know it varies which one I want to have done but this time I went for the motherlode. I did my face, my neck, my chest, and I did some spot treatments or had them do some spot treatments on my hands and arms. Because that’s a major aging factor, you know, it used to be a major aging factor. A woman gets a facelift, but you look at her neck, and it was before they were doing major neck lifts, you could see her age there. Well, now with a neck lift, you look at a woman’s hands, and you’re like, oh, those are older hands. So it’s just never ending. [MELISSA]: Is there anything comparable to this? Because a lot of the viewers were like, you know, oh, I can’t afford this or I can’t do that. Is there really anything out there on the market that is comparable? [DR. DENES]: No, no. And you know, I’d sort of warn your listeners about false claims because every time I go to a cosmetic surgery conference, there are 30 vendors showing off their hundred thousand dollar machines that are promising to tighten your skin, take away visible blood vessels, take 15 years off your face. And they just, after all of the technology that we’ve developed over the past 20 years, nothing beats the CO2 laser. You know, I got caught up in some of these machines. I bought some of these machines, we tried them, they were dismal failures. To this day, I believe that CO2 laser remains the gold standard. And you know, I had mentioned fractional before and if you don’t mind, Melissa, let me just spend a minute or two on on just exactly what that is because you’ll see that around. When we first started doing CO2 I had a an older model CO2 erbium, erbium is another type of a laser machine, which basically hit every square inch of the area we were treating. So every square millimeter of your skin was hit with a laser. And that resulted in a very long recovery time. The idea behind a fractional laser is that we’re not treating every dot on your face, we’re treating every other dot. So think of it as a checkerboard, and instead of treating all of the squares in the checkerboard, we only treat the black squares and leave the white squares alone. That’s got two huge potential advantages. Number one, we do less injury, and there’s less discomfort. And number two, there’s a quicker recovery because only 50% of your face has been burned, if you know what I mean. So that’s what the fractional laser does. When we got into it, I was very reluctant. I said, you know, if you do a 50% treatment, you get a 50% outcome. And I resisted it, but we went ahead and bought Laser and I’ve been very, very impressed with it. People recover quicker, they’re more comfortable with the treatment. And I would say that the outcome, if not exactly the same, I would say it’s 90% the same. [APRIL]: Well, I can say that I’ve had both our old girl the Derma K, the complete ablative CO2, I’ve had a few of those, and now a few with our CO2RE machine and I find the results extremely comparable. But I do love the fact that I heal quicker with our new CO2RE. Yeah. And I would know because I’ve done a lot of these. [MELISSA]: You’re the go to for it. But it makes sense, the recovery, that’s important because not everyone can take off that many days from work, you know, or driving into LA like I do. [DR. DENES]: Exactly right. You know, people need need to get on with their lives so it’s nice that we can offer, you know, various degrees of treatments. And even like, like we said, even the more aggressive treatment. I mean, you know, I used to do a fair amount of facelifts when I was in was doing surgery. And since we got the laser, of course I don’t do surgery anymore, but I think since I got my first laser, I hadn’t done a facelift after that, because we have an alternative. I don’t want to present this as being an alternative to facelift in its outcome because it’s not. A facelift is still going to make you tighter and smoother. But a facelift is much more expensive, there’s much more downtime, there’s scarring, there’s a knife, whenever you cut, you’re gonna get a scar and the recovery time is much longer. I’ve had a facelift and I would, personally, I would never do it again. I would just, and I had Michael do a CO2 on me not that long ago. It’s so, we now have an option. There are still people that are going to want the facelift and that’s fine, but most people I think nowadays are looking for less invasive procedures. [MELISSA]: Yeah. And I like that it makes your body do it on its own. It’s making your body produce the collagen, you’re damaging it and like it’s not, I don’t know, cutting, pulling, tightening, stitching. [DR. DENES]: Right. There’s no knife, we don’t break the skin. And that’s the nice thing about the laser, laser can penetrate the skin and injure just at the certain depth that you want it to injure at and basically pass through the skin without harming it. That’s why the ablative laser’s so effective in getting very nice results with minimal risk. Now, I should mention that this is not a totally risk free procedure. I don’t want people to think that nothing ever goes wrong. [MELISSA]: There’s risk with everything. [DR. DENES]: Exactly. The biggest risk we have, which is totally avoidable by the way, is the sun. Because if you go out into the sun, right after a laser treatment within four or five days of it, you will hyper pigment. There’s no question about it. And then we have to do another procedure to get rid of the pigmentation. So we’re death on the sun immediately. I mean, when people leave our office, we’ve got a sheet over their face or wearing a big wide brim hat, they’ve got sunscreen on, we really don’t want any sun exposure. So when people are planning for their procedure, that’s one of the things they have to think about is we want total avoidance of sun and that includes sitting next to a window inside your home for several days because it is going to get splotchy if you get sun exposure on it. [MELISSA]: Yeah, I remember you saying that. So how long before the results take place? Because we have this healing process. And then you’re like, okay, looking like a human again. When do you get the full results, the full benefit? [DR. DENES]: That’s a great question Melissa. So two things, the resurfacing portion of it, where we denude the skin and we have the skin grow back, that’s very, very quick. Within five to seven days, you’re going to see that. You’re going to see your skin have a better quality, a more even texture, more even color. That’s almost immediate, five to seven days. The tightening, and the tightening remember comes from the collagen damage, the tightening is going to take probably four to six weeks. Because collagen, like any protein in the body, doesn’t heal overnight. It’s like damage to your skin. It takes a while to heal. So we tell patients expect smoother, more even skin in five to seven days, tightening four to six weeks. [APRIL]: And, studies have shown that you can note increased collagen stimulation for up to six months after a CO2 laser. [DR. DENES]: Right. [MELISSA]: Like you’ll keep getting results? [DR. DENES]: Yes. So when we say four to six weeks, that’s when you start seeing the tightening and it just gets better from there. And people do vary, some people tighten more than others. You know, one thing, and just honest disclosure, we are not very successful at tightening, loose necks. We really aren’t, not with the laser. We’ll get a little bit of tightening, we’ll get some color changes, we’ll get some more even coloration of the skin, but we are not very good at tightening neck skin with the laser. [APRIL]: Okay, it does markedly decreased the crepiness of it. I have a beautiful, of one of my CO2s, before and after picture of my neck, and it markedly decreased the crepiness of it. But if you have a heavy neck or you’re quite older, because we can’t hit the neck as hard as we can hit the face, we’re not going to get the tightening that we do of the face. [MELISSA]: Makes sense? [DR. DENES]: Correct. [MELISSA]: Yeah, that makes sense. Now you mentioned the feathering, which is just a lighter hit of the laser basically right? [APRIL]: Yes, it’s more superficial, kind of like getting a chemical peel and that peel like a ViPeel that takes off a lot of your dead skin, right? Yeah, it’s kind of like doing that but, with a ViPeel, you can actually get some flaking and peeling for up to two weeks and it does not look good under your makeup, I tell you. But, with the CO2, you can have a downtime of three or four days. It gives you not only the new skin, the cellular turnover, the regeneration of the epidermis, but it also gives you a smoother appearance and you recover so much faster. I love it. I love it. I’ll never do another ViPeel. I just do a feather CO2. [MELISSA]: And you can feather your whole face, you could just feather an area? [APRIL]: Yep, absolutely. That’s what they did on me when they did that one feathering. I was kind of like the guinea pig with our new toy. Because with this laser we can, there’s so many different variables in how deep we can go, how superficial, I love it. Anyway, we did my nasal labial folds, my bunny hop, I get the little creases that go across the nose, and my oral commissures, the corners of my mouth going down, and those little crepiness I had, poof gone. Gone. That was it. [MELISSA]: And did you stay awake for just the feathering? [APRIL]: Yes, believe it or not, April stayed awake for it. And all I had was some topical anesthetic. Now, we do have a very strong topical anesthetic, but still, that’s saying a lot for me. Everyone that knows me knows I’m like the worst patient. [MELISSA]: And did you need to bite down on a leather strap? [APRIL]: No, I was amazingly surprised. Alex was very happy, I didn’t bite him. [DR. DENES]: That time. She did bite me when I gave her Botox though. [APRIL]: Yes. That’s a whole nother story. [MELISSA]: A whole nother episode. Now, I know you use the Retin-A April, I use Retin-A too. How long will you wait until you start using your Retin-A again? [APRIL]: Oh, it’ll probably be at least, it depends every time, I just, you just kind of get the feel of where your skin is at and where you’re at. It’s so bizarre. Like you guys were talking about not getting in the sun. You literally turn into a vampire, you just know instinctively not to let any sun or heat hit your face. It’s, you just have to experience it. It just happens naturally, organically. The Retin-A, I’ll probably go back on in about, for me, on average is about six weeks. But, my hydroquinone, my Obagi, I can usually start in about four weeks because I want to keep the hyperpigmentation abated by keeping it suppressed with the hydroquinone. [MELISSA]: Right, right. Oh my gosh, you guys this was like so educational. Like, I thought I knew a lot about this, I didn’t. I just learned so much and I’m excited. I can’t wait to get the whole thing done. [APRIL]: Oh that’s wonderful. [MELISSA]: Seriously, I can’t wait. Yeah, maybe I’ll just start with a feathering too and then and then work my way, you know? [APRIL]: Well, now remember, if you’re doing a feathering it most likely will be with Michael. And if you tell Michael to hit you harder, he will. [MELISSA]: I love that. Oh my gosh. Okay, so tell our listeners again how they can find you guys. Where are you at? Because I don’t even think we said on this episode yet where you guys are at? [DR. DENES]: Well. Oh, go ahead April. [APRIL]: We’re on Instagram and on Facebook we have a web page, and it’s Canyon Lake Med Spa. We also actually, I’m taking your advice, Melissa, and we’re redoing our website and we have a new website coming up probably fairly soon, and it’s canyonlakemedspa.com. [MELISSA]: Very cool. And they are in, we’re in Riverside County here in California, and like we said before, patients come from all over to see these guys. So, it doesn’t matter if you’re like, h, I’m not in Canyon Lake or I’m not in Riverside, it doesn’t matter. Like, fly out and see Dr. Denes because this is where it’s going down. Oh, thank you guys so much for being on here. If you guys have any other questions or concerns, email me. You can email me, you can contact April. My email is info@melissavogelfitness.com, I can pass it on to them or you can send them a DM or a message @CanyonLakeMedSpa. But you guys, just ask questions, be educated, don’t just go to any provider. Like April said earlier, make sure you ask, like, there’s no dumb question I say in fitness and there are not any dumb questions when it comes to your health and your face and treatments. So, make sure you guys rate and review this podcast because that shows us your love and we greatly appreciate it. And thank you so much April and Dr. Denes for being on here. [DR. DENES]: Well, and thank you for the opportunity of being with you. [APRIL]: It was our pleasure truly, [MELISSA]: Oh, of course, I, everyone, I just think knowledge is power. And the more you know, and you take away and you could just tuck things away, the stronger you’re going to be, the healthier you’re going to be, the better decisions that you’re going to make in life. [DR. DENES]: Agreed. [APRIL]: Absolutely. [DR. DENES]: We agree. [MELISSA]: It’s just another egg added to our basket so thank you. Alright you guys, everyone stay safe, stay healthy. Until next time, have a great week. If you’re ready to become a Bomb Mom, join my free course over at www.melissavogelfitness.com/course. This podcast is designed to provide accurate and authoritative information in regards to the subject matter covered. This is given with the understanding that neither the host, Practice of the Practice, or the guests are providing legal, mental health, nutritional or other professional information. If you need a professional you should find one.