← The Peter Attia Drive

#13 - Brett Kotlus, M.D.: How to look younger while you live longer

Sep 3, 2018 1h 48m 14 insights
<p>This episode explores the question of how we can maintain a naturally youthful look as we get older. Brett — a New York City oculofacial plastic surgeon who specializes in both non-surgical and surgical cosmetic and reconstructive procedures of the eyes and face — shares some remarkably practical advice on everything from the most extensive procedural options, down to the simple steps one can do themselves, starting today, that can make a tremendous impact. Brett also discusses how to pick a provider you trust while you're sorting through the ever-growing list of facial treatments and cosmetic procedures.</p> <p>We discuss:</p> <ul> <li>History of medical training that led to Brett's current interests [5:00];</li> <li>What changes occur that make skin look older over time? [8:00];</li> <li>How to avoid the "unnatural" look associated with cosmetic surgery [17:00];</li> <li>Facial augmentation, fixing eye-bags, and picking the right provider [22:15];</li> <li>Common botox mistakes, and how to do it right [37:30];</li> <li>Protect and rejuvenate your skin with these 3 main tools [46:30];</li> <li>Latest trends in cosmetic industry, botox, cryolipolysis, the various forms of facials, and PRP [1:05:00];</li> <li>Importance of picking a provider you trust, rather than a device you want [1:31:30];</li> <li>Future of the cosmetic field [1:33:00]; and</li> <li>More.</li> </ul> <p> <span> Learn more at <a href="http://www.peterattiamd.com/"><span><u>www.PeterAttiaMD.com</u></span></a></span></p> <p> <span>Connect with Peter on <a href=""> <span> <u>Facebook</u></span></a> | <a href=""> <span> <u>Twitter</u></span></a> | <a href=""> <span> <u>Instagram</u></span></a>.</span></p>
Actionable Insights

1. Embrace Small, Consistent Changes

Adopt a philosophy of making small but consistent changes over time, as these seemingly minor improvements accumulate to produce significant long-term results in areas like health, longevity, and appearance.

2. Adopt a Daily Skincare Trifecta

Implement a core daily skincare routine by applying broad-spectrum physical sunscreen (SPF 30+) and topical Vitamin C serum in the morning, and using a retinol or tretinoin product at night. This powerful regimen is highly effective for anti-aging and overall skin health.

3. Prioritize Daily Sun Protection

Protect your skin from UV radiation by applying broad-spectrum physical sunscreen with at least SPF 30 every morning, reapplying every two hours when exposed. Focus on the face, hands, and chest, and wear a wide-brimmed hat for additional protection, as sun avoidance is crucial for preventing skin damage and cancer.

4. Incorporate Retinoids into Night Routine

Use a retinol (over-the-counter) or prescription tretinoin product nightly to promote collagen synthesis, increase skin cell turnover, and reduce wrinkles and pigment. Start with lower potency or less frequent application if new to retinoids, and apply to the entire face, including eyelids, for comprehensive results.

5. Apply Topical Vitamin C Serum

Integrate topical Vitamin C serum into your morning routine, ideally after cleansing and before sunscreen, to act as a powerful antioxidant, scavenge free radicals, and protect against UV damage. It works synergistically with Vitamin E, and you should allow it to dry for a couple of minutes before applying sunscreen.

6. Select Cosmetic Providers Carefully

When choosing a provider for any cosmetic procedure, seek referrals from trusted sources, interview multiple doctors to ensure good rapport and shared goals, and prioritize their experience, knowledge of anatomy, and patient selection over specific labels or training types.

7. Ask Critical Questions to Providers

During consultations, ask providers about the number of procedures they’ve performed, request to speak with previous patients, inquire about potential complications and their management, and ask if they offer alternative solutions or refer out for procedures they don’t specialize in.

8. Aim for Natural-Looking Botox

If considering Botox, seek a provider who understands facial anatomy and aims for subtle, natural results by primarily treating the corrugator and procerus muscles (furrow lines) with only a light sprinkling in the forehead to preserve natural brow elevation and expression.

9. Consider Under-Eye Filler with Cannula

For under-eye bags or tear troughs, explore hyaluronic gel filler injected with a blunt-tipped cannula from the cheek, as this technique minimizes needles under the eye and can effectively brighten the face by replacing lost fat or disguising bulging fat pads.

10. Set Realistic Cosmetic Goals

Approach cosmetic procedures with a healthy mindset, aiming to look refreshed or about 7-10 years younger, rather than trying to revert to a much younger age, as chasing an unrealistic ideal can lead to unnatural or distorted results.

11. Evaluate Procedure Efficacy Critically

When considering new procedures or devices (e.g., energy devices, PRP), be skeptical of cure-all claims and critically examine before-and-after photos for genuine improvement, being wary of results that might be due to lighting differences or overselling.

12. Verify Device Authenticity & Approval

For non-surgical fat reduction (e.g., CoolSculpting), ensure the clinic uses genuine, FDA-approved devices, as knock-off machines may not be safe or effective, and prioritize the provider’s reputation over the specific device itself.

13. Understand Chemical Peel Risks

If considering chemical peels, recognize that they are highly operator-dependent and carry risks like burns or scars; thoroughly discuss the type of peel, its strength, and safety for your specific skin type with an experienced provider.

14. Take an Anti-Gravity Selfie

To see how your face looks without the effects of gravity, take a selfie while lying down, as this can reveal contours and volume status that are obscured when standing.