July 7, 2026 • 29 mins
What does it actually mean when a med spa says it offers “laser treatments”? The answer is far more complicated than most patients realize.
In this episode of Plastic Surgery Uncensored, Dr. Rady Rahban is joined once again by Charlene, RN, for part three of their series examining the increasingly popular and often misunderstood world of nonsurgical aesthetic treatments. T
ogether, Dr. Rahban and Charlene break down technologies including BBL, IPL, erbium resurfacing, and HALO, while exploring one of the most important issues in laser medicine: treating darker skin tones safely. They also discuss the relationship between downtime and results, why more aggressive treatments are not always appropriate for every patient, and how improper settings or inadequate pre- and post-treatment skincare can lead to burns, worsening pigmentation, and disappointing outcomes.
This episode is not about promoting one laser or claiming that a single device can do it all. In fact, that is precisely the point. The right technology must be matched to the right problem, the right skin type, and the right patient.
✨ If you enjoyed this episode of Plastic Surgery Uncensored:
✔️ Subscribe on Apple Podcasts, Spotify, or wherever you listen.
✔️ Rate & Review—your feedback helps more people find us.
✔️ Follow Dr. Rady Rahban across all platforms for daily insights, behind-the-scenes, and patient education:
In this episode of Plastic Surgery Uncensored, Dr. Rady Rahban is joined once again by Charlene, RN, for part three of their series examining the increasingly popular and often misunderstood world of nonsurgical aesthetic treatments. T
ogether, Dr. Rahban and Charlene break down technologies including BBL, IPL, erbium resurfacing, and HALO, while exploring one of the most important issues in laser medicine: treating darker skin tones safely. They also discuss the relationship between downtime and results, why more aggressive treatments are not always appropriate for every patient, and how improper settings or inadequate pre- and post-treatment skincare can lead to burns, worsening pigmentation, and disappointing outcomes.
This episode is not about promoting one laser or claiming that a single device can do it all. In fact, that is precisely the point. The right technology must be matched to the right problem, the right skin type, and the right patient.
✨ If you enjoyed this episode of Plastic Surgery Uncensored:
✔️ Subscribe on Apple Podcasts, Spotify, or wherever you listen.
✔️ Rate & Review—your feedback helps more people find us.
✔️ Follow Dr. Rady Rahban across all platforms for daily insights, behind-the-scenes, and patient education:
- Instagram: @drradyrahban
- TikTok: @radyrahbanMD
- YouTube: @Rady Rahban
- Facebook: @Rady Rahban
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:06):
All right, welcome to another episode of Plastic Surgery and Censored.
I'm your host, doctor Roddy Rabon, and we are part
three of a multi part series here with Charlene, and
our goal was to create a series of episodes that
focus exclusively on the non surgical MEDSPA world. Everyone that
(00:26):
follows me and knows me knows I'm sort of very
I don't like the word anti because obviously I'm not
anti because we haven't met SPA. I'm very cautious about
the MEDSPA world. The reason I have been is because
I think it's an environment that's generally very unregulated and
very wild wild West. I think that's an area where
consumers are exposed to more wrongdoing than others because there's
(00:48):
less information and the philosophy. Oh, it's just minor. I
just walked in. It's no big deal. So the reason
Charlene and I get together is to create this sequence.
We did one on neurotoxins like botox, we did one
on filler, and this episode is going to predominantly be
pretty much about lasers. So interestingly enough, if you would
(01:11):
have spoken to me last year and said, hey, what
are your thoughts on lasers. I tell you, I have
no thoughts. Yeah, because I knew nothing about lasers. I
knew that just about lasers. But like everything else, I'm
a very big believer that if you offer something to
a patient, you should really know what the hell you're
talking about. Yeah, of course, right. No, So many places,
(01:35):
the medical director, the doctor is offering treatments they know
nothing about, and they just have them there and the
machines run or the nurses are doing things and the
doctor a because they're a pediatrician, be their radiologists see,
they don't have a clue, they don't care, they're not there.
So for me, because of the nature of who I am,
(01:56):
when I decided that we were going to build this
wellness slash medsac Esthetic METSPAS center, it was imperative that
I knew what I was talking about. And so obviously
I'm incredibly familiar with neuromodulators and fillers, and laser was
a whole new area for me. So I did a
ton of homework by myself, a ton of homework with
(02:17):
colleagues and dermatologists that I knew, picking their brain as
to why do you have this one, why do you
have that machine? And like everything else, there's a thousand options.
It's like saying, hey, I knew nothing about cars. I
went to go buy a car, and I was like, whoa,
There's like a thousand different cars out there. There's a Mercedes,
there's a BMW, there's a Porter, there's a Lamborghini, there's
a Volvo. Like, how do I know? It's the same thing.
(02:39):
So the way I the thing I want people to
understand about lasers is laser is a very very very
broad term. It means nothing in that you can have
a laser whose wavelength which we're going to elaborate on
in a second, is designed exclusively towards hair. Yeah, and
(03:05):
it will do nothing for your sun spots. And you
can have a laser who only works sunspots and do
nothing for your hair. Yet they're advertising this as a laser.
So why many patients have been disenchanted by lasers historically
is as a provider, here, doctor raband, I buy this
(03:27):
really expensive laser, and I wanted to do as much
as possible as possible, and I then market it as
doing hair removal, veins, skin resurfacing, la la la la la,
And obviously it's not. It's just impossible for it to
do that. So the basic principle of all lasers is wavelengths, right,
(03:49):
So why don't you, because you have a lot of
experience with lasers, explain this whole concept of wavelengths and
how it targets different things in the skin.
Speaker 2 (03:58):
Yeah, So essentially there's different ways links with the laser,
and the wavelength is kind of the time that it
takes for the energy to go in and out of
the skin tissue. So different wavelengths can target different issues
or concerns that you have. There's wavelengths to help with redness,
so any sort of vessels, rosation, any sort of you know,
broken blood vessels and things like that. We have wavelengths
(04:20):
to help with pigmentation, dark spots, sunspots, issues in that manner.
And then we have lasers that can help with texture,
so fine lines, wrinkles, pores, scars, you know, we have
different ones, and we really wanted to break it down
to address those two main components pigment and texture.
Speaker 1 (04:38):
Right, So why I want you to pay attention is
each laser, you need to know what that laser was
designed to target. So let me explain why this is.
So if you go into a spa and your goal
is to get sunspots removed, you need to ask them
before you go in. What laser are you using. We're
(05:01):
using a Syton laser. Great, what's the wavelength that they're using?
Then you before you go in, you google that and say,
does this laser with that wavelength address the thing that
I'm going in for? Because all too often what happened
just patients call and say, hey, I have some sunspots, Like,
come on in, we have a laser. You go in,
(05:22):
they numb you up, they zap you, and you leave.
What laser do you have done? I don't know. What
was a wavelength? I don't know? And then how did
it go? M wasn't that effective? Well? Yeah, because you
use a screwdriver to put in a nail, Like, that's
not what it was. But it was a laser. Again,
lasers are so specific, so really really important that you
(05:45):
know that. In my quest obviously, in my quest, obviously,
my goal was to address the things that I think
were helpful in a surgical practice. Right, like my goal,
you can go get hair removal. Great, there are lasers
that are super good at hair removal. You have lasers
that remove tattoos. You have lasers that, as you said,
(06:07):
get rid of vessels and spider vessels and you know,
spider angiomas and things like that. You have vessel you
have lasers that resurfaced your skin and take off a
layer of it. Our goal at our met spa, or
our goal in our wellness center was to provide something
(06:29):
that's adjunctive to a surgical practice. So the reason why
I think it's so critical is that we have a
met SPA where I'm the medical director, right, I am
the one who is curating the treatments we provide, making
sure it's the best treatment technologies, making sure the results
are being held to the same standards that you would
(06:49):
want when you come get a facelift or rhinoplasty. Where
I run into trouble is that the majority of met
spas are isolated by themselves. The the medical director is
there once in a blue moon, they're not in the
specialty of this. They're like an ob who is helping
out a friend, and often the nurses and providers are
(07:10):
sort of just figuring out things on their own. I
think those are distinctly different than those that are provided
under the umbrella of a surgeon who does esthetics totally
two different animals, so at any rate in looking for
a laser, the things that I wanted to address were
the things that I thought that here you come in.
Patient comes in, she's in her late forties, fifties, maybe sixties,
(07:34):
once facial rejuvenation, like, hey, you know it's time. I
think it's time. My eyelids are starting to get a
little excess. I got some sagging, I got a little jow,
little neckband, and they wanted a rejuvenation. And despite being
a great surgeon, there's just certain things I can't do.
I just can't do it. What do you mean you
can't do I can't change the quality of your skin.
(07:57):
I can change the gift. I can't change gift wrapping.
And so I had reached a level now that my
practice is so much heavier in esthetics, facial aesthetics, that
is it would be. It was frustrating not to be
able to provide the totality of what I think a
patient needs in order to get a home run result.
(08:20):
You could do a facelift, you could do their eyelid,
you can do whatever, and then they'd look good, but
they still have crappy skin, they still have a bunch
of sun spots and sun damage. So the areas that
we focused in on is we here in in our
met spot focused on predominantly sun damage right, pigmentary related
(08:45):
sun damage types of things all the way down to
melasma which technically isn't sun damage but hormone driven, as
well as skin texture, wrinkles, resurfacing pores, things of that nature.
We dabble in the vessels and suns, the rosetia thing
because the laser we have is so broad, but generally
(09:08):
that's the bulk of it. And so after extensive homework,
it became apparent to me that the laser that we
ultimately acquired, in my opinion, currently, as you know, with
the technologies, it's constantly going to change. But I think
that the laser that we got is the Bugatti of lasers.
(09:30):
And why that is is because number one, I think
that consistency of results, meaning it consistently produces fantastic results.
Number Two, it allows us to treat more patients than normal.
So a traditional laser, laser energy coming out of a
(09:51):
machine was designed for white people. Not let me rephrase
that it wasn't designed for white people. It was just
that white people were the only people that could do it.
It wasn't like they went out their way and they
were like racist, I'm gonna make a laser only for
the white folk. No, it was just that the technology,
because it's heat, only white skin people could take advantage
(10:12):
of it, because darker skinned people like me, like you,
like Latinos, like African Americans, likedmoices, couldn't because they would
create a host of new problems. And so as a result,
let's go over skin coloring. The whole spectrum of skin
colors is designed by is categorized by a term Fitzpatrick.
(10:35):
I'm assuming it was doctor Fitzpatrick. I'm assuming, and we
call it Fitzpatrick scale from one to six. One being
snow white, six being African black. Right, So one, two
and some threes have always been able to do lasers,
four five, six never been able to do lasers. And
(10:57):
because my practice is so heavy in four fives and
six is right, we have Asians, Middle Easterners, Latinos, African Americans,
people that are of Indian descent. I mean shit, eighty
percent of my patients are kids Fitzpatrick, four, five and six.
(11:22):
So the current technologies in most companies, their lasers don't
really can't really treat four, five, and six. They just
haven't gotten there. The laser we ultimately decided on, which
is a Syton laser. This is not an ad for
Sitan is really the only one of the only laser
(11:46):
companies that has advanced the technologies such that darker people
can benefit from these lasers. And I think for me,
as a person who has never had a laser, this
is the best time to enter because I now have
acquired a laser that I can do a lot with
the patients that we have. So in the Syton laser world,
(12:09):
they have many lasers. We went ahead and selected what
we felt were the three most critical lasers and we're
going to talk about what they do and who they're
for and what to look for and whatnot. One of
them is a technically not a laser. Yeah, it's called
BBL and I'm not talking about Brazilian butt lifts. It
took me a while. I was like, what butt lifts
(12:31):
are getting into lasers? So Brazilian butt lift slash BBL
is broad band light and what people will know it
as is IPL right intense pulse light. And what you
had told me about it is that it's just a
flash of light that goes straight through the skin, finds pigment,
(12:54):
explodes pigment, and then the pigment finds its way to
the surface. So historically it was done with IPO, and
Cyton came up with their own technology of the in
the intent in the light technology. They renamed it as
broadband light, essentially the same as an IPO, but now
(13:16):
you can start treating higher Fitzpatrick and I think that's
a game changer, right, So tell me about yours. You're
a lighter eight, you're a lighter Asian woman, but you're
still a four.
Speaker 2 (13:28):
And I'm still four.
Speaker 1 (13:29):
Exactly what makes you a four is what.
Speaker 2 (13:32):
Well, my Asian descent and I'm Filipino, so that in
general we do have more melanosites in our skins.
Speaker 1 (13:38):
Right, the tanning POTENTI exactly. So people that are white
that tan are not white. That's the key. White means
that when you go to in the sun, you have
no melanocytes. You get red and beat beat red, lobster,
red peel, and you just don't when you're whitish and
you go in the sun and you get darker and
(13:59):
you get freckles. Then technically you're not a one or two,
you're like a three four. So Charlene's a four, I'm
probably a four, which means that if you know, we
went to you know, Costa Rica for a month, we
probably much darker now you can you and I can't
really do IPL no, And.
Speaker 2 (14:17):
I've you know, I've worked with lasers for maybe fifteen
years and I've I've tested and IPL myself. I would
give myself a lil test spot just to see if
I could even do it, because obviously I want to
get the benefits for a machine that I'm using on
other patients. And I have had some hyper pigmentation and
burned from it.
Speaker 1 (14:32):
Yeah, even with.
Speaker 2 (14:32):
The lowest settings and the safest settings that I think
I could use.
Speaker 1 (14:35):
Yeah. So I think that's the reason why their BBL,
their broadband light siitons is such a game changer, because
you can't treat fives, you can't treat sixes, yeah, but
you can pretty safely address three fours and some.
Speaker 2 (14:51):
Five maybe lighter five.
Speaker 1 (14:52):
Right, And that's that's that's kind of like synonymous to
autonomous driving cars, Like it's a big leap in the
laser world.
Speaker 2 (15:02):
Wouldn't you say, yeah, yeah, they were able to integrate
these different filters that can you go to use it
with other skin types, right, So I.
Speaker 1 (15:11):
Think that's really really remarkable. So of course we got
that it's not a laser, but that mode mode. The
next mode was we wanted something that would resurface. Right.
So here you are, you come in for a facelift.
You're in your late forties, early fifties and sixties and beyond,
and we're going to tighten up your skin and pull
(15:34):
it and make it snug. But your skin has now
had fifty years of road rash, right, It's got pores
and fine wrinkles in whatever, and so a perfect time
for us to resurface your skin clean off the top layer,
depending on your tolerance. Your tolerance is during the OAR
and so there are two main technologies CO two resurfacing
(15:59):
and erbium resurfacing. By and large, for the average consumer,
they're the same. What that means is they're ablative, meaning
they are burning, burning layers of skin off. And the
laser is so advanced that I can dial it in
by micro nanometer micro microns and dial it in layer
(16:24):
by layer. I'm talking ten microns one hundred microns, which
is insane because it means that the laser can take
a little of the layer off. And why this I
chose the erbiuan version. Their name is TRL. It just
is an erbium resurfacing laser. And what I love about
this laser is that it allows me to do a
(16:46):
you're under anesthesia, you're asleep, you have no pain, you
can't feel nothing. I'm going to crank up this resurfacing
and I'm going to burn the outer layer of your
face off off. And the benefit is A you can
tolerate it, because normally you wouldn't be able to tolerate
such a deep resurfacing. And b is you're down for
(17:08):
the count because the number one issue with all lasers
is recovery. So the more aggressive we get, the more
amazing the results, the more downtime you have. And so
when you're having surgery and you're out for sure for
at least a week, we have the luxury of having downtime.
(17:32):
So I am now not only doing this resurfacing on
all my facelip patients. I'm doing this resurfacing. I did
a Mommy makeover on Friday. I resurface the shit out
of her face because frankly, she has no pain when
she's under anesthesia and she's out for a week. So
it's been a game changer in that regard. But the
reason I love this laser is because in addition to
(17:55):
being in the OAR and major downtime and major outcome
is we have a milder versions that you are now
able to do in the clinic with less downtime, almost
no pain, less recovery, and higher skin types. So again,
(18:18):
I think the laser, this particular laser, the Syton laser,
was a game changer because it started giving us tools
to help with all the patients I never were to
be able to. So the two types of peels that
we can sorry, excuse me, the two types of resurfacings
we can do in the clinic side is something that
we just refer to as a nano peel, aka of
(18:40):
very gentle resurfacing, which we can do in black patients that.
Speaker 2 (18:47):
Is nuts properly pre treated.
Speaker 1 (18:50):
Right, We're gonna get to the pre treatment, and then
we can do something called a micro peel, which is
a more aggressive form which we would which we can
also do in certain types of people. A we got
the BBL pigment b we got the resurfacing, which was
a TRL. Now the final game changer was this thing
(19:11):
where now we have what's called a halo. And the
reason the halo is a game changer is it's a hybrid.
It literally takes both of those technologies and wraps them
into one. And what it allows you to do is
sends two wavelengths simultaneously. In one is it penetrates deep
zaps the pigment like the BBL but different, and then
(19:34):
at the same time it resurfaces the top. So in
one treatment with the halo, you get the benefits of
pigment and the resurfacing. And that one is right now
probably the hottest laser on the market. There used to
be a laser called not used to there still is.
There's a laser called FRAXOYL and FRAXOYL is the laser
(19:58):
that originated this on set and they were the og
of this technology and for many years they were the
main thing. Like anyone who wanted to get resurfacing of
their skin, they were, you know, in their forties and fifties,
even in their late thirties, they'd go get a Fraxel.
This technology really is the new iteration and blows the fractional.
Speaker 2 (20:22):
So this laser apart though, is that with the fraxl
I mean, it is a great technology and you could
still use it today, but you were limited to the
skin types that you had to use it on. You
couldn't treat fives and sixes with that, yeah, maybe even fourst.
But with the halo we can actually even treat up
to a six skin type six.
Speaker 1 (20:38):
Yeah, which which again for anyone in the laser world,
I think this idea of even treating darker skinned people
is just like Wow, this is such a game changer. Literally,
it's like it's a revolution in my opinion. So essentially
what we did was we acquired these three modalities. We
have a pure pigmentary light based laser BBL, which we
(21:04):
have a true resurfacing layer that the laser that we
can do from mild moderate, severe, oh my god. And
then we have this incredible hybrid laser that we can
do both in one shot. You can do these lasers
in the clinic under numbing cream and you can do higher,
more aggressive ones in the oar under anesthesia. The other
(21:27):
thing about it that's really cool is that you know,
you can stack these treatments, so like you can do
a nanopel and a BBL in one setting and they
work completely differently, and they almost mimic a halo.
Speaker 2 (21:44):
It's for the people who want less downtime. I'd say, Yeah,
obviously have to do more sessions than a halo, but
you have very little downtime but still get just as
great as results.
Speaker 1 (21:54):
Yeah, So the key to lasers in general, what I
want you guys to understand first. First thing is I
need to make sure I'm using the right laser for
the right problem. So if you don't know what your
issue is, it's pigment, it sprinkles, it's vessels, and you
don't identify that the laser that the place is using
is the best laser for that problem, don't bother going in.
(22:15):
The Next thing you need to decide is how much
downtime am I willing to have? How much downtime am
I willing to have? Understand, more downtime equals better results
the end, there is no laser amazing results zero downtime
that just doesn't exist. The greater the downtime, the better
(22:37):
the results. So your options are a suck it up.
I'm going to take a week off. I'm off for vacation.
My kids are this, I broke my leg. I'm going
in for a breast dog whatever, go more aggressive, be
done with it, and or I don't have that such luxury.
I work my kids. Do da da do more sessions?
(22:58):
Get there anyways and have lesser downtime. Do you only
downside to the more sessions, it's it's more sessions. The
upside is that you don't lose. You don't lose a beat. Now,
the next thing that I think is super important is
that without skincare, do not do lasers. Without skincare, do
(23:23):
not do lasers. I am a prime example. I did lasers.
I did it without skincare. I kind of was being
a little bit of a cavalier and it didn't work
out as well as I like. Because at the end
of the day, I'm still a Fitzpatrick four. I still
go outside. I need thist at the other if you
are white and you are Fitzpatrick one and two, you
(23:43):
are lucky. You don't need anything. If you are everyone
else in the world three four, five, six. If you
go in and you just go into a spa, get
a laser done to your face and walk out, you
are likely to have more pigment, more sun spots, more irregularities.
Did you hear what I just said? Because these things
(24:04):
are heat driven, and if you don't do the pre
and post skin care, if you are not committed, if
you don't have the whatever it takes, then don't bother
because you have to get the skin ready to get heated,
and then you need the skin to be treated after
(24:24):
it's been heated. Now, it's very mild, it doesn't take
a lot. It's not a major to do. It's not
a huge ordeal. But like, you can't have a laser
and not worse SPF. You just can't. Like you just
forget it, don't go. It's a waste of time. Not
only is a waste of time, I actually think you
get worse. Yeah, you know there's people who have gone
(24:44):
and gotten lasers and then they've gone on vacation or
something and then they're like sunspots that I actually when
I was twenty something, I went in I had like
five hairs on my back and I had my laser
I had. I went somewhere I had my back hairs
lasered off. I was like, oh cool, because my friend
is an idiot. He took me with him and he's
a hairy bear and he lasered his back. And then
(25:05):
like two weeks later we went to Vietnam and like
beach cities. The amount of freckles on my back right now, actually,
as a matter of fact, you got to be beyond
my back. The amount of freckles on my back is insane.
And that was my stupidity. I didn't use any SBF.
So and then that's really really really important. What can
(25:26):
go wrong with lasers. Let's talk about what can go
wrong with lasers.
Speaker 2 (25:30):
So, again, if you're not properly using the proper skincare
pre treating, post treating, you can definitely get your results
can be worse.
Speaker 1 (25:38):
Pigment, your pigment can skyrocket. Pigment can skyrocket. If you
went in there fix your pigment and you don't get
the right settings, the right pre treatment, the right post treatment,
your pigment could get worse.
Speaker 2 (25:54):
You could get a burn burn.
Speaker 1 (25:57):
So if you are oh, oh I've been on retinee
all day long, I I you know, you're an acutaine
or something, and you go in there and you get
lasered and you your skin is thin, you can get burned,
or the setting is too high, you can get burned. Yeah, absolutely,
cold source cold sore. So if you are prone to
(26:19):
cold source, it's not a complication, but it's certainly not
going to be fun. And if you get a shingles outbreak,
you'll be pissed. So if you are prone to cold source,
any type of stress, as you know, stress of a flu.
I got COVID. I'm undergoing of divorce triggers these viruses.
So you want to make sure you tell your provider. Hey,
they should be asking you anyways, but hey, I get
(26:40):
cold source, you should take a voutrex and a few
and a little bit of medication for a day or
two around the lasers. Those are really the two main
things I think you can get pigmentary changes or burns.
It's pretty much the main main main issues. We're very
excited about our new laser. To me, it's almost like
(27:01):
it's exciting because it's things that I was never able
to do. And I think that it really is a
cherry on top and this sort of, if you will,
the hood ornament on a rolls or a Bentley. Without it,
it's just sort of an incomplete process and I'm very
excited that we're able to do this and do it
at a high level. Now. So listen, we happen to
have this Syton laser. It's not to suggest that other
(27:23):
laser's not good. There's actually a ton of other great lasers.
You just need to become educated. And I it took
me a while to become educated, but I now know
like a Piko Shore, a Piko Shore specific for this.
I want to get my tattoo removed. I would google
best removal tattoo remove a laser, and they each laser
will have a will be really honed in to do
(27:44):
one very specific thing. One thing is for sure, no
laser does it all like. There isn't one hand piece
with one wavelength. Then you just go in there and
zap off your hair, remove your tattoo, get rid of suns.
It just it just doesn't work that way. By the way, Also,
we talked about just briefly, and I'll just touch on
this because no, actually we'll do this in another episode.
(28:06):
I was gonna talk about micro needling, but we'll talk
about our f microneedling, but we'll talk about that on
micro needels. At any rate, I hope you found that
to be informative. Obviously, it's a very superficial crash course
on lasers. It's sort of what I think would be
relevant for you to know, and hopefully it was helpful.
We're gonna do. Our next episode will be on micro needling, which,
(28:28):
if you talk to my wife, is the wife and
charlene favorite treatment in the whole universe. I would argue
that it truly is, and we'll touch on this whole
new world of radio frequency micro needling, which is r
F and things like Morpheus. So anyway, I hope you
enjoyed that episode. As always, two parting favors. One, if
(28:49):
you like the show, go write something sweet, Go write
a review, go say hey, it was great and we
really do appreciate it. Secondly, send our episode, send it
to friends, family members. You never know who's going to
go and do something stupid and foolish and you're like, oh,
I just listened to an episode. I wish you would
have listened to it. You just don't know what's going
(29:10):
to happen to someone you love, So share, subscribe, and download.
All right, that's a wrap. You hat another episode of
plastic surgery and censor. We'll see you next week, your host,
doctor Roddy Raban,
All right, welcome to another episode of Plastic Surgery and Censored.
I'm your host, doctor Roddy Rabon, and we are part
three of a multi part series here with Charlene, and
our goal was to create a series of episodes that
focus exclusively on the non surgical MEDSPA world. Everyone that
(00:26):
follows me and knows me knows I'm sort of very
I don't like the word anti because obviously I'm not
anti because we haven't met SPA. I'm very cautious about
the MEDSPA world. The reason I have been is because
I think it's an environment that's generally very unregulated and
very wild wild West. I think that's an area where
consumers are exposed to more wrongdoing than others because there's
(00:48):
less information and the philosophy. Oh, it's just minor. I
just walked in. It's no big deal. So the reason
Charlene and I get together is to create this sequence.
We did one on neurotoxins like botox, we did one
on filler, and this episode is going to predominantly be
pretty much about lasers. So interestingly enough, if you would
(01:11):
have spoken to me last year and said, hey, what
are your thoughts on lasers. I tell you, I have
no thoughts. Yeah, because I knew nothing about lasers. I
knew that just about lasers. But like everything else, I'm
a very big believer that if you offer something to
a patient, you should really know what the hell you're
talking about. Yeah, of course, right. No, So many places,
(01:35):
the medical director, the doctor is offering treatments they know
nothing about, and they just have them there and the
machines run or the nurses are doing things and the
doctor a because they're a pediatrician, be their radiologists see,
they don't have a clue, they don't care, they're not there.
So for me, because of the nature of who I am,
(01:56):
when I decided that we were going to build this
wellness slash medsac Esthetic METSPAS center, it was imperative that
I knew what I was talking about. And so obviously
I'm incredibly familiar with neuromodulators and fillers, and laser was
a whole new area for me. So I did a
ton of homework by myself, a ton of homework with
(02:17):
colleagues and dermatologists that I knew, picking their brain as
to why do you have this one, why do you
have that machine? And like everything else, there's a thousand options.
It's like saying, hey, I knew nothing about cars. I
went to go buy a car, and I was like, whoa,
There's like a thousand different cars out there. There's a Mercedes,
there's a BMW, there's a Porter, there's a Lamborghini, there's
a Volvo. Like, how do I know? It's the same thing.
(02:39):
So the way I the thing I want people to
understand about lasers is laser is a very very very
broad term. It means nothing in that you can have
a laser whose wavelength which we're going to elaborate on
in a second, is designed exclusively towards hair. Yeah, and
(03:05):
it will do nothing for your sun spots. And you
can have a laser who only works sunspots and do
nothing for your hair. Yet they're advertising this as a laser.
So why many patients have been disenchanted by lasers historically
is as a provider, here, doctor raband, I buy this
(03:27):
really expensive laser, and I wanted to do as much
as possible as possible, and I then market it as
doing hair removal, veins, skin resurfacing, la la la la la,
And obviously it's not. It's just impossible for it to
do that. So the basic principle of all lasers is wavelengths, right,
(03:49):
So why don't you, because you have a lot of
experience with lasers, explain this whole concept of wavelengths and
how it targets different things in the skin.
Speaker 2 (03:58):
Yeah, So essentially there's different ways links with the laser,
and the wavelength is kind of the time that it
takes for the energy to go in and out of
the skin tissue. So different wavelengths can target different issues
or concerns that you have. There's wavelengths to help with redness,
so any sort of vessels, rosation, any sort of you know,
broken blood vessels and things like that. We have wavelengths
(04:20):
to help with pigmentation, dark spots, sunspots, issues in that manner.
And then we have lasers that can help with texture,
so fine lines, wrinkles, pores, scars, you know, we have
different ones, and we really wanted to break it down
to address those two main components pigment and texture.
Speaker 1 (04:38):
Right, So why I want you to pay attention is
each laser, you need to know what that laser was
designed to target. So let me explain why this is.
So if you go into a spa and your goal
is to get sunspots removed, you need to ask them
before you go in. What laser are you using. We're
(05:01):
using a Syton laser. Great, what's the wavelength that they're using?
Then you before you go in, you google that and say,
does this laser with that wavelength address the thing that
I'm going in for? Because all too often what happened
just patients call and say, hey, I have some sunspots, Like,
come on in, we have a laser. You go in,
(05:22):
they numb you up, they zap you, and you leave.
What laser do you have done? I don't know. What
was a wavelength? I don't know? And then how did
it go? M wasn't that effective? Well? Yeah, because you
use a screwdriver to put in a nail, Like, that's
not what it was. But it was a laser. Again,
lasers are so specific, so really really important that you
(05:45):
know that. In my quest obviously, in my quest, obviously,
my goal was to address the things that I think
were helpful in a surgical practice. Right, like my goal,
you can go get hair removal. Great, there are lasers
that are super good at hair removal. You have lasers
that remove tattoos. You have lasers that, as you said,
(06:07):
get rid of vessels and spider vessels and you know,
spider angiomas and things like that. You have vessel you
have lasers that resurfaced your skin and take off a
layer of it. Our goal at our met spa, or
our goal in our wellness center was to provide something
(06:29):
that's adjunctive to a surgical practice. So the reason why
I think it's so critical is that we have a
met SPA where I'm the medical director, right, I am
the one who is curating the treatments we provide, making
sure it's the best treatment technologies, making sure the results
are being held to the same standards that you would
(06:49):
want when you come get a facelift or rhinoplasty. Where
I run into trouble is that the majority of met
spas are isolated by themselves. The the medical director is
there once in a blue moon, they're not in the
specialty of this. They're like an ob who is helping
out a friend, and often the nurses and providers are
(07:10):
sort of just figuring out things on their own. I
think those are distinctly different than those that are provided
under the umbrella of a surgeon who does esthetics totally
two different animals, so at any rate in looking for
a laser, the things that I wanted to address were
the things that I thought that here you come in.
Patient comes in, she's in her late forties, fifties, maybe sixties,
(07:34):
once facial rejuvenation, like, hey, you know it's time. I
think it's time. My eyelids are starting to get a
little excess. I got some sagging, I got a little jow,
little neckband, and they wanted a rejuvenation. And despite being
a great surgeon, there's just certain things I can't do.
I just can't do it. What do you mean you
can't do I can't change the quality of your skin.
(07:57):
I can change the gift. I can't change gift wrapping.
And so I had reached a level now that my
practice is so much heavier in esthetics, facial aesthetics, that
is it would be. It was frustrating not to be
able to provide the totality of what I think a
patient needs in order to get a home run result.
(08:20):
You could do a facelift, you could do their eyelid,
you can do whatever, and then they'd look good, but
they still have crappy skin, they still have a bunch
of sun spots and sun damage. So the areas that
we focused in on is we here in in our
met spot focused on predominantly sun damage right, pigmentary related
(08:45):
sun damage types of things all the way down to
melasma which technically isn't sun damage but hormone driven, as
well as skin texture, wrinkles, resurfacing pores, things of that nature.
We dabble in the vessels and suns, the rosetia thing
because the laser we have is so broad, but generally
(09:08):
that's the bulk of it. And so after extensive homework,
it became apparent to me that the laser that we
ultimately acquired, in my opinion, currently, as you know, with
the technologies, it's constantly going to change. But I think
that the laser that we got is the Bugatti of lasers.
(09:30):
And why that is is because number one, I think
that consistency of results, meaning it consistently produces fantastic results.
Number Two, it allows us to treat more patients than normal.
So a traditional laser, laser energy coming out of a
(09:51):
machine was designed for white people. Not let me rephrase
that it wasn't designed for white people. It was just
that white people were the only people that could do it.
It wasn't like they went out their way and they
were like racist, I'm gonna make a laser only for
the white folk. No, it was just that the technology,
because it's heat, only white skin people could take advantage
(10:12):
of it, because darker skinned people like me, like you,
like Latinos, like African Americans, likedmoices, couldn't because they would
create a host of new problems. And so as a result,
let's go over skin coloring. The whole spectrum of skin
colors is designed by is categorized by a term Fitzpatrick.
(10:35):
I'm assuming it was doctor Fitzpatrick. I'm assuming, and we
call it Fitzpatrick scale from one to six. One being
snow white, six being African black. Right, So one, two
and some threes have always been able to do lasers,
four five, six never been able to do lasers. And
(10:57):
because my practice is so heavy in four fives and
six is right, we have Asians, Middle Easterners, Latinos, African Americans,
people that are of Indian descent. I mean shit, eighty
percent of my patients are kids Fitzpatrick, four, five and six.
(11:22):
So the current technologies in most companies, their lasers don't
really can't really treat four, five, and six. They just
haven't gotten there. The laser we ultimately decided on, which
is a Syton laser. This is not an ad for
Sitan is really the only one of the only laser
(11:46):
companies that has advanced the technologies such that darker people
can benefit from these lasers. And I think for me,
as a person who has never had a laser, this
is the best time to enter because I now have
acquired a laser that I can do a lot with
the patients that we have. So in the Syton laser world,
(12:09):
they have many lasers. We went ahead and selected what
we felt were the three most critical lasers and we're
going to talk about what they do and who they're
for and what to look for and whatnot. One of
them is a technically not a laser. Yeah, it's called
BBL and I'm not talking about Brazilian butt lifts. It
took me a while. I was like, what butt lifts
(12:31):
are getting into lasers? So Brazilian butt lift slash BBL
is broad band light and what people will know it
as is IPL right intense pulse light. And what you
had told me about it is that it's just a
flash of light that goes straight through the skin, finds pigment,
(12:54):
explodes pigment, and then the pigment finds its way to
the surface. So historically it was done with IPO, and
Cyton came up with their own technology of the in
the intent in the light technology. They renamed it as
broadband light, essentially the same as an IPO, but now
(13:16):
you can start treating higher Fitzpatrick and I think that's
a game changer, right, So tell me about yours. You're
a lighter eight, you're a lighter Asian woman, but you're
still a four.
Speaker 2 (13:28):
And I'm still four.
Speaker 1 (13:29):
Exactly what makes you a four is what.
Speaker 2 (13:32):
Well, my Asian descent and I'm Filipino, so that in
general we do have more melanosites in our skins.
Speaker 1 (13:38):
Right, the tanning POTENTI exactly. So people that are white
that tan are not white. That's the key. White means
that when you go to in the sun, you have
no melanocytes. You get red and beat beat red, lobster,
red peel, and you just don't when you're whitish and
you go in the sun and you get darker and
(13:59):
you get freckles. Then technically you're not a one or two,
you're like a three four. So Charlene's a four, I'm
probably a four, which means that if you know, we
went to you know, Costa Rica for a month, we
probably much darker now you can you and I can't
really do IPL no, And.
Speaker 2 (14:17):
I've you know, I've worked with lasers for maybe fifteen
years and I've I've tested and IPL myself. I would
give myself a lil test spot just to see if
I could even do it, because obviously I want to
get the benefits for a machine that I'm using on
other patients. And I have had some hyper pigmentation and
burned from it.
Speaker 1 (14:32):
Yeah, even with.
Speaker 2 (14:32):
The lowest settings and the safest settings that I think
I could use.
Speaker 1 (14:35):
Yeah. So I think that's the reason why their BBL,
their broadband light siitons is such a game changer, because
you can't treat fives, you can't treat sixes, yeah, but
you can pretty safely address three fours and some.
Speaker 2 (14:51):
Five maybe lighter five.
Speaker 1 (14:52):
Right, And that's that's that's kind of like synonymous to
autonomous driving cars, Like it's a big leap in the
laser world.
Speaker 2 (15:02):
Wouldn't you say, yeah, yeah, they were able to integrate
these different filters that can you go to use it
with other skin types, right, So I.
Speaker 1 (15:11):
Think that's really really remarkable. So of course we got
that it's not a laser, but that mode mode. The
next mode was we wanted something that would resurface. Right.
So here you are, you come in for a facelift.
You're in your late forties, early fifties and sixties and beyond,
and we're going to tighten up your skin and pull
(15:34):
it and make it snug. But your skin has now
had fifty years of road rash, right, It's got pores
and fine wrinkles in whatever, and so a perfect time
for us to resurface your skin clean off the top layer,
depending on your tolerance. Your tolerance is during the OAR
and so there are two main technologies CO two resurfacing
(15:59):
and erbium resurfacing. By and large, for the average consumer,
they're the same. What that means is they're ablative, meaning
they are burning, burning layers of skin off. And the
laser is so advanced that I can dial it in
by micro nanometer micro microns and dial it in layer
(16:24):
by layer. I'm talking ten microns one hundred microns, which
is insane because it means that the laser can take
a little of the layer off. And why this I
chose the erbiuan version. Their name is TRL. It just
is an erbium resurfacing laser. And what I love about
this laser is that it allows me to do a
(16:46):
you're under anesthesia, you're asleep, you have no pain, you
can't feel nothing. I'm going to crank up this resurfacing
and I'm going to burn the outer layer of your
face off off. And the benefit is A you can
tolerate it, because normally you wouldn't be able to tolerate
such a deep resurfacing. And b is you're down for
(17:08):
the count because the number one issue with all lasers
is recovery. So the more aggressive we get, the more
amazing the results, the more downtime you have. And so
when you're having surgery and you're out for sure for
at least a week, we have the luxury of having downtime.
(17:32):
So I am now not only doing this resurfacing on
all my facelip patients. I'm doing this resurfacing. I did
a Mommy makeover on Friday. I resurface the shit out
of her face because frankly, she has no pain when
she's under anesthesia and she's out for a week. So
it's been a game changer in that regard. But the
reason I love this laser is because in addition to
(17:55):
being in the OAR and major downtime and major outcome
is we have a milder versions that you are now
able to do in the clinic with less downtime, almost
no pain, less recovery, and higher skin types. So again,
(18:18):
I think the laser, this particular laser, the Syton laser,
was a game changer because it started giving us tools
to help with all the patients I never were to
be able to. So the two types of peels that
we can sorry, excuse me, the two types of resurfacings
we can do in the clinic side is something that
we just refer to as a nano peel, aka of
(18:40):
very gentle resurfacing, which we can do in black patients that.
Speaker 2 (18:47):
Is nuts properly pre treated.
Speaker 1 (18:50):
Right, We're gonna get to the pre treatment, and then
we can do something called a micro peel, which is
a more aggressive form which we would which we can
also do in certain types of people. A we got
the BBL pigment b we got the resurfacing, which was
a TRL. Now the final game changer was this thing
(19:11):
where now we have what's called a halo. And the
reason the halo is a game changer is it's a hybrid.
It literally takes both of those technologies and wraps them
into one. And what it allows you to do is
sends two wavelengths simultaneously. In one is it penetrates deep
zaps the pigment like the BBL but different, and then
(19:34):
at the same time it resurfaces the top. So in
one treatment with the halo, you get the benefits of
pigment and the resurfacing. And that one is right now
probably the hottest laser on the market. There used to
be a laser called not used to there still is.
There's a laser called FRAXOYL and FRAXOYL is the laser
(19:58):
that originated this on set and they were the og
of this technology and for many years they were the
main thing. Like anyone who wanted to get resurfacing of
their skin, they were, you know, in their forties and fifties,
even in their late thirties, they'd go get a Fraxel.
This technology really is the new iteration and blows the fractional.
Speaker 2 (20:22):
So this laser apart though, is that with the fraxl
I mean, it is a great technology and you could
still use it today, but you were limited to the
skin types that you had to use it on. You
couldn't treat fives and sixes with that, yeah, maybe even fourst.
But with the halo we can actually even treat up
to a six skin type six.
Speaker 1 (20:38):
Yeah, which which again for anyone in the laser world,
I think this idea of even treating darker skinned people
is just like Wow, this is such a game changer. Literally,
it's like it's a revolution in my opinion. So essentially
what we did was we acquired these three modalities. We
have a pure pigmentary light based laser BBL, which we
(21:04):
have a true resurfacing layer that the laser that we
can do from mild moderate, severe, oh my god. And
then we have this incredible hybrid laser that we can
do both in one shot. You can do these lasers
in the clinic under numbing cream and you can do higher,
more aggressive ones in the oar under anesthesia. The other
(21:27):
thing about it that's really cool is that you know,
you can stack these treatments, so like you can do
a nanopel and a BBL in one setting and they
work completely differently, and they almost mimic a halo.
Speaker 2 (21:44):
It's for the people who want less downtime. I'd say, Yeah,
obviously have to do more sessions than a halo, but
you have very little downtime but still get just as
great as results.
Speaker 1 (21:54):
Yeah, So the key to lasers in general, what I
want you guys to understand first. First thing is I
need to make sure I'm using the right laser for
the right problem. So if you don't know what your
issue is, it's pigment, it sprinkles, it's vessels, and you
don't identify that the laser that the place is using
is the best laser for that problem, don't bother going in.
(22:15):
The Next thing you need to decide is how much
downtime am I willing to have? How much downtime am
I willing to have? Understand, more downtime equals better results
the end, there is no laser amazing results zero downtime
that just doesn't exist. The greater the downtime, the better
(22:37):
the results. So your options are a suck it up.
I'm going to take a week off. I'm off for vacation.
My kids are this, I broke my leg. I'm going
in for a breast dog whatever, go more aggressive, be
done with it, and or I don't have that such luxury.
I work my kids. Do da da do more sessions?
(22:58):
Get there anyways and have lesser downtime. Do you only
downside to the more sessions, it's it's more sessions. The
upside is that you don't lose. You don't lose a beat. Now,
the next thing that I think is super important is
that without skincare, do not do lasers. Without skincare, do
(23:23):
not do lasers. I am a prime example. I did lasers.
I did it without skincare. I kind of was being
a little bit of a cavalier and it didn't work
out as well as I like. Because at the end
of the day, I'm still a Fitzpatrick four. I still
go outside. I need thist at the other if you
are white and you are Fitzpatrick one and two, you
(23:43):
are lucky. You don't need anything. If you are everyone
else in the world three four, five, six. If you
go in and you just go into a spa, get
a laser done to your face and walk out, you
are likely to have more pigment, more sun spots, more irregularities.
Did you hear what I just said? Because these things
(24:04):
are heat driven, and if you don't do the pre
and post skin care, if you are not committed, if
you don't have the whatever it takes, then don't bother
because you have to get the skin ready to get heated,
and then you need the skin to be treated after
(24:24):
it's been heated. Now, it's very mild, it doesn't take
a lot. It's not a major to do. It's not
a huge ordeal. But like, you can't have a laser
and not worse SPF. You just can't. Like you just
forget it, don't go. It's a waste of time. Not
only is a waste of time, I actually think you
get worse. Yeah, you know there's people who have gone
(24:44):
and gotten lasers and then they've gone on vacation or
something and then they're like sunspots that I actually when
I was twenty something, I went in I had like
five hairs on my back and I had my laser
I had. I went somewhere I had my back hairs
lasered off. I was like, oh cool, because my friend
is an idiot. He took me with him and he's
a hairy bear and he lasered his back. And then
(25:05):
like two weeks later we went to Vietnam and like
beach cities. The amount of freckles on my back right now, actually,
as a matter of fact, you got to be beyond
my back. The amount of freckles on my back is insane.
And that was my stupidity. I didn't use any SBF.
So and then that's really really really important. What can
(25:26):
go wrong with lasers. Let's talk about what can go
wrong with lasers.
Speaker 2 (25:30):
So, again, if you're not properly using the proper skincare
pre treating, post treating, you can definitely get your results
can be worse.
Speaker 1 (25:38):
Pigment, your pigment can skyrocket. Pigment can skyrocket. If you
went in there fix your pigment and you don't get
the right settings, the right pre treatment, the right post treatment,
your pigment could get worse.
Speaker 2 (25:54):
You could get a burn burn.
Speaker 1 (25:57):
So if you are oh, oh I've been on retinee
all day long, I I you know, you're an acutaine
or something, and you go in there and you get
lasered and you your skin is thin, you can get burned,
or the setting is too high, you can get burned. Yeah, absolutely,
cold source cold sore. So if you are prone to
(26:19):
cold source, it's not a complication, but it's certainly not
going to be fun. And if you get a shingles outbreak,
you'll be pissed. So if you are prone to cold source,
any type of stress, as you know, stress of a flu.
I got COVID. I'm undergoing of divorce triggers these viruses.
So you want to make sure you tell your provider. Hey,
they should be asking you anyways, but hey, I get
(26:40):
cold source, you should take a voutrex and a few
and a little bit of medication for a day or
two around the lasers. Those are really the two main
things I think you can get pigmentary changes or burns.
It's pretty much the main main main issues. We're very
excited about our new laser. To me, it's almost like
(27:01):
it's exciting because it's things that I was never able
to do. And I think that it really is a
cherry on top and this sort of, if you will,
the hood ornament on a rolls or a Bentley. Without it,
it's just sort of an incomplete process and I'm very
excited that we're able to do this and do it
at a high level. Now. So listen, we happen to
have this Syton laser. It's not to suggest that other
(27:23):
laser's not good. There's actually a ton of other great lasers.
You just need to become educated. And I it took
me a while to become educated, but I now know
like a Piko Shore, a Piko Shore specific for this.
I want to get my tattoo removed. I would google
best removal tattoo remove a laser, and they each laser
will have a will be really honed in to do
(27:44):
one very specific thing. One thing is for sure, no
laser does it all like. There isn't one hand piece
with one wavelength. Then you just go in there and
zap off your hair, remove your tattoo, get rid of suns.
It just it just doesn't work that way. By the way, Also,
we talked about just briefly, and I'll just touch on
this because no, actually we'll do this in another episode.
(28:06):
I was gonna talk about micro needling, but we'll talk
about our f microneedling, but we'll talk about that on
micro needels. At any rate, I hope you found that
to be informative. Obviously, it's a very superficial crash course
on lasers. It's sort of what I think would be
relevant for you to know, and hopefully it was helpful.
We're gonna do. Our next episode will be on micro needling, which,
(28:28):
if you talk to my wife, is the wife and
charlene favorite treatment in the whole universe. I would argue
that it truly is, and we'll touch on this whole
new world of radio frequency micro needling, which is r
F and things like Morpheus. So anyway, I hope you
enjoyed that episode. As always, two parting favors. One, if
(28:49):
you like the show, go write something sweet, Go write
a review, go say hey, it was great and we
really do appreciate it. Secondly, send our episode, send it
to friends, family members. You never know who's going to
go and do something stupid and foolish and you're like, oh,
I just listened to an episode. I wish you would
have listened to it. You just don't know what's going
(29:10):
to happen to someone you love, So share, subscribe, and download.
All right, that's a wrap. You hat another episode of
plastic surgery and censor. We'll see you next week, your host,
doctor Roddy Raban,
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If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
Betrayal Weekly
Betrayal Weekly is back for a new season. Every Thursday, Betrayal Weekly shares first-hand accounts of broken trust, shocking deceptions, and the trail of destruction they leave behind. Hosted by Andrea Gunning, this weekly ongoing series digs into real-life stories of betrayal and the aftermath. From stories of double lives to dark discoveries, these are cautionary tales and accounts of resilience against all odds. From the producers of the critically acclaimed Betrayal series, Betrayal Weekly drops new episodes every Thursday. If you would like to share your story, you can reach out to the Betrayal Team by emailing them at betrayalpod@gmail.com and follow us on Instagram at @betrayalpod and @glasspodcasts. Please join our Substack for additional exclusive content, curated book recommendations, and community discussions. Sign up FREE by clicking this link Beyond Betrayal Substack. Join our community dedicated to truth, resilience, and healing. Your voice matters! Be a part of our Betrayal journey on Substack.