November 16, 2024 • 27 mins
Is RF microneedling the fountain of youth—or could it actually age your skin? In this episode, we unpack the truths and misconceptions about this buzzworthy cosmetic trend, made famous by influencers like Kim Kardashian. Discover why RF microneedling might not be the best choice for facial and neck rejuvenation, but shines when used for body treatments like post-pregnancy abdominal skin laxity or areas like the arms and knees.
We also tackle the hype around collagen supplements—are they the secret to youthful skin or just savvy marketing? And don’t miss our spotlight on EltaMD UV Clear sunscreen, a must-have skincare product that’s perfect for acne- and rosacea-prone skin.
Dr. Arash Akhavan and Alyssa DiBenedetto, Director of Operations at The Dermatology and Laser Group, advocate for a personalized approach to skincare, sharing expert insights that go beyond social media trends. Subscribe now to stay in the loop on the latest discussions in skincare and cosmetic procedures!
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Arash Akhavan, M.D. (00:04):
This is the Dr A Explains it All podcast.
A podcast about cosmeticprocedures, skincare,
dermatology and everything inbetween.
I'm board-certifieddermatologist, dr Arash Akhavan.
Let's get started, but first aquick disclaimer.
Speaker 2 (00:19):
Medical disclaimer.
The information provided onthis podcast is for general
information and educationalpurposes only.
It is not intended as medicaladvice, diagnosis or treatment
and should not be relied upon assuch.
Listening to this podcast doesnot establish a
physician-patient relationshipbetween you and the host or any
(00:40):
contributors.
If you have specific medicalconcerns or questions, we
encourage you consult directlywith a licensed healthcare
provider or physician in yourarea.
The views expressed in thispodcast are solely those of the
individuals and do notnecessarily represent the views
of any affiliated institutionsor organizations.
Always seek the advice of yourphysician or other qualified
(01:02):
healthcare provider with anyquestions you may have regarding
a medical condition ortreatment.
Never disregard professionalmedical advice or delay seeking
it because of something you haveheard on this podcast.
Arash Akhavan, M.D. (01:22):
Hey everyone, welcome to the second
episode of our podcast.
Today I'm joined by AlyssaDiVenedetto, who visitors to our
office know very, very well.
She's my first ever hire at theDermatology and Laser Group,
been with me since day one.
She's the Director ofOperations here at the
Dermatology and Laser Group andher Cosmetic Coordinator here at
(01:46):
the Dermatology and Laser Groupand our cosmetic coordinator.
A lot of our patients andpeople who email and call the
practice know Alyssa very welland Alyssa was saying that one
of the things that she thoughtwe should talk about and she
wanted to cover in today'sepisode was something that's
been in the sort of social mediaworld and even in magazines and
(02:06):
things like that quite a bitover the last couple of years,
and that's RF microneedling,kind of made most popular by um
uh, as you were saying, Morpheuseight um, which kind of got a
lot of buzz going uh, with postswith, like Kim Kardashian and
other Instagram and TikTokcelebrities and, yes, I feel
(02:29):
like it did come out very strong.
Alyssa DiBenedetto (02:32):
Everyone wanted to do it, everyone was
doing it.
And then I have noticedrecently which is kind of
showing on Instagram that peopleare feeling a little bit more
negative.
They're seeing bad effects fromit, which I know.
You've always had a very strongfeeling about that from the
(02:53):
beginning, so I think we shoulddefinitely review that.
Arash Akhavan, M.D. (02:57):
Sounds good .
Alyssa DiBenedetto (02:58):
So should people be getting RF
microneedling on their face?
Arash Akhavan, M.D. (03:03):
It wouldn't be at the top of my Christmas
list.
So I think there's for multiplereasons, there's better devices
for facial and neckrejuvenation than RF
microneedling, no matter whatbrand RF microneedling you're
talking about.
And we do have a couple, andwe'll kind of go over the fact
that we do have a couple of RFmicroneedling devices in the
office.
So before we get started, letme just get that out of the way,
(03:25):
any conflicts of interest.
We do.
I am a paid consultant for afew companies that produce RF
microneedling devices butdespite that, like I've said
from the beginning, the goalwith this podcast is the truth
on everything and kind of beingupfront and honest and very
simple with our discussion.
So, yeah, I'm not a huge fan ofRF microneedling for the face
(03:48):
and neck.
We do, we, we can do it and wedo do it every now and then and
we'll get into why.
But, um, you know the the socialmedia trend began and everybody
was very excited about whatthey were reading on TikTok and
(04:08):
Instagram and also magazines andwebsites about the skin
tightening effects and liftingeffects of these devices.
We had patients coming in evenbefore it was a trend asking
about it, because we have prettyknowledgeable patients and you
know I've always kind of saidstay away from it when
recommended I was seeing badthings in people who were
(04:31):
getting it.
I had sort of extra access tothe clinical studies from the
manufacturers of some of thesedevices and saw long-term
results and I was concerned thatthe patients looked better
(04:52):
three months after the procedurewhen their skin was tighter,
but they actually looked likethey'd aged a bit.
When you looked at pictures ayear down the road or even six
months down the road, I start toget a little concerned.
Road, or even six months downthe road, I start to get a
little concerned.
So, yeah, I was.
I was kind of fighting the trenda couple of years ago when
everybody was talking about itand it all kind of started when,
(05:15):
um, I think Kim Kardashian waslinked on Instagram getting a
Morpheus eight procedure.
It wasn't clear where, but itwas sort of assumed that it was
the face.
That wasn't clear.
And then you know the sort ofthe social media influencers
(05:36):
then started posting it as alife-changing procedure and I
look 10 years younger and blah,blah, blah and I was like, oh,
this is going to be bad.
I'm glad we didn't succumb to it.
I'm glad we didn't do it, thosesort of treatments for our
patients and, like I said, wehave done RF microneedling.
We will continue to do RFmicroneedling when appropriate
and for the appropriate things,and we can get into that.
(05:59):
But, um, now, as you mentioned,what you keep seeing on social
media is people talking abouthow it ruined my face and it
melted my fat and my skintexture is ruined and I have
more wrinkles and all this stuff, which is kind of what I was
expecting to see, and it'sfinally caught on.
Alyssa DiBenedetto (06:22):
Yeah, caught on, yeah, so, like you
mentioned, we do have two ofthese devices and I know that
you do not have devices in theoffices that you don't truly
believe in.
So if we can talk about kind ofwhat we use those for, yeah, so
body treatments, as you know.
Arash Akhavan, M.D. (06:42):
So I think you say, wouldn't you say that's
kind of mostly what we use itfor?
Um, a lot of people afterpregnancy, people with like
laxity in their arms or abovethe knees, but abdomen is
probably our number one placeafter pregnancy, so I'm fine
with it on the body.
So the main problem I have withRF microneedling is if it's
(07:05):
used incorrectly, which I thinkit is honestly the majority of
the time unfortunately and bythat I mean if it's used at too
high of a setting, you'reintroducing too much of a too
high of a temperature at the tipof these RF microneedles and
potentially you are damaging thefat right at the tip of these
(07:28):
RF microneedles and Potentiallyyou are damaging the fat right
at the tip there.
So with With radiofrequency,radiofrequency is a great
technology if it's usedcorrectly.
If you use the appropriatetemperature, which is in the low
40 degrees, like 40 degrees, 41, 42 On the skin, you can get
collagen on elastin generation,um, you could get smoothing of
(07:50):
wrinkles, the skin gets a glow,it actually gets hydrated, it
produce uh, they can cause anincrease in hyaluronic acid
production, so the skin lookshydrated, looks and feels firmer
.
I love traditional radiofrequency.
When you're doing it withmicroneedling, the way it works
is the tip is very, very hot andthen as you get away from the
(08:11):
tip it's a little less hot.
If you get above 45 degreesCelsius you can actually
permanently damage fat cells andthat's not something you see
right away.
So the fat cell first dies andthen it sort of slowly empties
and dies off over the course ofa few months and it's absorbed.
So you know that worries mewith the way most people are
(08:34):
using RF microneedling.
We will use it on the body, ifon somebody's abdomen, because
if we lose a little bit of fat,if we're using it, the strong
settings, that's still okay, um,and we'll use it anywhere, as
long as the temperature isreally turned down, um.
The one thing that patientsthat need to be like aware of is
(08:57):
then don't expect, like a skintightening, a profound skin
tightening, or certainly not alifting effect or anything like
that.
So you know, that's why I sayit's not my favorite device for
face and neck rejuvenation,because we have better things.
We can use it if it's aconvenient thing to use or very
rare cases, like if you want toeliminate a little bit of fat
(09:18):
under someone's, like underunder their lower eyelid, we can
actually use this side effectto our benefit.
Alyssa DiBenedetto (09:26):
But um, yeah , yeah, we use it judiciously in
the right places, right timeyeah for the right person yeah,
um, and then just to kind of getinto some cool things that we
have on the device um that wecurrently use, um, one like the
patenza that has the infusiontip, um, if you wanted to.
Arash Akhavan, M.D. (09:50):
Yeah, so that's one that we um.
So there's two that we have inthe office out of all, uh I
don't know, like dozens anddozens of rf microneedling
devices out there.
The patenza, like you mentioned, has the infusion tip.
So that's a cool technologywhere it, uh, it has like a
spring that it kind of pushes inthe serum that you have on the
(10:11):
face, whether it's prp or growthfactor serums or things like
that.
We can push it in with forcewith that, which I find really
cool.
So we turn the energy way down.
We are basically using it likea microneedling device and we're
getting a little bit of benefitfrom very gentle heating as
well.
And then another one is Exxon,which is made by BTL, which is
(10:34):
again sort of really gentle, notsuper painful, the way that RF
microneedling devices can bequick and easy, minimal downtime
.
The way that RF microneedlingdevices can be quick and easy,
minimal downtime.
And that company is a very sortof concerned with getting it
right with um.
I know they're science peoplepretty well with making sure
that their technology isproducing collagen and elastin,
(10:57):
not getting too hot, beinggentle.
They've shown the hyaluronicacid increase in the skin.
So there's a, there's a coupleof products and that's why we
pick those, um, because you knowthey were safer.
Um, but yeah, if I stillwouldn't use those, if, like
somebody said, they wanted alift in their face, you know I
(11:18):
may then use something like alltherapy which I can use safely
because I could see exactlywhere the heat's going.
I could use M face, which doesit in a completely different way
, by building muscle tone.
So you know, they're not thedevice effects or issues other
(11:56):
than the fat loss that.
So what we have seen sometimesis, if, again, high energy is
used and the needle depth isn'tappropriate, you could get weird
texture in the skin too.
So, instead of forming collagenand elastin, the way our body
normally has in the skin, youform these collagen tracks that
are essentially scar tissue.
So the skin gets like atextured feel and I feel like
(12:17):
you almost see the pores moreclearly.
Not quite a orange peel, peaud''orange as they call it um,
fancy, um, not not that kind ofuh, skin texture, not that
severe, but uh, the pores seem alittle bit more prominent.
The skin looks a little woody,a little bit more texture that
you're seeing.
Yeah, um, that used to be abigger problem, like five years
ago, when the first devices hadcome out.
Alyssa DiBenedetto (12:36):
The needles weren't insulated correctly, so
a lot of heat was going to thesurface of the skin.
Arash Akhavan, M.D. (12:39):
That used to be a bigger problem, like
five years ago when the firstdevices had come out.
The needles weren't insulatedcorrectly, so a lot of heat was
going to the surface of the skin.
With the more modern devices,that isn't as big of an issue.
It still is, though, a lot ofsort of user-dependent.
So you don't want to have superhigh settings and you want the
(12:59):
needle to be at the correctdepth.
Alyssa DiBenedetto (13:02):
Yeah, so why do you think people are still
using this device incorrectlyand people are still going to
get it?
Arash Akhavan, M.D. (13:13):
Well, the social media trends.
You know they take a while todie out and then you know.
More important than that is thefact that when these trends
started, you know we had a lotof pressure on us as providers
to provide this for our patients.
Supply and demand.
Patients were demanding and weneed to supply it and a lot of
(13:36):
doctors, med spas and othersorts of clinics ended up buying
these and some it's their onlyrejuvenation device.
For some clinics and they'vespent $100,000 or something like
that on these devices andthat's a big investment and you
need to use it to make yourmoney back.
And you unfortunately have alot of people just using it for
(13:58):
crazy things, like inappropriatethings that it makes zero sense
for, like acne scars or thingslike that, where there's so many
better devices, likemicroneedling alone or lasers,
and it's kind of that.
When all you have is a hammer,everything looks like a nail,
sort of expression.
(14:19):
So people have bought thesedevices.
Alyssa DiBenedetto (14:21):
They want to use them Sometimes, oftentimes-
in a lot of med spas, it may bethe only rejuvenation device
that they have.
Do you think there's one betterthan the other in terms of
devices for RF microneedling?
Arash Akhavan, M.D. (14:46):
No, I mean, I think it really comes down to
the person using it.
So all of them can be usedcorrectly and safely as long as
the person who's doing it knowswhat they're doing and is
conscious of it and isn't pushedto produce results that are
unsafe.
So, you know, isn't pushed totry and overt over, tighten or
lift or do anything crazy likethat.
Alyssa DiBenedetto (15:04):
Yeah, and we've mentioned that we have
tons of other equipment herethat we use.
So what is kind of thealternative to doing RF
micro-needling?
Arash Akhavan, M.D. (15:19):
Yeah.
So that's one thing I thinkit's important to note Any
practice you're going to getfacial rejuvenation or neck or
body or anything like that, youwant to make sure they have
options.
They're not using aone-size-fits-all and they can
kind of tailor make theirapproach to what your individual
needs are.
So it really depends on whatyou're looking for.
(15:39):
Like I said, if you're tryingto get a little bit more of a
lift, something I call therapyM-FACE would be my go-to of a
lift, something I call therapy mface, um would be my go-to all
therapy actually being even fdacleared as a non-surgical lift,
the um.
If you're doing just generalface rejuvenation, lasers are
great.
Rf alone, strangely enough, isgreat and microneedling alone,
(16:02):
strangely enough, is great.
So if you take those twocomponents and separate them and
we do this for some patientswho really have their friends
got rf microneedling and theyreally want it we say we can do
it really light with our rfmicroneedling device or, even
better, we can separate out thetwo and the reason it's better.
So rf devices like um,temperature thermy, things like
(16:27):
that they're wands that are likemassaged on the skin and they
are very precise.
Within milliseconds they canmeasure the temperature.
So whatever energy they'reputting in, they can measure
exactly what temperature yourskin's at, so it can never get
overheated and you maintain thetemperature and get collagen
elastin generation throughoutthe whole skin.
So it's not just in certainareas where the needle's going
(16:48):
in or this or that, it'smassaging the entire surface of
the skin.
You get great deep collagen andelastin with these in the
dermis, and a very pleasantprocedure too.
Yeah, not super painful, nodowntime.
If you want more texturalissues, things on the surface,
and you don't want to do a laser, the microneedling alone is
great.
And why microneedling is betterthan RF microneedling?
(17:09):
A traditional RF microneedlingdevice uses a stamping technique
, so you're getting just wherethe device stamps.
You had that series of needlesgo in.
Then you go to the next spotand the same thing happens With
a microneedling device.
You're getting thousands oflittle pokes, so much more
collagen and elastin generation,much more damage being created
(17:30):
healthy damage being created bythese needles on the surface of
skin, again covering moresurface area and having a safer
treatment because that heat'snot being used so weirdly.
The rf microneedling,separating out the two
components, is a great option.
Lasers are great.
There's ultrasound devices,there's muscle building devices,
there's injectables, there'slots of things.
It really depends on the need.
Alyssa DiBenedetto (17:53):
So if somebody is very set on getting
RF microneedling, that's whatthey have in their mind.
What do you suggest that theydo to get the best treatment?
Arash Akhavan, M.D. (18:06):
I think go to a provider that is very
experienced that's one thing Awell-educated.
Look at their educationbackground, look at their
experience.
Go to a place that has lots ofoptions to offer you.
(18:27):
They're not just like you comein there and no matter what you
say, they say this rfmicroneedling device will cure
all your needs.
You know that's.
That's a red flag.
And then don't push them foramazing before and after results
.
A good rf microneedling youshould barely see anything or
nothing at all on your beforeand after results.
A good rf microneedling youshould barely see anything or
nothing at all on your beforeand afters.
(18:49):
So you want your skin to look alittle smoother, a little more
hydrated, a little bit moreglowy and not tighter, not
lifted, none of that stuff.
If that happens, you'vepotentially permanently damaged
your skin, yeah, and long termyou've aged yourself.
So bad decision.
So you want to go super light.
Alyssa DiBenedetto (19:08):
Yeah, I feel like that's one thing that I've
learned working for you for allthese years that you know, just
going slow into a treatment,doing lighter treatments, in the
long run you're going to getthe better results, you know,
and sometimes you may needsomething stronger, but for most
just cosmetic concerns or aging, we, you know, we'll do the
(19:33):
lighter options.
Arash Akhavan, M.D. (19:34):
Yeah, I mean, I think that's probably
best with almost everything,even like surgical procedures
that plastic surgeons do youknow.
Taking a less is more approachis definitely our way, but I
think it's the right way.
Alyssa DiBenedetto (19:47):
Yeah, all right, so switching gears now.
Um, for this week's review oftiktok and instagram trends, I
wanted to talk about collagensupplements, something that
patients will ask a lot if theyshould take them to maintain
their results, and I find it'smixed reviews everywhere on how
(20:13):
people feel about them.
Arash Akhavan, M.D. (20:18):
So what are your thoughts?
Yeah, I have no problem withthem.
I think they're a good sourceof protein.
So collagen is a protein.
It's found in our skin,cartilage, connective tissue,
veins, hair, nails.
It's found in animals.
It's a big component of ourbody.
It's basically a series ofthree long peptides made of
(20:45):
amino acids glyine, proline,hydroxyproline, different amino
acid combos and different typesof collagen.
Oh, there's lots of types ofcollagen, by the way, and
they're these.
The collagen in our skin givesit its structure and we talked
about it all day long.
With all of our procedures,we're trying to maintain and
(21:06):
generate new collagen.
The collagen that you consume inthe supplements is a healthy
way to get protein.
The one thing you know I thinkit's a little bit of marketing,
but they make you think thatyou're consuming the collagen.
They make you think that you'reconsuming the collagen and
somehow it's going into yourbloodstream and popping into
(21:29):
your skin as collagen, orpopping into your nails as
collagen or hair.
That's definitely not happening.
It's just breaking down likeany other protein.
You eat the protein in yoursteak, the protein in your
almonds, you know, or whateverfood you're eating.
So it's breaking down intoamino acids and small little
peptides getting absorbed inyour blood and your body decides
(21:51):
what to do with it.
Maybe it's going to repairmuscle, maybe it's going to use
it to burn as calories, asenergy.
Maybe it's going to makecollagen, um.
So there's nothing magicalnecessarily about collagen.
You're you're primarily you'retalking about two types of
collagen.
There's marine collagen, theycall it, which is fish, um, fish
skin, and there's, they call itit's again marketing term, but
(22:15):
they call it grass fed collagen.
They never say so, that's cow,um.
So those are the two types ofcollagen you're consuming the,
the, that fish skin isn't likegoing into your blood and
becoming collagen for you.
You're not getting rid ofwrinkles that way.
There are some studies that haveactually shown that consuming
collagen peptides and collagensupplements could potentially
(22:37):
improve skin texture, skinhydration, things like that.
But there's nothingparticularly special about those
studies, because the same thinghas been shown with consuming
whey protein.
So that protein shake that youeat that's dairy derived, has
the same studies behind it.
And the same thing has beenshown with soy protein.
(22:58):
So edamame and soy proteinshakes and all tofu have also
been shown to have the same sortof skin benefits.
So there's similar studies forall of them.
I'm not convinced that there'sanything special about collagen,
but it is another good, healthysource of protein and I know a
lot of people like it.
I know you like it.
Alyssa DiBenedetto (23:19):
Yeah, I mean I've been highly influenced to
try it.
One specifically that JenniferAniston really likes and I'll do
anything to what she likes Um,and what's nice about it is?
It just dissolves in anythingyou want to put it in.
Yeah, that's what I found aboutit actually.
Arash Akhavan, M.D. (23:39):
Um, with collagen, as opposed to like
when you have like a wheyprotein shake.
It's so filling, you know it'slike a meal.
The collagen you don't even youcould literally have it in the
collagen water and it's justhydrating water, so it's not a
big deal.
I actually have read on I'venever tried this on Instagram
that you can actually bake withcollagen.
(23:59):
It's really heat resistant.
I don't know how well thatworks, but I've heard of like
baking it into cookies and stufflike that too, just to add a
little protein.
Alyssa DiBenedetto (24:09):
Yeah, I've seen the putting it oatmeal and
yeah, I think it dissolveseasily and it's heat resistant,
so why not?
Arash Akhavan, M.D. (24:16):
Yeah, no, I have no problems with collagen.
I don't think it's magical, um,but so I don't think it's
necessarily any better or worsethan having other sources of
protein.
That hasn't been proven.
But it's a healthy source ofprotein and protein is good.
Alyssa DiBenedetto (24:31):
Yeah, anything to make you feel good
about it?
Yeah, and then every week we'regoing to talk about a skincare
product.
So one of my favorites and anoffice favorite that I really
love is Elta MD UV clear.
Um, I use that every day foryears.
(24:52):
Um, it's super light, easy toput on.
I can wear makeup over it.
Um, they have a tinted shade,which is nice, uh, for summer,
and then they also came out witha deep shade as well.
Arash Akhavan, M.D. (25:06):
Um, so, yeah, yeah, I love that you
picked that one.
That's kind of um, when we'rewhen we have a new patient come
into the office and we ask themabout their uh, skincare.
That's like 90% of the time theone they mentioned, um, you
know, since the beginning of mycareer I feel like we've been
mentioning it as arecommendation.
With the niacinamide that ithas as an ingredient, it's
(25:31):
helpful for acne prone skin,rosacea prone skin,
anti-inflammatory effects.
It's broad spectrum protectswell against skin cancer and
aging.
It's lightweight.
People like it.
Like you said, the threedifferent tinted and two
different tints and one untinted, so three different varieties
of it.
It's a super popular product.
I think a great pick.
(25:51):
That's like out of that sort ofclass of sort of physician
recommended skincare products, Ithink that's number one.
It's got to be the number onerecommended dermatologist
product.
I don't know if that's true ornot, but it feels like it's got
to be because all my friends whoare dermatologists use it and
recommend it as well.
It's like in everybody's house.
Alyssa DiBenedetto (26:13):
Yeah, I've never heard anybody have any
issues with it.
I have super sensitive skin andcannot use anything, and that's
always been an easy product forme.
Arash Akhavan, M.D. (26:23):
Yeah, yeah, no Good pick.
Easy product for me yeah, yeah,no good pick.
Alyssa DiBenedetto (26:25):
Okay, All right.
Well, that does it for thisweek and we hope you all enjoyed
.
Make sure to follow and reviewour podcasts.
Reach out with any suggestions.
We loved hearing from all ofyou last week.
Arash Akhavan, M.D. (26:40):
And yeah, we've been getting a lot of
people um DMing and filling outour contact form.
It's been it's been really cool.
Speaker 2 (26:48):
I like the feedback thanks, of course all right,
thank you thank you so much fortuning in today.
If you enjoyed this episode,please make sure to subscribe to
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(27:10):
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(27:30):
To see us as a patient at ourNew York clinic.
Visit us atdermatologyandlasergroupcom.
This is the Dr A Explains it All podcast.
A podcast about cosmeticprocedures, skincare,
dermatology and everything inbetween.
I'm board-certifieddermatologist, dr Arash Akhavan.
Let's get started, but first aquick disclaimer.
Speaker 2 (00:19):
Medical disclaimer.
The information provided onthis podcast is for general
information and educationalpurposes only.
It is not intended as medicaladvice, diagnosis or treatment
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(00:40):
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(01:02):
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Arash Akhavan, M.D. (01:22):
Hey everyone, welcome to the second
episode of our podcast.
Today I'm joined by AlyssaDiVenedetto, who visitors to our
office know very, very well.
She's my first ever hire at theDermatology and Laser Group,
been with me since day one.
She's the Director ofOperations here at the
Dermatology and Laser Group andher Cosmetic Coordinator here at
(01:46):
the Dermatology and Laser Groupand our cosmetic coordinator.
A lot of our patients andpeople who email and call the
practice know Alyssa very welland Alyssa was saying that one
of the things that she thoughtwe should talk about and she
wanted to cover in today'sepisode was something that's
been in the sort of social mediaworld and even in magazines and
(02:06):
things like that quite a bitover the last couple of years,
and that's RF microneedling,kind of made most popular by um
uh, as you were saying, Morpheuseight um, which kind of got a
lot of buzz going uh, with postswith, like Kim Kardashian and
other Instagram and TikTokcelebrities and, yes, I feel
(02:29):
like it did come out very strong.
Alyssa DiBenedetto (02:32):
Everyone wanted to do it, everyone was
doing it.
And then I have noticedrecently which is kind of
showing on Instagram that peopleare feeling a little bit more
negative.
They're seeing bad effects fromit, which I know.
You've always had a very strongfeeling about that from the
(02:53):
beginning, so I think we shoulddefinitely review that.
Arash Akhavan, M.D. (02:57):
Sounds good .
Alyssa DiBenedetto (02:58):
So should people be getting RF
microneedling on their face?
Arash Akhavan, M.D. (03:03):
It wouldn't be at the top of my Christmas
list.
So I think there's for multiplereasons, there's better devices
for facial and neckrejuvenation than RF
microneedling, no matter whatbrand RF microneedling you're
talking about.
And we do have a couple, andwe'll kind of go over the fact
that we do have a couple of RFmicroneedling devices in the
office.
So before we get started, letme just get that out of the way,
(03:25):
any conflicts of interest.
We do.
I am a paid consultant for afew companies that produce RF
microneedling devices butdespite that, like I've said
from the beginning, the goalwith this podcast is the truth
on everything and kind of beingupfront and honest and very
simple with our discussion.
So, yeah, I'm not a huge fan ofRF microneedling for the face
(03:48):
and neck.
We do, we, we can do it and wedo do it every now and then and
we'll get into why.
But, um, you know the the socialmedia trend began and everybody
was very excited about whatthey were reading on TikTok and
(04:08):
Instagram and also magazines andwebsites about the skin
tightening effects and liftingeffects of these devices.
We had patients coming in evenbefore it was a trend asking
about it, because we have prettyknowledgeable patients and you
know I've always kind of saidstay away from it when
recommended I was seeing badthings in people who were
(04:31):
getting it.
I had sort of extra access tothe clinical studies from the
manufacturers of some of thesedevices and saw long-term
results and I was concerned thatthe patients looked better
(04:52):
three months after the procedurewhen their skin was tighter,
but they actually looked likethey'd aged a bit.
When you looked at pictures ayear down the road or even six
months down the road, I start toget a little concerned.
Road, or even six months downthe road, I start to get a
little concerned.
So, yeah, I was.
I was kind of fighting the trenda couple of years ago when
everybody was talking about itand it all kind of started when,
(05:15):
um, I think Kim Kardashian waslinked on Instagram getting a
Morpheus eight procedure.
It wasn't clear where, but itwas sort of assumed that it was
the face.
That wasn't clear.
And then you know the sort ofthe social media influencers
(05:36):
then started posting it as alife-changing procedure and I
look 10 years younger and blah,blah, blah and I was like, oh,
this is going to be bad.
I'm glad we didn't succumb to it.
I'm glad we didn't do it, thosesort of treatments for our
patients and, like I said, wehave done RF microneedling.
We will continue to do RFmicroneedling when appropriate
and for the appropriate things,and we can get into that.
(05:59):
But, um, now, as you mentioned,what you keep seeing on social
media is people talking abouthow it ruined my face and it
melted my fat and my skintexture is ruined and I have
more wrinkles and all this stuff, which is kind of what I was
expecting to see, and it'sfinally caught on.
Alyssa DiBenedetto (06:22):
Yeah, caught on, yeah, so, like you
mentioned, we do have two ofthese devices and I know that
you do not have devices in theoffices that you don't truly
believe in.
So if we can talk about kind ofwhat we use those for, yeah, so
body treatments, as you know.
Arash Akhavan, M.D. (06:42):
So I think you say, wouldn't you say that's
kind of mostly what we use itfor?
Um, a lot of people afterpregnancy, people with like
laxity in their arms or abovethe knees, but abdomen is
probably our number one placeafter pregnancy, so I'm fine
with it on the body.
So the main problem I have withRF microneedling is if it's
(07:05):
used incorrectly, which I thinkit is honestly the majority of
the time unfortunately and bythat I mean if it's used at too
high of a setting, you'reintroducing too much of a too
high of a temperature at the tipof these RF microneedles and
potentially you are damaging thefat right at the tip of these
(07:28):
RF microneedles and Potentiallyyou are damaging the fat right
at the tip there.
So with With radiofrequency,radiofrequency is a great
technology if it's usedcorrectly.
If you use the appropriatetemperature, which is in the low
40 degrees, like 40 degrees, 41, 42 On the skin, you can get
collagen on elastin generation,um, you could get smoothing of
(07:50):
wrinkles, the skin gets a glow,it actually gets hydrated, it
produce uh, they can cause anincrease in hyaluronic acid
production, so the skin lookshydrated, looks and feels firmer
.
I love traditional radiofrequency.
When you're doing it withmicroneedling, the way it works
is the tip is very, very hot andthen as you get away from the
(08:11):
tip it's a little less hot.
If you get above 45 degreesCelsius you can actually
permanently damage fat cells andthat's not something you see
right away.
So the fat cell first dies andthen it sort of slowly empties
and dies off over the course ofa few months and it's absorbed.
So you know that worries mewith the way most people are
(08:34):
using RF microneedling.
We will use it on the body, ifon somebody's abdomen, because
if we lose a little bit of fat,if we're using it, the strong
settings, that's still okay, um,and we'll use it anywhere, as
long as the temperature isreally turned down, um.
The one thing that patientsthat need to be like aware of is
(08:57):
then don't expect, like a skintightening, a profound skin
tightening, or certainly not alifting effect or anything like
that.
So you know, that's why I sayit's not my favorite device for
face and neck rejuvenation,because we have better things.
We can use it if it's aconvenient thing to use or very
rare cases, like if you want toeliminate a little bit of fat
(09:18):
under someone's, like underunder their lower eyelid, we can
actually use this side effectto our benefit.
Alyssa DiBenedetto (09:26):
But um, yeah , yeah, we use it judiciously in
the right places, right timeyeah for the right person yeah,
um, and then just to kind of getinto some cool things that we
have on the device um that wecurrently use, um, one like the
patenza that has the infusiontip, um, if you wanted to.
Arash Akhavan, M.D. (09:50):
Yeah, so that's one that we um.
So there's two that we have inthe office out of all, uh I
don't know, like dozens anddozens of rf microneedling
devices out there.
The patenza, like you mentioned, has the infusion tip.
So that's a cool technologywhere it, uh, it has like a
spring that it kind of pushes inthe serum that you have on the
(10:11):
face, whether it's prp or growthfactor serums or things like
that.
We can push it in with forcewith that, which I find really
cool.
So we turn the energy way down.
We are basically using it likea microneedling device and we're
getting a little bit of benefitfrom very gentle heating as
well.
And then another one is Exxon,which is made by BTL, which is
(10:34):
again sort of really gentle, notsuper painful, the way that RF
microneedling devices can bequick and easy, minimal downtime
.
The way that RF microneedlingdevices can be quick and easy,
minimal downtime.
And that company is a very sortof concerned with getting it
right with um.
I know they're science peoplepretty well with making sure
that their technology isproducing collagen and elastin,
(10:57):
not getting too hot, beinggentle.
They've shown the hyaluronicacid increase in the skin.
So there's a, there's a coupleof products and that's why we
pick those, um, because you knowthey were safer.
Um, but yeah, if I stillwouldn't use those, if, like
somebody said, they wanted alift in their face, you know I
(11:18):
may then use something like alltherapy which I can use safely
because I could see exactlywhere the heat's going.
I could use M face, which doesit in a completely different way
, by building muscle tone.
So you know, they're not thedevice effects or issues other
(11:56):
than the fat loss that.
So what we have seen sometimesis, if, again, high energy is
used and the needle depth isn'tappropriate, you could get weird
texture in the skin too.
So, instead of forming collagenand elastin, the way our body
normally has in the skin, youform these collagen tracks that
are essentially scar tissue.
So the skin gets like atextured feel and I feel like
(12:17):
you almost see the pores moreclearly.
Not quite a orange peel, peaud''orange as they call it um,
fancy, um, not not that kind ofuh, skin texture, not that
severe, but uh, the pores seem alittle bit more prominent.
The skin looks a little woody,a little bit more texture that
you're seeing.
Yeah, um, that used to be abigger problem, like five years
ago, when the first devices hadcome out.
Alyssa DiBenedetto (12:36):
The needles weren't insulated correctly, so
a lot of heat was going to thesurface of the skin.
Arash Akhavan, M.D. (12:39):
That used to be a bigger problem, like
five years ago when the firstdevices had come out.
The needles weren't insulatedcorrectly, so a lot of heat was
going to the surface of the skin.
With the more modern devices,that isn't as big of an issue.
It still is, though, a lot ofsort of user-dependent.
So you don't want to have superhigh settings and you want the
(12:59):
needle to be at the correctdepth.
Alyssa DiBenedetto (13:02):
Yeah, so why do you think people are still
using this device incorrectlyand people are still going to
get it?
Arash Akhavan, M.D. (13:13):
Well, the social media trends.
You know they take a while todie out and then you know.
More important than that is thefact that when these trends
started, you know we had a lotof pressure on us as providers
to provide this for our patients.
Supply and demand.
Patients were demanding and weneed to supply it and a lot of
(13:36):
doctors, med spas and othersorts of clinics ended up buying
these and some it's their onlyrejuvenation device.
For some clinics and they'vespent $100,000 or something like
that on these devices andthat's a big investment and you
need to use it to make yourmoney back.
And you unfortunately have alot of people just using it for
(13:58):
crazy things, like inappropriatethings that it makes zero sense
for, like acne scars or thingslike that, where there's so many
better devices, likemicroneedling alone or lasers,
and it's kind of that.
When all you have is a hammer,everything looks like a nail,
sort of expression.
(14:19):
So people have bought thesedevices.
Alyssa DiBenedetto (14:21):
They want to use them Sometimes, oftentimes-
in a lot of med spas, it may bethe only rejuvenation device
that they have.
Do you think there's one betterthan the other in terms of
devices for RF microneedling?
Arash Akhavan, M.D. (14:46):
No, I mean, I think it really comes down to
the person using it.
So all of them can be usedcorrectly and safely as long as
the person who's doing it knowswhat they're doing and is
conscious of it and isn't pushedto produce results that are
unsafe.
So, you know, isn't pushed totry and overt over, tighten or
lift or do anything crazy likethat.
Alyssa DiBenedetto (15:04):
Yeah, and we've mentioned that we have
tons of other equipment herethat we use.
So what is kind of thealternative to doing RF
micro-needling?
Arash Akhavan, M.D. (15:19):
Yeah.
So that's one thing I thinkit's important to note Any
practice you're going to getfacial rejuvenation or neck or
body or anything like that, youwant to make sure they have
options.
They're not using aone-size-fits-all and they can
kind of tailor make theirapproach to what your individual
needs are.
So it really depends on whatyou're looking for.
(15:39):
Like I said, if you're tryingto get a little bit more of a
lift, something I call therapyM-FACE would be my go-to of a
lift, something I call therapy mface, um would be my go-to all
therapy actually being even fdacleared as a non-surgical lift,
the um.
If you're doing just generalface rejuvenation, lasers are
great.
Rf alone, strangely enough, isgreat and microneedling alone,
(16:02):
strangely enough, is great.
So if you take those twocomponents and separate them and
we do this for some patientswho really have their friends
got rf microneedling and theyreally want it we say we can do
it really light with our rfmicroneedling device or, even
better, we can separate out thetwo and the reason it's better.
So rf devices like um,temperature thermy, things like
(16:27):
that they're wands that are likemassaged on the skin and they
are very precise.
Within milliseconds they canmeasure the temperature.
So whatever energy they'reputting in, they can measure
exactly what temperature yourskin's at, so it can never get
overheated and you maintain thetemperature and get collagen
elastin generation throughoutthe whole skin.
So it's not just in certainareas where the needle's going
(16:48):
in or this or that, it'smassaging the entire surface of
the skin.
You get great deep collagen andelastin with these in the
dermis, and a very pleasantprocedure too.
Yeah, not super painful, nodowntime.
If you want more texturalissues, things on the surface,
and you don't want to do a laser, the microneedling alone is
great.
And why microneedling is betterthan RF microneedling?
(17:09):
A traditional RF microneedlingdevice uses a stamping technique
, so you're getting just wherethe device stamps.
You had that series of needlesgo in.
Then you go to the next spotand the same thing happens With
a microneedling device.
You're getting thousands oflittle pokes, so much more
collagen and elastin generation,much more damage being created
(17:30):
healthy damage being created bythese needles on the surface of
skin, again covering moresurface area and having a safer
treatment because that heat'snot being used so weirdly.
The rf microneedling,separating out the two
components, is a great option.
Lasers are great.
There's ultrasound devices,there's muscle building devices,
there's injectables, there'slots of things.
It really depends on the need.
Alyssa DiBenedetto (17:53):
So if somebody is very set on getting
RF microneedling, that's whatthey have in their mind.
What do you suggest that theydo to get the best treatment?
Arash Akhavan, M.D. (18:06):
I think go to a provider that is very
experienced that's one thing Awell-educated.
Look at their educationbackground, look at their
experience.
Go to a place that has lots ofoptions to offer you.
(18:27):
They're not just like you comein there and no matter what you
say, they say this rfmicroneedling device will cure
all your needs.
You know that's.
That's a red flag.
And then don't push them foramazing before and after results
.
A good rf microneedling youshould barely see anything or
nothing at all on your beforeand after results.
A good rf microneedling youshould barely see anything or
nothing at all on your beforeand afters.
(18:49):
So you want your skin to look alittle smoother, a little more
hydrated, a little bit moreglowy and not tighter, not
lifted, none of that stuff.
If that happens, you'vepotentially permanently damaged
your skin, yeah, and long termyou've aged yourself.
So bad decision.
So you want to go super light.
Alyssa DiBenedetto (19:08):
Yeah, I feel like that's one thing that I've
learned working for you for allthese years that you know, just
going slow into a treatment,doing lighter treatments, in the
long run you're going to getthe better results, you know,
and sometimes you may needsomething stronger, but for most
just cosmetic concerns or aging, we, you know, we'll do the
(19:33):
lighter options.
Arash Akhavan, M.D. (19:34):
Yeah, I mean, I think that's probably
best with almost everything,even like surgical procedures
that plastic surgeons do youknow.
Taking a less is more approachis definitely our way, but I
think it's the right way.
Alyssa DiBenedetto (19:47):
Yeah, all right, so switching gears now.
Um, for this week's review oftiktok and instagram trends, I
wanted to talk about collagensupplements, something that
patients will ask a lot if theyshould take them to maintain
their results, and I find it'smixed reviews everywhere on how
(20:13):
people feel about them.
Arash Akhavan, M.D. (20:18):
So what are your thoughts?
Yeah, I have no problem withthem.
I think they're a good sourceof protein.
So collagen is a protein.
It's found in our skin,cartilage, connective tissue,
veins, hair, nails.
It's found in animals.
It's a big component of ourbody.
It's basically a series ofthree long peptides made of
(20:45):
amino acids glyine, proline,hydroxyproline, different amino
acid combos and different typesof collagen.
Oh, there's lots of types ofcollagen, by the way, and
they're these.
The collagen in our skin givesit its structure and we talked
about it all day long.
With all of our procedures,we're trying to maintain and
(21:06):
generate new collagen.
The collagen that you consume inthe supplements is a healthy
way to get protein.
The one thing you know I thinkit's a little bit of marketing,
but they make you think thatyou're consuming the collagen.
They make you think that you'reconsuming the collagen and
somehow it's going into yourbloodstream and popping into
(21:29):
your skin as collagen, orpopping into your nails as
collagen or hair.
That's definitely not happening.
It's just breaking down likeany other protein.
You eat the protein in yoursteak, the protein in your
almonds, you know, or whateverfood you're eating.
So it's breaking down intoamino acids and small little
peptides getting absorbed inyour blood and your body decides
(21:51):
what to do with it.
Maybe it's going to repairmuscle, maybe it's going to use
it to burn as calories, asenergy.
Maybe it's going to makecollagen, um.
So there's nothing magicalnecessarily about collagen.
You're you're primarily you'retalking about two types of
collagen.
There's marine collagen, theycall it, which is fish, um, fish
skin, and there's, they call itit's again marketing term, but
(22:15):
they call it grass fed collagen.
They never say so, that's cow,um.
So those are the two types ofcollagen you're consuming the,
the, that fish skin isn't likegoing into your blood and
becoming collagen for you.
You're not getting rid ofwrinkles that way.
There are some studies that haveactually shown that consuming
collagen peptides and collagensupplements could potentially
(22:37):
improve skin texture, skinhydration, things like that.
But there's nothingparticularly special about those
studies, because the same thinghas been shown with consuming
whey protein.
So that protein shake that youeat that's dairy derived, has
the same studies behind it.
And the same thing has beenshown with soy protein.
(22:58):
So edamame and soy proteinshakes and all tofu have also
been shown to have the same sortof skin benefits.
So there's similar studies forall of them.
I'm not convinced that there'sanything special about collagen,
but it is another good, healthysource of protein and I know a
lot of people like it.
I know you like it.
Alyssa DiBenedetto (23:19):
Yeah, I mean I've been highly influenced to
try it.
One specifically that JenniferAniston really likes and I'll do
anything to what she likes Um,and what's nice about it is?
It just dissolves in anythingyou want to put it in.
Yeah, that's what I found aboutit actually.
Arash Akhavan, M.D. (23:39):
Um, with collagen, as opposed to like
when you have like a wheyprotein shake.
It's so filling, you know it'slike a meal.
The collagen you don't even youcould literally have it in the
collagen water and it's justhydrating water, so it's not a
big deal.
I actually have read on I'venever tried this on Instagram
that you can actually bake withcollagen.
(23:59):
It's really heat resistant.
I don't know how well thatworks, but I've heard of like
baking it into cookies and stufflike that too, just to add a
little protein.
Alyssa DiBenedetto (24:09):
Yeah, I've seen the putting it oatmeal and
yeah, I think it dissolveseasily and it's heat resistant,
so why not?
Arash Akhavan, M.D. (24:16):
Yeah, no, I have no problems with collagen.
I don't think it's magical, um,but so I don't think it's
necessarily any better or worsethan having other sources of
protein.
That hasn't been proven.
But it's a healthy source ofprotein and protein is good.
Alyssa DiBenedetto (24:31):
Yeah, anything to make you feel good
about it?
Yeah, and then every week we'regoing to talk about a skincare
product.
So one of my favorites and anoffice favorite that I really
love is Elta MD UV clear.
Um, I use that every day foryears.
(24:52):
Um, it's super light, easy toput on.
I can wear makeup over it.
Um, they have a tinted shade,which is nice, uh, for summer,
and then they also came out witha deep shade as well.
Arash Akhavan, M.D. (25:06):
Um, so, yeah, yeah, I love that you
picked that one.
That's kind of um, when we'rewhen we have a new patient come
into the office and we ask themabout their uh, skincare.
That's like 90% of the time theone they mentioned, um, you
know, since the beginning of mycareer I feel like we've been
mentioning it as arecommendation.
With the niacinamide that ithas as an ingredient, it's
(25:31):
helpful for acne prone skin,rosacea prone skin,
anti-inflammatory effects.
It's broad spectrum protectswell against skin cancer and
aging.
It's lightweight.
People like it.
Like you said, the threedifferent tinted and two
different tints and one untinted, so three different varieties
of it.
It's a super popular product.
I think a great pick.
(25:51):
That's like out of that sort ofclass of sort of physician
recommended skincare products, Ithink that's number one.
It's got to be the number onerecommended dermatologist
product.
I don't know if that's true ornot, but it feels like it's got
to be because all my friends whoare dermatologists use it and
recommend it as well.
It's like in everybody's house.
Alyssa DiBenedetto (26:13):
Yeah, I've never heard anybody have any
issues with it.
I have super sensitive skin andcannot use anything, and that's
always been an easy product forme.
Arash Akhavan, M.D. (26:23):
Yeah, yeah, no Good pick.
Easy product for me yeah, yeah,no good pick.
Alyssa DiBenedetto (26:25):
Okay, All right.
Well, that does it for thisweek and we hope you all enjoyed
.
Make sure to follow and reviewour podcasts.
Reach out with any suggestions.
We loved hearing from all ofyou last week.
Arash Akhavan, M.D. (26:40):
And yeah, we've been getting a lot of
people um DMing and filling outour contact form.
It's been it's been really cool.
Speaker 2 (26:48):
I like the feedback thanks, of course all right,
thank you thank you so much fortuning in today.
If you enjoyed this episode,please make sure to subscribe to
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By subscribing, you'll nevermiss an episode and you'll be
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(27:10):
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(27:30):
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