Which Botox Is the Best

Episode Transcript

Speaker 1 (00:00):
The following is a paid podcast. iHeartRadio's hosting of this
podcast constitutes neither an endorsement of the products offered or
the ideas expressed.

Speaker 2 (00:09):
Well, Doctor Arthur Perry, he's one of the top plastic surgeons.
He's got offices in Manhattan, New Jersey. You know what,
He's been doing the show here on w R for
years and years and years. Very popular show and a
great plastic surgeon. Everybody has questions on this subject, so
he's the guy to ask.

Speaker 3 (00:26):
Doctor Arthur Perry, and the public wants to know that
public doesn't get a damn.

Speaker 4 (00:30):
And I went to his office and I said, I said,
look at my face. He goes, yeah, look at your face.
We're going to do with your fan. What can you
do with his face? I go like that, I said,
what you got? I go look at this, I'm getting old.
I said, I want to maybe he could fix it
up a little bit.

Speaker 3 (00:40):
Doctor Oz, are you there?

Speaker 5 (00:42):
I'm here Ark, and I want to get applaud you.
Having worked with you on a book and numerous other activity.

Speaker 3 (00:46):
You want to talk to Arthur Perry the best in plastic.

Speaker 5 (00:49):
Surgery, workable knowledge, but also your grace at delivery content
which is why it's been a blessing to have you
on my show so many times.

Speaker 3 (00:54):
When I was a resident at the University of Chicago,
we had.

Speaker 5 (00:57):
A me you smart as a really brilliant giftus position.
I want to pay you the highest true I can
give to a surgeon, which is when people come to you,
they don't come for an operation, they come for an opinion.
And that's why I trust you with my friends relatives.

Speaker 3 (01:09):
I didn't realize we were going to get the Michael
Jordan of Plastic Surgeon nine oh two and zero bows
to this guide and welcome. This is port certified plastic surgeon,
doctor Arthur Perry. You're listening to What's your Ankle right
here on WOR, and you're also listening to straight talk
about cosmetic surgery, because that's what this is and that's
the name of the podcast. I hope you're all having

(01:32):
a great weekend. It's kind of a soggy, typical unfortunately
cold New York weekend, but we're gonna make the best
of it here and I hope you are also all right.
This is the Plastic Surgery Show here on WOR, and
I hope you're already with your questions for me because

(01:52):
it's a call and show. The phone number here at
WR is eight hundred three two one zero seven ten.
Eight hundred three to two one zero seven ten. If
you're listening on the podcast, write this down. It's six
pm on Saturday evenings. We broadcast live out of New
York and so that means you can call the podcast
and be on the podcast if you call. All right,

(02:14):
So we're gonna talk about some interesting things tonight. Noah,
get ready for this one. This may be the strangest
skincare thing I have ever seen. I'll leave you hanging
for a little bit, a little bit of time, but
it is. Some people are putting the weirdest things on
their face, and we're going to talk about that tonight.

(02:34):
We're gonna talk about something we tried to get to
last week but we did not, which is the best
of the six different botoxes. Yeah, we'll talk about that.
We're going to talk a little bit more because I
keep getting this question about the deep plane facelifts, So
we're gonna get into that a little bit, and then
we'll talk about a combination procedures. You know, it's only

(02:58):
a half hour show. How are we going to get
to all these topics. We'll get to some of them
and maybe most of them. Combination of laser and all
therare procedures doing both in the same setting. All right,
So I'm a board certified plastics churcheon. I've been broadcasting
here on WR for now twenty years, twenty years, it

(03:19):
seems like forever, with Noah as my sidekicking the studio. Today,
I'm broadcasting live from the Hamptons, the Saggy Hamptons, where
I spend a lot of weekends during the summer. And
you can give a call eight hundred and three to
two one zero seven ten. That's the phone number at WR.
And if you do have a question for me, and
I hope you do. I hope it's a good question.

(03:42):
You can try and stump me if you want, but
certainly ask me the questions that have been keeping you
up at night, the ones you know, like is that
a wrinkle? You know? Do we treat that with filler?
Do we treat it with a laser? Do I lift that?
How do we handle those? Those are the kinds of questions.
Or you can ask me a question about your breast
implants or your tummy tuck that you're thinking of having.

(04:05):
I saw a man a couple days ago in the
office and he came in and he had a very
protuberant belly and was about maybe thirty to forty pounds overweight,
and he was interested in lipos suction. And we sat down.
I looked at him, I examined his belly and there
was no fat at all on his belly. It was

(04:25):
all inside his abdomen. And with that, because it was
inside the abdom we can't do suction. We can't even
do a tummy tuck. That's one for doctor Caroline Messer
for a weight loss, you know, for those GLP one drugs.
But you can ask me the question about that. Save

(04:46):
you a consultation if you can ask the question. Or
maybe you're going to your plastic surgeon this Wednesday and
you've got similar questions, Well, you know, fire him at
me right now. Let's see if I can answer him.
Eight hundred three to two one zero seven ten. And
if you do call, we're going to be giving away
bottles of let's give out daytime. Daytime is the SPF

(05:07):
twenty SPF twenty sunscreen that's more than a sunscreen. You know,
you might call it a sunscreen, but it's got nias
cinnamone in it. That's vitamin B three. It's got vitamin
B five that's pansathenic acid. It's really a powerhouse of
skin protection. You put it on in the morning and
if you are a woman, you put it on, let

(05:28):
it dry, give it about two or three minutes, and
then you put powder makeup over it. If you use
a cream based makeup. Ah, you know it's a chemistry
experiment and it could pill. You know what that is
if you mix different types of makeup. So we don't
want to do that. So let it dry and put
your powder makeup on. It'll look wonderful all day unless

(05:49):
you wash your face or sweat or something, and then
you know what to do. All right. So while we've
got Sondra on the line, Sondra, what can I do
for you? What's your wrinkle?

Speaker 6 (05:58):
Well? I have a question. I notice sometimes people have
like a hollow neist under the lower lids, like it
below the eyelashes. Like a few want swimming and wore
goggles and then when you took off those goggles you
would notice what I'm talking about. It's like a hollowness
it's like it doesn't It looks like it needs something.

(06:19):
And I guess I remember someone once put pills in there,
but she had regrets because it came out lumpy. So
what do you do for that?

Speaker 3 (06:30):
You know? Uh, first of all, thank you for the
the terminology. It's now going to be the goggle deformity.
How's that's that's what we'll call it. So you're talking
about the grooves and the lower eyelid that we tend
to get as we get older, and there's a couple
of reasons for those grooves. First of all, the fat

(06:51):
of the lower eyelid tends to protrude as we get older.
It kind of herniates through the tissue. So that fat
has always been there. It's protecting your eye. Your eye
floats in it. It's under your eye. It's to the
sides behind and above your eye, so that when you
run or get poked in the eye, your eyeball doesn't

(07:12):
get injured. It gets the impact gets absorbed by that fat.
That's the reason for that fat. But as we get older,
our tissues tend to thin, and that fat tends to
kind of protrude forward like a hernia. And some people say,
look at all. This fat I've developed, it actually hasn't
changed at all since you were fifteen years old. It's

(07:33):
just protruding out. You haven't gotten more fat, so that
casts a shadow, and that makes that groove look even
more more visible. So the real treatment for this is
a blephroplasty. That's a lower eyelid lift. That's the best treatment.
But you know what I found out in my thirty
something years in practice, not everybody likes surgery. Why is that?

(07:53):
I love operating, Yeah, really, but not everyone wants to
go into the operating room and have a lower eyelid lift.
And when we do a lower eyelid lift, by the way,
I make an incision right underneath the eyelashes. I lift
up the skin and I expose those fat pads. There's
three in the lower eyelid, and I tease a little

(08:14):
of that fat out and I remove just a little
bit of it. We call it a judicious amount, just enough,
not so much that you get a hollow appearing lower eyelid,
but enough so that it looks good and flat. And
then I tighten the skin, remove a little bit of skin.
We can't overdo it with the lower lids. If you do,
you will look like a basset hound. You have to

(08:34):
be very careful. And sometimes people's lids are loose to
begin with, and we have to do a tightening procedure,
not just a lifting procedure. It's called a CANTHOPEXI. That's
the name of the extra operation that we do through
the same incision. So that's a lower eyelid lift. But
if you don't want that, the two things that I
have to offer are one is filler. And there's a

(08:58):
filler called eyelight E y E l I g h T.
It's made specifically for this purpose. It is it is
a rest lane product, and I introduce it through what's
called the canula, all these big names, right, A canula
is a tube as opposed to a needle, and I
put it on top of the bone and then also

(09:20):
underneath the skin. And that's a pretty good filler. It's
better than the older fillers that we used to use.
You're talking about lumpiness that you know, that's one of
the risks of the lower islid. It's the it's the
thinnest skin of the body, the lower eleid. Right, it's
you can you can actually see through it, right, you
can see through. That's one of the issues. You can

(09:41):
see the muscle and you can see the blood vessels
right through the islet skin, so we have to be
very careful, and that is one of the risks of
putting filler in, But with these newer fillers it's less
risky than the old way. A lot of people also
put fat in, and I was never happy with the
tradition fat grafting techniques for the lower elid because of

(10:03):
exactly what you talked about, the potential for visibility of
the little chunks of fat that we put in. But
now we use this nano fat. Don't you love these
names nanofat. It's fat that is placed through progressively smaller
filters until it becomes a liquid fat, and it can
be used for the same purpose as that rest lane

(10:24):
highlight to fill that eelid group. Now it has a
chance of being permanent, but it could also go away
just as quickly as the filler, so and it costs
a lot more, and it's an operation instead of a procedure,
so office procedure. So that's the option with filler. It's
either fat grafting or putting filler in. The other option

(10:46):
is alfra high energy focused ultrasound or maybe a laser procedure,
depends on the exact issue that you are. The person
you're talking about is having sondra and the old standby,
by the way, is thickening the skin, and how can
you do that? You can do that with ten percent

(11:07):
vitamin C in the form of l ascorbic acid. Be
very careful you don't get it in your eye. The
study was done probably a good ten years ago, and
it showed that that with six months of every night
application of this l ascorbic acid, that's correct. But remember

(11:28):
what we say, it is very dangerous to use it
really close to the eye because if you get that
serum like my Nighttime has a pH of three point
five and it's twenty percent acid. It's very potent, so
it works on the elid, but if you get it
in your eye, you were going to irritate your cornea
and you'll remember that day. So that's why mine and

(11:51):
every other potent I cream gives you the warning. It says,
don't use an eyelid. It does not sound silly if
it's a If it's a there's one company I will
remain nameless, but they make a very good I cream.
It's not mine, it's a different company, and it says
on the label not for use on eyelids. Well, how

(12:11):
are you gonna have an eyelid? But they're doing that
because their lawyers said be careful because if people get
this in their eyes, you know, it could really hurt
their vision. So you have to be careful. But those
are your options. Thicken the skin, put filler in, or
do an eyelid lift.

Speaker 6 (12:28):
Okay, oh, very interesting. Thank you so much.

Speaker 3 (12:33):
Thank you for your phone call, Sondra, and have a
great weekend. All right. I'm Board certified Plastic surgeon, doctor
Arthur Perry, host of What's Your Wrinkle. We're gonna take
a short break right now. Noah, We'll be back after
these words. Eight hundred three two one zero seven ten
is the number. Did you know that your skincare may

(12:53):
be hurting you more than helping you. I'm Board certified
Plastic surgeon, doctor Arthur Perry. The foundation for looking good
is clean, healthy skin. So I've created a program that
is so simple that everyone can stay on it long
enough to see real results. It starts with an incredible
skin cleaner called clean Time. It's actually good for your skin.

(13:14):
Protect your skin with my Daytime SPF twenty cream in
the evening, feed your skin with my Powerhouse Nighttime Serum.
Nighttime has vitamin CNA, antioxidants and skin brighteners. And if
you like moisturizers, well, I've created Soft Time with seramides
and vitamin D. Throw away the bags of useless products

(13:34):
and try Doctor Perry's Skincare. Join the thousands of people
whose skin is healthier. That's Doctor Perry's Skincare on Amazon
dot com. And don't forget to listen to my radio
show right here on Wor every Saturday evening at six pm.
You're listening to What's Your Wrinkle with Doctor Arthur Perry.
What's your wrinkle? And what is your wrinkle? I'm board

(13:56):
certified plastic serchon Doctor Arthur Perry. Is this the first
time you've ever listened to the show? How could that be?
I've been on every Saturday evening for twenty years, and
Noah has been there also. I think he's taken maybe
one vacation day and all that time, and for the
most part, we don't like to run reruns on the show.

(14:16):
I try and do it live every single week. Much
to the misery of the people that I live with
and spend time with because Saturday evenings. But you like it.
And if you're driving in your car going over the
George Washington Bridge, now this is the best show. Don't
bother changing the station. This is it? All right? How

(14:37):
many of you use botox? I'll bet a lot of
listeners use botox. And we call it botox, right because
that was the very first botch A line of talks
and I've been injecting it into my patients since nineteen
ninety seven. That's a long time. That's what about twenty
eight years of injecting botox, and I've injected and thousands

(15:00):
of people. And yeah, it's a great drug, it really is.
But it's there's six of them now, you know, Botox
was the first one. We call all the bochulinum toxins
botox by just like you call kleenex. You know, you
have a box of tissues and it might not be
by the Kleenex company, and you call the you call
it Kleenex, uh, you know, or fridge came frigid air, right,

(15:24):
something like that. Anyway, So botox, there's six of them.
Now there's Botox, there's zm In, there's disport, there's Javou,
there's Daxifi, and the newest one, which is just getting
out there. It's got the funniest name. It's like leg

(15:44):
Bo or something. You know. They first they were called
uh bochel Ax, which is a terrible name if you
think about that, because it's it sounds like something your
gastroonologist would prescribe for you. Uh. But they very quickly
changed that name to Legbo. I don't know. I guess
they pay money for these names, but you know, okay,
but they're all good drugs and they all work very

(16:07):
very similarly. So my patients come to me and they say, well,
why aren't you using botox? And you know, some weeks
I use Botox, and some weeks I use disport in,
some weeks I use Javu, and some weeks I use
zm in and some Daxify. I haven't used that newest
one yet, but I consider those pretty interchangeable. And there

(16:28):
wasn't really good data that showed one was better than
the other until hmm, that's what we're talking about today.
Until now. There actually was a really good study that
did a head to head study of botox Disport, Javou
hardest one to pronounce, right, it's an American drug but
it sounds French, right, and zm in. And I'll bet

(16:51):
you all think that Botox won as the best one,
the fastest on set and the longest acting, right, But
I don't know. It did not, did not didn't win
the oscar here. In fact, the ones that were the
fastest onset were Disport and Javou, and they acted by
about day three on average, So Disport and Javou, and

(17:16):
then the ones that lasted the longest, interestingly, of those
four were z men that spelled with an x by
the way, X C O, M I N and Javou.
So interesting that the Boatox, which was the very first
one and is the market leader, was neither the fastest

(17:37):
onset nor the longest duration of the of those four drugs.
They did not put in the other two. They didn't
test Daxifi and this new and leg leg boor whatever
they call it. So interesting, I use all these interchangeably.
Now when we talk about onset of day three, you know,

(17:58):
you're talking about Botox being like day four and zem
and day four, so we're talking very very slight differences
between these and the conclusion of this study was that
they all work. They all work, they all have very
similar peak effects, and they all pretty much last about
the same amount of time. So if you go into

(18:22):
your doctor's office and your doctor is using zem in,
for instance, well you say okay, good, And I always say,
you know, the choice of the drug. I mean, there
are people that stop reacting, stop responding to one or
the other, and then if we change that, because you
make antibodies to one particular drug, if we change the drug,

(18:42):
then usually you'll respond to that. So let's say you've
been using botox for ten years and then you stop responding.
You come in, you say, well, you know you injected
it and it didn't work anymore. Well, that's not the
drug and it's not me. It is the fact that
your body begins to make antibodies against the specific drug.

(19:04):
And usually in that situation, when I switch you to
let's say disport or zem in, you'll start responding again.
So and that happens fairly frequency frequently. If you look
at the data, anywhere between four and seven percent of
people eventually get resistant to one of the different drugs.
So you just switch it up and now that there

(19:25):
are six of them. Back when there was only one,
we have no choices. But now there's six, so we
can switch up these drugs. So last year, over five
million people I think closer to eight million people had
botox or one of the boche linum toxins in the
United States. They're great drugs. I use this new needle.
I started using it about a month or so ago.

(19:46):
This is the smallest that you can't even see this
thing just about. It's smaller than an acupuncture needle. Those
of you who understand needle sizes, you know that when
you go I just gave blood yesterday in a blood drive,
and they used a number sixteen needle. That's a pretty
big needle to draw my blood and give the pint

(20:07):
of blood. Right when I inject you to numb up,
let's say a mole, I'll use a thirty gauge needle.
That's pretty small. You know, the general surgeons don't use
those little needles. An acupuncture needle is somewhere in the
area of thirty three gauge. These new needles for botox
thirty four gauge. You hardly feel them going into your skin.

(20:27):
So I've done now three four dozen people, and they
really tell me it makes a big, big difference, less
likely to cause bruising, and it's a nice advance in
the world of botox. When we come back from our break,
our last break, we're going to talk about some more
interesting things and in fact, maybe the most disgusting thing

(20:49):
I've ever seen people put on their face as a
skin cream. NOA, We're going to take another break. Iboard
certified plastic surgeon, Doctor Perry will be back after these
were They say that sixty is the new fifty. But
while you may feel and act fifty, the mirror doesn't lie.

(21:12):
But that's where plastic surgery comes in. I'm Board certified
plastic surgeon, Doctor Arthur Perry, and I love helping patients
look younger and better. If you've got sagging cheeks, jowls,
and that dreaded turkey gobbler, it might be time for
a little nip and a tuck. You look more rested
and yes, younger. With my short scar facelift and the
artistic injection of wrinkle filler or a laser peel, well,

(21:34):
that might be just what it takes to get you
looking as good as you feel. Let's sit down for
an hour consultation in my new Park Avenue office. Together,
we'll come up with a plan to help you look
your best. Give me a call at eight three three
Perry MD. That's a three three p E R R
Y M D. Check me out on the web at
periplastic surgery dot com. And don't forget to listen to

(21:55):
me doctor Arthur Perry. Every Saturday evening at six pm
right here on w A you.

Speaker 6 (22:01):
Are listening to what's your Wrinkle with Doctor Arthur Perry.

Speaker 3 (22:04):
What's your wrinkle? And what is your wrinkle? What's your wrinkle?
You know, everybody's got one. As we grow older, we
begin to age, and you know, there's not much you
can do about that other than don't smoke, use sunscreen,
choose your parents well so that you have good genes.
You know, those are the things you could do. And

(22:25):
see your plastic surgeon a shameless plug for plastic surgery,
but really, you know, we like to look as good
as we can, and that's what we're here to do.
We're here to help you look as good as possible,
all right. And by the way, I've mentioned over the
last few weeks that I have joined the practice of
doctor Caroline Messer. I still have my own practice and

(22:48):
my office up on eighty fifth in Park in Somerset,
New Jersey, but I've joined well By Messer. They are
a group. The longer I'm with them and the more
I get to know the doctors at well By Messer,
the more impressed I am. It's a group of four
enter chronologists headed by doctor Caroline Messer, and there's two internists,
and there's a psychologist and a gynecologist, and a sports

(23:12):
medicine person and nutritionists. And it's a great office and
such a group of smart people. I have to tell you,
it's really wonderful to be working with the doctor Messer
and her colleagues. I'm seeing patients in her office now
in well By Messer, which is on the sixtieth Street
between Park Avenue and Lexington. It's a beautiful new office,

(23:36):
and I'm doing filler there and boatox there and taking
off moles and things like that in the office, doing
all the laser procedures and things like that, and of
course operating at Manhattan Ianeer and at Robert wood Johnson
at ed Care Surger Center. So come see me and
you can visit also the other doctors at well By Messer.

(23:57):
Their phone number is six four six seven six zero
thirty two to fifty six. So write that down six
four six seven six zero thirty two fifty six. And
it's a very complete medical practice because any of your issues,
internal medicine issues, general medical issues, they can handle. And

(24:19):
I can make you look better, all right. So you
know skincare, it's one of my favorite topics. I have
a skincare line, and I use the most scientifically available
ingredients and scientifically studied ingredients to make you look as
good as possible. But this week on the internet, there's
one person. She's not a doctor, she's not an esthetician.

(24:41):
She's an influencer from South America who's now putting you
ready for this Noah, okay, don't fall off your seat. Noah,
she's putting stool. Oh my goodness, that's right. Feces. Oh
can you believe this. People do the weirdest things. And
she's gotten hundreds of thousands of five She puts us
on her face. Oh, you can't make this up, and

(25:03):
it's really disgusting. She says, her face never look better,
it just looks red. And yeah, well that's because it's
an irritant shock full of bacteria and viruses, and it's
probably the stupidest thing you could possibly put on your face.
I mean, how can you even talk about this? But okay,
so don't do it. Don't do it. Use my skincare

(25:25):
or another good company. Don't put a stool, human vice
they're doing anything. It's really you can't make this up though.
I see his face all the way through the studio there,
all right, I'm board certified plastic surgeon, doctor Arthur Perry.
Check me out on the web Perryplastic Surgery dot com.
You can order the products we talk about exclusively on

(25:47):
Amazon dot com. It's such a great story, isn't it.
Amazon is great and you can take advantage of your
prime benefits and get very rapid shipping. So Amazon dot
com for the products. Check me out and my phone
number during the week two when to seven, five, three,
eighteen twenty, give me a call. Noah, thanks so much
for great engineering. We'll see everybody next week. Stage drivers,

(26:08):
bye bye. Now.

Speaker 1 (26:09):
The proceeding was a paid podcast. iHeartRadio's hosting of this
podcast constitutes neither an endorsement of the products offered or
the ideas expressed,