December 13, 2025 • 39 mins
When do ‘preventative’ injections cross the line and start making you look older? Can wearing a bra to bed really prevent sagging? And do you need to see a gynaecologist if you've never had sex?
In this episode, we speak to Consultant Dermatologist and Specialist Cosmetic Injector, Dr Cara McDonald to get the truth about anti-ageing, skincare ingredients and cosmetic procedures. She gives her expert rating (out of 10) for the most popular skincare ingredients - from your hyaluronic acids to your retinoids - and if they’re really that great in the fight against ageing.
We cover everything from why the operator is more important than the device, the dangers of over-filling and when removing all movement from your face can actually backfire…
Dr Mariam breaks down the serious risks of ‘cosmetic tourism’, the differences between a ‘Plastic Surgeon’ and ‘cosmetic surgeon’ and how to identify a properly credentialed practitioner.
Plus, we settle the "to bra in bed or not to bra in bed" debate, and whether it has any proven impact on sagging.
And, in our quick consult, Dr Mariam answers a listener’s question about whether you still need to see that doctor if you've never done the deed.
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CREDITS
Hosts: Claire Murphy and Dr Mariam
Guest: Dr Cara McDonald
Senior Producers: Claire Murphy and Sally Best
Audio Producer: Scott Stronach
Video Producer: Julian Rosario
Social Producer: Elly Moore
Mamamia acknowledges the Traditional Owners of the Land we have recorded this podcast on, the Gadigal people of the Eora Nation. We pay our respects to their Elders past and present, and extend that respect to all Aboriginal and Torres Strait Islander cultures.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:08):
You're listening to a MoMA mea podcast.
Speaker 2 (00:14):
High out Louders, it is Jesse here and today we
are bringing you a bit of an eyebrow raising episode
of MoMA MEA's women's health podcast, well hosted by Dr
Mariam and Claire Murphy. This week they speak to dermatologist
and specialist cosmetic injector doctor Kara McDonald to get the
(00:34):
truth about anti aging and cosmetic procedures. Plus, she gives
you her expert assessment of the most popular skincare ingredients,
from your hyaluronic acids to your retinoids, what actually works
and what doesn't. Also in this episode, Claire and doctor
Marriam settle the debate on weather wearing her bra to
(00:55):
bed really does prevent sagging. Plus, in the Quick Consult,
they answer a question from a listener who has never
had sex.
Speaker 3 (01:04):
We hope you enjoy And one of the biggest problems
I see, especially in young people, is that they think
if they've got any movement at all, that's a wrinkle.
But a wrinkle is only when you see it when
you're not moving. Being able to move your forehead and
frown a little bit and have some movement that's not
a wrinkle, and so it's really important to educate that
movement is okay.
Speaker 1 (01:31):
Hello and welcome to well Australian women. This is your
full body health check. I'm Claire Murphy and I'm very
happy to say that I inherited my mom's skin and
not my dad's. My dad looks a little bit like
that rock guy from The Fantastic Four, I think because
he's worked with a lot of construction materials over the years,
a lot of sun exposure, a lot of sun exposure.
Thank you, mum, and thank you for giving me your
(01:53):
good skincare regime.
Speaker 4 (01:55):
Hello Mary, and I'm doctor Mariam. Two older sisters, so
lots of sunscreen and lots of moisturize is growing up.
Speaker 1 (02:01):
You had access to their older sisters shorty regimes.
Speaker 4 (02:05):
My skin has a lot to thank my sisters.
Speaker 1 (02:12):
Well, if you haven't figured it out today we are
talking about skin, but we'll also be talking about things
like anti aging, so whether that's actually a thing. Can
you reverse the hands of time? And what the heck
do you do with all of these ingredients. I don't
know if you've gone to a chemist recently and looked
at the wall of things that you can potentially put
it on your skin can be really overwhelming and a
(02:34):
little bit daunting. So we're going to try and get
to the bottom of that. The quick consult today is
a question about whether you need gynecological assistance if you've
never done the deed, if you've never had sex, do
you need to get checked? But next to bra in
bed or not to br in bed? That is the question.
So let's go to med school.
Speaker 3 (02:52):
Welcome to med school.
Speaker 1 (02:54):
So Mary, remember we talked a few weeks ago about
whether we're underwear to bed or not. Well, I had
someone in the DMS ask, okay, but what about a bra?
And I have had this discussion with a few of
my friends because I have a friend who wears every
night and she swears and declares that means her boobs
will be perky forever. I've never seen her not in
a bra. Yeah, so I can't tell whether that has
actually worked for her or not. So I mean, it
(03:15):
may or it may not. So there's this idea of
maybe it'll stop the girls from getting affected by gravity
over the years. But then there's another school of thought
that think wearing a bra toer bed might actually be
detrimental to your health. Yeah, so we'll get into that
in a second. Are you a two bed bra wearer
or not?
Speaker 4 (03:33):
It depends on the day and the bra that I've worn.
After I've had kids, I've kind of lost the nice
lacy bras.
Speaker 1 (03:40):
We go a bit more utilitarian after the baby. Yeah.
Speaker 4 (03:44):
Yeah, So if I feel like, oh god, it's been
a day, you know, just like you get home and
you're like, I've been restricted all day and you just
take it off and it just feels like you've got
that you wear an underwhire. I don't wear an underwire.
So all my bras are like those supported maternity ones.
They're just so comfortable. How do you give those away?
Speaker 1 (04:02):
After my kid was born, like five years after, I
still had maternity bras in the rotation, really pretty and
very comfortable. But then like if you wear them with
a single that you can see a little or it's
like quick access, like it doesn't happen to be from
your kids exactly. There you get thinking ahead.
Speaker 4 (04:20):
But most nights, especially when hubbies are eight, I'm not
wearing a bar because when he's there to get their
hands up the top situation, it's like, no, it's not
an invitation to play it's just let them breathe.
Speaker 3 (04:32):
Yeah.
Speaker 1 (04:33):
I never have been a brighter bed girly.
Speaker 3 (04:35):
Yeah.
Speaker 1 (04:36):
I'm not big, but I'm not small. Yeah, So I
don't feel like it's a problem. And the thing is
for some women. For example, I've got a friend who's
got really large boobs, and she said to me, if
I don't wear some kind of support to bed, they
will choke me to death in much less.
Speaker 4 (04:52):
It's just like rougher out a neck.
Speaker 1 (04:53):
Yeah. And then I've got another friend who said if
she goes sideways, they kind of they go to the
side and laying on and they can get kind of
pinched in there. So like there's reasons for that. There's
also people who might have piercings and things that don't
want to be let free in the bed. Like, there's
many reasons why you may yes or may not want
to wear one. But it turns out there is no
strong scientific evidence that wearing a bra to bed has
(05:15):
any major positive or negative impacts on you. So obviously,
as we've discussed, there are personal choices. If you want
to wear a brat to bed or not, that is
totally fine. The only thing I came across was that
it may make you a little bit hotter at night
to have that extra layer in that restriction, and that
can decrease your melotonin, which we know to go sleep.
But there's no large scale studies to actually support that either,
(05:38):
so that is not as yet scientifically proven. But the
biggie is those myths about wearing a bra to bed
at night increasing your risk of breast cancer or preventing
sagging long term. None of that has any scientific research
to prove at this point that that is true. There
is some suggestion wearing a bra, especially an underwire one,
(05:59):
may impact your lymphatic drainage, but again no studies prove
or disprove that that is just a theory that's being
worked on at this stage. And of course it can
cause some skin irritations if there's heat and moisture building
up under a bra. But also for those of us
who have boobs that aren't you know, perky high things,
we know skin irritations can occur even without a bra.
Speaker 4 (06:20):
That's right from the underside. I see a lot of
like contact dermatitis or have fungal infections in that area.
Speaker 1 (06:26):
And the under boob sweat can be very real.
Speaker 4 (06:31):
Do you ever sniff it. It's got a.
Speaker 1 (06:34):
How how do you like?
Speaker 4 (06:36):
Sometimes I'm like curious, I'm like, oh, I'm sweaty. I
went to what that smells like? Is that not a thought?
Speaker 1 (06:41):
Like I'm presuming you sniff a finger after touching, because
if you can get down that sniff like wow.
Speaker 4 (06:47):
It's just like, oh, I'm sweaty, and then oh wow,
that's just kind of like a.
Speaker 1 (06:51):
Sweet Is it more because of moisturizers or something.
Speaker 4 (06:53):
Maybe I'm not sure, but it's a nice sweaty smell.
Speaker 1 (06:56):
There you go, sweet stinky under boob sweat. Basically, wear them,
don't wear them. It's kind of up to you and
how you feel and what you're comfortable.
Speaker 4 (07:04):
Yea, do what works for you. Yeah yeah, But for
me when Harby in bed, I'm gonna wear it. Bro's
touching my movies.
Speaker 1 (07:10):
I need all of the things to protect me against
any more babies, as she currently incubates one as we speak.
All right, it is check up time. Next, we're talking
about skin and weather. You can actually reverse the signs
of aging and can you really take back chicken neck.
It's time for the check up. So mar in the
last one hundred years or so, has seen some pretty
(07:33):
dramatic advances in technology where it comes to skin care
and the products and services that we have in regards
to turning back the hands of time. Now, I do
want to start this conversation, though, with saying, neither you
or I actually care a single bit about what you
do or do not do yep in order to reverse
the signs of aging or allow all the things or
none of the things exactly. So, if you are Earth
(07:56):
Mother just allowing the elements freedom to do as they
wish upon your skin, more power to you. If you're
also a queen who's had stuff done in your twenties
to stop looking at a day over twenty five, or
you've had lots of other work done to look forty
when you're seventy or eighty, like Share for example, more
power to you whatever you want to do and whatever
makes you feel good. The thing is, we've been taught
(08:18):
to really harshly judge women who don't do anything and
who do everything yea, and all of the ranges between that.
So we're going to talk about it today because it
is something that we do deal with, and anti aging
doesn't always necessarily mean the way you look either, taking
care of your skin obviously is really important. So Marian,
what do you say to someone who might speak to
(08:38):
you about choosing, say, some of the more dramatic procedures,
not using creams and serums? Obviously? Do you speak to
people who are considering surgical intervention, because I understand there
are some more guidelines in place now for people who
are considering that, which is great.
Speaker 4 (08:53):
So honestly, the leaps from serums to surgery, it's not uncommon,
happens very frequently in practice. As females, we can get frustrated.
You know, we've been using our fourteen cycle skincare regimen.
Nothing's happening. Scroll past someone on Instagram and you're like,
I want that? Should I just do something bigger?
Speaker 1 (09:12):
Instagram face was a thing for a really long time
where we all essentially wanted to look like a version
of the Kardashians. I think it was like the base levels,
and that required a lot of things to be done.
Speaker 4 (09:22):
Exactly, And I'd say pause, not because you shouldn't do it,
but because it's worth doing it the right way. In Australia,
cosmetic procedures are no longer the wild West they once were.
I'm sure you've heard a lot of things in the
areas about cosmetic procedures in the past, so it's good
that we've got these regulations now. So we've seen too
many stories of botch jobs, unqualified providers and clinics that
(09:44):
value speed over safety. So the rules have changed and
here's what's new. So we have stronger guidelines in Australia
and they're there to protect you. So you need a
GP referral for most surgical cosmetic procedures. It's not gay keeping,
it's about having medical oversight and that's really important.
Speaker 1 (10:00):
Does that include oversight into people who might be suffering
from mental health disorders exactly? Contributing to yeah, exactly, because
you've got people with bodies to small fear or eating
disorders that are doing these procedures and just going to
be worsening their condition. Another part which is important just
going on that is psychological assessments are now part of
the process for certain procedures because your mental health matters
(10:24):
as much as the result. Right, practitioners must meet strict standards,
use accredited facilities, and be transparent about risks, recovery and
realistic outcomes. And yes, marketing is now being.
Speaker 4 (10:38):
Very closely watched so those flashy ads promising lunchtime nose
jobs are undiscrutiny.
Speaker 1 (10:44):
Yeah, that's the thing too. When we're talking to you
about these things, we have to be really careful in
the language that we use because the TGA monitors all
of the things that we talk about where it comes
to specially surgical procedures and now others like anti wrinkle
injections or fillers and things like that, we have to
be very careful not to be seen to be promoting them.
So if it sounds like we're talking around things, sometimes
(11:05):
that might be why, because we've got to be careful
about the language that we're using.
Speaker 4 (11:08):
Yeah, that's exactly right. So they're not hoops to jump
through their safety nets, and in the long run, they
help make sure that you're making decisions with clarity and
not just impulse. And I also wanted to talk about
cosmetic tourism because that's massive. I get a lot of patients.
Speaker 1 (11:24):
Coming in and there's lots of funny things about Turkish
teeth and a lot of men going to transplant translats
like yeahose.
Speaker 4 (11:33):
Men in the plane. Yeah sounds glamorous, like get a
new face and a beach holiday while you're at it.
But here's the reality check. Many people end up in
Australian emergency rooms with complications from overseas procedures. We're talking infections,
poor healing, implant issues, scarring that needs to be corrected,
often at your own expense. So surgery recovery, let's be real,
(11:55):
on a beach, is not really realistic. You're not going
to be sipping cocktails by the pool while you're swollen,
sore and trying not to sweat through your compression. Yeah yeah, yeah,
So just have a real think about that you are considering.
If someone's thinking about something more dramatic like surgery, i'd
encourage them to start with a great GP, especially one
with an interest in maybe dermatology, cosmetic medicine or woman's health.
Speaker 1 (12:18):
And again you can look that up online. Your gps
will all have bios, so you go and see what
their special interests are.
Speaker 4 (12:24):
They'll give you honest feedback. They'd recommend safe for alternatives
if something else exists, or refer you to a specialist
if needed. Choosing qualified practitioners really important. If you do
pursue surgery injectables, make sure they're properly credentialed. They're using
license facilities and make sure they prioritize your safety. There's
(12:45):
ongoing follow up and review. It's not like you've done
the surgery, see you and asking about that follow up
care is really important. So what happens if something goes wrong?
Who will look after you post operatively? If the answer
is vague, run that's a massive red flag.
Speaker 1 (12:59):
Yeah, when you say find someone who's properly credential because
there's people who say that they're cosmetic doctors, like what
does that mean?
Speaker 4 (13:07):
So we always recommend looking up the credentials of the
person doing the procedure. So for major surgeries in Australia,
we'd always recommend going to a plastic surgeon. So a
qualified plastic surgeon who's done training and is affiliated with
the College of Surgery.
Speaker 1 (13:26):
They're like the AFRO website. Can you go on that?
Speaker 4 (13:28):
Yeah, you can check, but they should also have their
credentials on their website. But you can also check that
as well, because you know some people do lie, which is.
Speaker 1 (13:37):
Illegal, So it's good to check reviews because sometimes there
might be complaints about except as as well, so you
need to make sure that's right to.
Speaker 4 (13:46):
And there are some doctors who don't have that plastic
surgery training but fall under that cosmetic department, and so
they identify as cosmetic physicians or cosmetic surgeons. And you know,
some are great, but obviously they don't have that expertise
training and they're not affiliated with the college. So I
(14:08):
would just kind of err on the side of caution.
Talk to your GP. It all depends on really what
you're doing as well. Before those major surgeries. We'd always
encourage patients to see a plastic surgeon with appropriate qualifications.
Speaker 1 (14:23):
Amazing, So do a little bit of research before you
rush into anything. So we are going to be continuing
this conversation about skin and anti aging. We are chatting
to dermatologists doctor Kara McDonald next to find out what
all those anti aging ingredients actually do and whether they're
doing anything at all.
Speaker 4 (14:45):
So Mariam I.
Speaker 1 (14:47):
Tasked doctor Kara McDonald, who is an amazing dermatologist who
has also just quietly posted an incredibly confronting real recently
on her socials, to give your heads up on what
your neck might end up looking like if you keep
following tanning trends, which are quite big on social media
at the moment.
Speaker 4 (15:04):
You've seen the vagina tanning trend.
Speaker 1 (15:07):
I saw anal sonning and then that turned into volver sonning,
Like you.
Speaker 4 (15:11):
Don't do these ladies on the fills with their like
legs open.
Speaker 1 (15:15):
No, don't put your dinner out in the sun.
Speaker 4 (15:17):
Please do not put your vulver out in the side.
Speaker 1 (15:21):
There's a reason it exists where it exists. I tested
her to rate out of ten a range of very
popular skin care ingredients that we commonly use in our
fight against aging. One that we hear about probably the
most might just surprise you a little bit. But I
kicked off the chat asking her how much influence our
mum and dad and their jeens have on how our
(15:42):
skin looks as we get older. There is a comment
that you will hear pretty regularly when it comes to
looking at a woman who seems to have aged gracefully,
which we obviously say tongue in cheek, because what does
age in gracefully even mean? But if we look at
someone who seems to have aged well, we always say, oh,
she's got good genes. How much does genetics play a
(16:05):
part in how our skin look?
Speaker 3 (16:08):
It's very hard to be exact and know a clear answer,
but it certainly does play a role in general. You
need all your ducks lined up to age well. We
obviously start with good genes. We can start with genes that,
for example, naturally protect us better from the sun, so
we know that skin of color actually doesn't age as
(16:30):
quickly in a sun environment like Australia as fairer skinned people.
Fair skinned people are not designed to be in the sun.
We are fair because we need to be able to
get vitamin D and the nutrients from the sun from
very small amounts of sun. So when we put fair
skinned people into a sunny environment, it's overwhelming for our skin,
(16:51):
whereas darker skinned people can tolerate the sun. So sun
makes probably the biggest difference to our skin aging. Genetics
play a huge role in our general health and skin aging,
and then all the other things we do on top
of that is sort of on the cake, I think,
but general health as well is often overlooked. You know, sleep, stress,
(17:12):
and nutrition are the three big things, and that's obviously
more environmental than genetic.
Speaker 1 (17:18):
Do Skincare regimes antiaging regimes work the same for people
who have darker skin as opposed to those who are farer.
Speaker 3 (17:26):
Yes, they do, but the needs of the skin can
be quite different. So obviously with skin care, we're trying
to target what each person's skin needs, not just be
generic in what we do. I always think of skin
care as being much better at prevention than cure, although
obviously it can correct some problems we already have. Skin
(17:48):
care is best in reducing or slowing down breaks on aging.
We just need to look at each person's individual skin
and their skin type and skin color and work out
what's best for them.
Speaker 4 (18:00):
Oka.
Speaker 1 (18:00):
Can I throw a bunch of the ingredients that we
hear about in anti aging skin care quite regularly now,
and I'd love you to rate it out of ten
for me as to how effective it is in your
opinion and what is actually supposed to do. So let's
start off with the one that we hear probably most often,
that's high luronic acid. What does it do? Out of ten?
How is it infighting the signs of aging?
Speaker 3 (18:21):
In fighting signs of aging, it's probably a four or
five out of ten. It's a humectant, so it holds
water on the skin. It adds hydration, but it's probably
a slightly overhyped ingredient because hyaluronic acid needs to be
held into the skin to be effective at all, So
on its own it doesn't do that much. It's going
to evaporate off. If we include it in a lot
(18:43):
of our other skincare products, it will actually hold that
hydration into the skin so long as it is sealed in.
But on its own it doesn't do a lot, and
in some people it can even be irritating, believe it
or not.
Speaker 1 (18:55):
Right, what about retinoids, things like vitamin A.
Speaker 3 (18:59):
So the retinoid family which includes rettin aud hide, retino
I would give it a ten out of ten. On
the whole, it is definitely the ingredient that has the
strongest evidence for reducing signs of photoaging. But most of
that does come from the prescription form, but we can
extrapolate that to the weaker forms which may be bet
are tolerated for consumers, which are available over the counter.
(19:22):
The key to a retinol or a retinoid is to
go slowly, go carefully, but go consistently. We get more
benefits with one year, two years, three years, five years
with retinols or retinoids, so stick with them rather than
swapping and changing and giving up every time you get irritation.
Speaker 1 (19:40):
What about the family of antioxidants, things like vitamin C,
vitamin E. Green tea extracts those kind of things.
Speaker 3 (19:45):
Again, I would give them a pretty high rating, probably
an eight out of ten, nine out of ten, even
for some of them. The problem with antioxidants is that
they need to be stable, and you need to look
for products that have evidence behind them. Not all antioxidants
are made equal. The ones that work well and have
good scientific data behind them work very well at reducing
(20:09):
environmental damage to the skin by mopping up free radicals.
Because of that, they can improve the appearance of the
skin and also reduce future signs of aging. But you
really need to find formulations that are scientifically proven, because
just having those ingredients in your bottle does not necessarily
do anything.
Speaker 1 (20:28):
What about nice cinamide.
Speaker 3 (20:30):
Nicinamide or this is one of our favorite ingredients. I'd
give it a nine out of ten. Nicinamide has many
proven benefits and it depends on your skin, but it
can inhibit pigmentation. It definitely helps with barrier repair, reduces inflammation,
and offers some degree photo protection as well. So the
(20:51):
good thing about nicinmid it's fiamin B three. It's tolerated
really by all skin types and all skin types will
benefit from it, so it's a great ingredient.
Speaker 1 (20:59):
What about hydroxy acids.
Speaker 3 (21:01):
So beta hydroxy acid is salacilic acid, just to differentiate that,
and it is a soluble acids, So that is a
very effective ingredient for people who have congestion or acne
prone skin because the fat soluble acid will basically track
down pores, so it's actually going to find the oily
part of the skin, track down the poor and help
(21:22):
unclog a poor So beta hydroxy acid is fabulous for
congested or acne prone skin. Alpha hydroxy acids are water
soluble and they will more be an exfoliating ingredient to
help strip off the dead, non functioning layer on the
surface of the skin, but also stimulate your own high
luronic acid, so they are again very effective. You need
(21:44):
to be careful not to overdo it because a lot
of people get in trouble with causing an irritant dermatitis
or inflammation by overdoing the acids. But used carefully, excellent ingredient,
probably a six or seven out of ten.
Speaker 5 (21:58):
What about seramides, So seramides are a natural lipid that
exists in the skin and really is or mental critically
in our skin barrier.
Speaker 3 (22:09):
People who have naturally dryer skin exmaprone skin are lacking
in seramides, So seramides are very important for those people.
They can actually replenish the natural lipids in the skin
to help improve our skin barrier and reduce the water
loss what we call transipit water loss from the skin.
So really they're acting like a barrier stopping the hydration
(22:33):
coming out of the skin and stopping the irritants from
the outside going into the skin. Nine out of ten.
Speaker 1 (22:38):
Next, I want to move away from more typical things
and look at more procedures now, so a lot of
people are now looking at laser therapy. What exactly is
laser therapy doing and is it a good option for
people if they're dealing with, say, deep wrinkles, et CETERA.
Speaker 3 (22:55):
Great question, So lasers are a big topic. What lasers
are is that they are technically a single wavelength of light,
and that wavelength of light will penetrate at a certain
level of the skin to target a specific target in
the skin. So, for example, we can have something called
a vascular laser and the wavelength of light it's essentially
(23:17):
a green light and it's looking for a red pigment,
so that's why they're very specific. They're going to basically
leave the rest of the skin alone until they find
something red, and then they're going to cook the red thing. Okay,
if you've got a pigment laser, they're more targeting brown
kind of colors, and they're going to leave alone a
lot of the rest of the skin, so they're not
going to burn or damage the rest of the skin
(23:38):
at the right settings. They're going to look for something
brown and deliver their energy into the brown pigment. So
that's why lasers are quite specifically targeting certain things in
the skin, and we need to make sure that we're
using the right laser for the right indication in each
patient and the right skin color. When you're talking about
using it for wrinkles and so on, we're looking at
(23:59):
more targets where we're often targeting, say water, because water
is obviously throughout the skin, so we can really burn
anything the skin with a laser that's targeting water, and
then we're using these lasers for a very controlled burn essentially.
So I like to describe, for example, a fractional CO
two laser, which is probably the one that's been in
(24:22):
social media a lot lately and being promoted for treating
wrinkles and fine lines and acne scarring. So if you
think about it, it's like, if you have the skin,
you're creating millions of tiny little burn holes into that skin,
so you can burn a small, deep column of skin.
But because every little burn hole you make is only
(24:42):
a fraction of a millimeter or a millimeter deep and thick,
each one of those holes heals very quickly without so
much risk of leaving a scar. They are extremely effective,
but there's a big butt here. The problem with lasers
is that it's not so much the device you're using,
it's the operator that's going to determine which results you get.
(25:05):
And the result you can get from a laser can
be anything from completely underwhelming I don't even know what
it did to causing severe complications because you've overcooked the
skin and caused a scar or a burn. So lasers
require a lot of training, a lot of expertise, experience,
nuance with different people, nuanced with different skin types. But
(25:26):
they are great when used well by the right person
in the right person.
Speaker 1 (25:31):
What's the difference between getting laser therapy and using say
an LED light mask.
Speaker 3 (25:38):
Very different, I mean huge difference. So one, an LED mask,
which is a light emitting DIDE is usually a red
or infrared light wavelength, so this is a visible light,
but it's not a laser, which has only one wavelength.
So as I was saying with lasers before is that
(25:58):
they're designed to penetrate through certain tissue to get to
a target, whereas an LED mask is a kind of
group of wavelengths of bright light, but it's not going
to do damage. Okay, So the problem with a laser
is that it delivers enough energy that it can damage something.
That's kind of the point of it. But if we're
specific enough, we're damaging the right thing. So if we're
(26:20):
treating red blood vessels broken capillories, we are actually cooking
those tiny little blood vessels under the skin so that
they disappear, whilst not delivering too much heat around it
to damage the other tissue. With a LED light, we're
actually trying to deliver energy to the skin. And it's
been shown that our mitochondria in particular can use red
(26:42):
light near infrared light as an energy source. So if
you think about LED lights, they are delivering a kind
of energy to stimulate the skin. They stimulate our mitochondria,
we hopefully produce more collagen. We definitely know we can
heal faster if we use an LED light, so they
are more a stimulation versus a laser, which is technically
(27:04):
causing damage.
Speaker 1 (27:06):
Can we talk out injectibles. So there's a lot of
people who now are talking about using injectibles as a
preventative rather than treatment for say crows feed or forehead
wrinkles or whatever. But then there's people who say, but
if you start using this stuff too young, you're actually
causing an issue down the track that you maybe wouldn't
have had had you not used injectibles. How do we
(27:28):
navigate that. Should we be using only for treatment or
should we be using as a preventative?
Speaker 3 (27:33):
Great question. I'm going to preface this with just saying
that in Australia we're limited in what we can say
about injectibles by the TGA because they are a prescription
only medication. But we can talk about them in an
educational capacity so long as we present a balanced view.
So I'm certainly going to try and do that. Let's
look at anti wrinkle injections because they're the ones that
(27:55):
most people talk about using it as a preventative mechanism.
What anti wrinkle injections do that will give us anti
aging benefit is two main things. One is that they
treat dynamic wrinkles, so they are the wrinkles we see
on our face from moving our muscles. The classic one
is our globellar line, so our frown line between our
(28:16):
brows when we frown, when we look angry, we'll create
a line there and it gives us a wrinkle over time.
In most people. Crows feet are the other ones. They
come from more smiling or squinting, and they are literally
wrinkles caused by muscle contraction. Now, if we look at
people when they're younger and they don't actually have those
(28:37):
lines yet, if they are very strong in those muscles,
or you look at their mother and they've got deep
wrinkles that they haven't been able to address because they
weren't treated early, you can certainly target those strong muscles
to try to weaken them or reduce them so that
they never develop those deep movement lines. And that is
(28:59):
very effective. But if you take away all movement in
some areas, those muscles can actually shrink down and down
over time and actually give a slightly aged appearance. So
if you look at someone that's been having muscle relaxant
injections for a long time, they sometimes have this almost shiny,
thin looking skin, and that's often because they've actually lost
(29:21):
that muscle underneath the skin. Their skin sort of has
lost its normal function, and the skin looks aged before
it's time. So I'm not against targeting strong muscles in
younger people if they are looking like causing deep wrinkles,
but I try to do it with a moderate dose
so that it's not over frozen. You don't want to
(29:42):
take away all movement. And one of the biggest problems
I see, especially in young people, is that they think
if they've got any movement at all, that's a wrinkle.
But a wrinkle is only when you see it when
you're not moving. Being able to move your forehead and
frown a little bit and have some movement that's not
a wrinkle. And so it's really important to educate that
movement is okay. So it's about trying to stop them
(30:05):
being so strong in a muscle that they're going to
have deep wrinkle they can't fix later without letting them
get frozen. Or shiny too soon. The other thing that
antirangular injections do, which is often overlooked completely, is that
they can treat the depressor muscles in the face. And
what I mean about that is that our brows when
we frown, not only do they go in and give
(30:26):
us a line, but they go down they give us
saggy eyelids. Our mouth. For example, when we frown, not
only does our mouth turn down we look sad, but
it actually gives us jows and sagging in the jawline.
When we contract the neck, it actually pulls the whole
face down and gives us sagging. So a lot of
people think that our saggy faces in our fifties and
(30:48):
beyond all due to gravity and laxity and sun damage,
but a lot of it is just due to the
strength of our facial muscles that pull down on our
face the whole time. So if you have a balanced approach,
what you should be doing is actually weakening some of
the depressor muscles that are sagging you. Especially in the
approach person who has very strong depressed muscles, your injectors
(31:11):
should be looking at do you have strong depressor muscles?
Can we target them because they actually make us look
older than our wrinkles do in later years.
Speaker 1 (31:19):
What are the side effects of anti wrinkle injections that
we need to be aware of.
Speaker 3 (31:24):
The thing about them is that they wear off, and
so it's very unlikely to ever have any cases of
permanent issue from anti wrinkle injections. The main side effects
are too much, in which case you end up with
heaviness where you don't want it, so frozen forehead but
heavy brows, can't lift your eyelids, and as I said before,
(31:45):
overdoing it so you see skin changes. But most of
the side effects are reversible and temporary at least, so.
Speaker 1 (31:53):
The same for fillers. I know a lot of celebrities
who are very filler obsessed have decided that that's no
longer a thing that they want to be, so they're
allowing them to dissolve and float away. But are there
long term implications? So mostly people get filler in their lips,
and I'm just wondering, like, over time does that stretch
your lip skin? If you do want to reverse it,
(32:13):
what is that actually doing while it's in there?
Speaker 3 (32:15):
Again, there's been a lot of negative talk about fillers.
A lot of people, you know, put off fillers, blaming
fillers for all sorts of things, saying filler here or
filler there is terrible. They had to get it dissolved.
And sadly, it's not the filler that's the problem. That
comes down to the injector.
Speaker 1 (32:32):
It's the operator again again.
Speaker 3 (32:34):
And the right amount in the right place with the
right product will extraordinarily rarely cause your problem. Most of
the problems people are having are because many injectors have
a fairly limited skill set. Often it's cheeks and lips,
and so people go and what do they get? They
get cheeks and lips, and they might look okay the
first time, and then they go back for some more
(32:56):
because they think, oh, you know, feeling a bit old again,
what do they get? They get cheeks and lips, and
then they get cheeks and lips, and it doesn't take
very long before you start to look a bit odd.
And then, of course the filler can all so cause problems.
The reason it causes problems is because there's too much
in any one place, or the wrong product or the
wrong layer. So that's when we hear about migration. We
(33:17):
hear about swelling, we hear about puffiness, we hear about
issues with overfilling, and generally it is repeated treatments in
the same area causing the problem and or the wrong
area treated in the first place with the wrong product.
Speaker 1 (33:36):
So Mariam I did speak to doctor McDonald about navigating
sunscreen because it's become quite difficult in recent times. We're
getting a lot of mixed messages about it from not
actually being the correct SPF as it's telling us it
is on the bottle. There's also this idea being spread
online that it's sunscreen that causes cancer, not prevents cancer,
(33:57):
and we're going to hear about that in an upcoming episode.
We are going to focus in a little bit more
on skin cancer itself. So spoiler alert, the benefits of
using sunscreen far outweighs any issues that they may be,
so but we'll get into that more when we speak.
Speaker 4 (34:10):
About looking forward to that chat. Bottom line is your
genes matter, but it's really the sun doing most of
the damage to your skin. So good news is you
can absolutely do something about that. And when it comes
to all these fancy treatments and procedures, remembering that it's
not so much about what's being used, but who's doing it.
And that's so important. Having a skilled practitioner with the
(34:32):
right approach will always beat the latest trendy treatment.
Speaker 1 (34:35):
Don Poorley, exactly right, Okay, Quick consult time next Today
it's from an anonymous contributor. She wants to know about
going to get her downstairs checked out if she's never
used them for sexy time with a partner. It's time, Mariam,
let's do. Let's get into today's quick consult Welcome us
(34:57):
in please.
Speaker 3 (34:58):
The doctor will see you now. Just through here to
consort room one.
Speaker 1 (35:03):
Thanks for waiting.
Speaker 4 (35:04):
How can I help you?
Speaker 1 (35:05):
Alrighty? We are taking your questions to find out what
general advice. The word general is very important there. It's
not specific to you go speak to your own doctor.
That our good doctor Marriam here can impart for you
to take your own health care into your own control
and then take it to your doctor and figure it out.
So today it is a question via our anonymous waiting room.
Speaker 6 (35:25):
I'm a forty nine year old woman who has never
had sex. I wanted to, but life just never happened.
Should I be seeing a gynecologist to check on my
health though my friends talk about getting pap smeares, etc.
Or more broadly, should I see a gynecologist and if so,
how often what can they share that's different from my GP?
Speaker 4 (35:48):
Great question. A lot of people think about it, but
never really say it out loud, So let's get into it.
Just because you haven't had sex doesn't mean you should
think about skipping follow up for your reproductive health. In Australia,
GPS your first port of core for women's health concerns,
So think cervical screening previously known as PATS, smears. Contraception, Yes,
(36:09):
even if you're not currently using it or having sex.
We use contraception for other purposes like heavy periods, painful periods, menopause,
perimenopause chats, weird periods, pelvict pain, and all the stuff
you'd be googling at midnight about your for JJ.
Speaker 1 (36:26):
This could be anything from denotitis on your volva to
clitteral adhesions that we talked about.
Speaker 4 (36:31):
A little while ago, all sorts of things.
Speaker 1 (36:33):
Yeah, you know, ovarian cancer. Like, there's a billion things
happening in there that aren't related to Heaver having had
sex before.
Speaker 4 (36:39):
Right, that's right, And most of the time, if everything's
tracking normally, you don't really need to see a gynecologist.
Often that said, gynecologists are experts for a reason. They
go deep, literally and be reachably into reproductive health. They're
the people you'd see for more complex or specific concerns
like persistent pain of normal vaginal bleeding, suspected conditions like
(37:01):
ENDO or fibroids, for instance, or if something just doesn't
feel right down there in your GP wants an expert opinion.
There's no rule that says you see a guyano on
a set schedule. It's more of a when needed kind
of thing. Your GP can absolutely help you figure that
out and when a referral makes sense. If you want
to skip the GP and go straight to the gynecologists,
(37:24):
you can just keep in mind you'll need a referral
if you want that Medicare rebate. If you're unture where
to start, here's what I'd suggest. Book a well woman.
Check with a GP, ideally one who has a special
interest in women's health. Check their bio online, bring your questions.
Ask about cervical cancer screening, remembering that we still encourage
you to do it even if you haven't had sex.
(37:45):
Oral sex also counts any concerns you've got, even if
they feel small, and whether seeing a gynecologist would be
useful for you. So whether you're twenty nine, forty nine,
sixty nine or anywhere in between, and whether you've had
sex or not, your reproductive health matters, So never too
late to check in with your friendly GP.
Speaker 1 (38:01):
Can you remember the first time you did an exam
on a woman, because I imagine it would be fascinating
to say, see how people's structures are, because not every
woman looks the same, right, So can you remember what
it's like looking in there and suddenly discovering all of that? Yeah?
Speaker 4 (38:16):
I do, but I've seen so many cervixes and vaginas
that like it's just the whole range.
Speaker 1 (38:22):
You haven't committed any of us to memory.
Speaker 4 (38:24):
No, no, but it's interesting, Like I have young patients
and then you've got ladies well and truly heading towards
seventy and things start to look different down there.
Speaker 1 (38:32):
But it's beautiful.
Speaker 4 (38:33):
It's all part of the process.
Speaker 1 (38:35):
No judgment. We're not judging your cervix, I would hope not.
Thank you so much for sending in your questions, and
thank you for spending some time with us and the
good doctor Marriam here today. We'll be back next week
to talk more skin. This time. We're talking all the
itchy and scratchy stuff, which is something I will be
very invested in as a very itchy, scratchy person in general,
So things like xmera and psoriasis and all that kind
(38:56):
of business. If you do want to chat to doctor
Mariam or myself, I mean, I can't give you any
kind of helpful advice, but we can chat. You can
do it in a few ways. We have a waiting room,
you can be AnonymOS, you can chuck in a question.
It's like our online form. The link to that is
in our show notes. Email us Well at mamamea dot
com dot au, or have a little chatski in the
(39:16):
dms of Instagram. Just so you know, this discussion is
for general information only and is not medical advice. Cosmetic
injection procedures are prescription only and must be discussed with
a qualified medical practitioner. We don't endorse or promote any
particular product or treatment. Always seek professional medical advice before
considering any procedure. Have a top stay. We'll catch you
(39:40):
for your appointment next week. Bye Bye Well is produced
by me Claire Murphy and our senior producer Sally Best
with audio production by Scott Stronik, video production by Julian Rosario,
and social production by Illimore.
Speaker 2 (39:56):
If you want to hear more about women's health, Well
is your full body health check and it drops every
week on a Thursday,
You're listening to a MoMA mea podcast.
Speaker 2 (00:14):
High out Louders, it is Jesse here and today we
are bringing you a bit of an eyebrow raising episode
of MoMA MEA's women's health podcast, well hosted by Dr
Mariam and Claire Murphy. This week they speak to dermatologist
and specialist cosmetic injector doctor Kara McDonald to get the
(00:34):
truth about anti aging and cosmetic procedures. Plus, she gives
you her expert assessment of the most popular skincare ingredients,
from your hyaluronic acids to your retinoids, what actually works
and what doesn't. Also in this episode, Claire and doctor
Marriam settle the debate on weather wearing her bra to
(00:55):
bed really does prevent sagging. Plus, in the Quick Consult,
they answer a question from a listener who has never
had sex.
Speaker 3 (01:04):
We hope you enjoy And one of the biggest problems
I see, especially in young people, is that they think
if they've got any movement at all, that's a wrinkle.
But a wrinkle is only when you see it when
you're not moving. Being able to move your forehead and
frown a little bit and have some movement that's not
a wrinkle, and so it's really important to educate that
movement is okay.
Speaker 1 (01:31):
Hello and welcome to well Australian women. This is your
full body health check. I'm Claire Murphy and I'm very
happy to say that I inherited my mom's skin and
not my dad's. My dad looks a little bit like
that rock guy from The Fantastic Four, I think because
he's worked with a lot of construction materials over the years,
a lot of sun exposure, a lot of sun exposure.
Thank you, mum, and thank you for giving me your
(01:53):
good skincare regime.
Speaker 4 (01:55):
Hello Mary, and I'm doctor Mariam. Two older sisters, so
lots of sunscreen and lots of moisturize is growing up.
Speaker 1 (02:01):
You had access to their older sisters shorty regimes.
Speaker 4 (02:05):
My skin has a lot to thank my sisters.
Speaker 1 (02:12):
Well, if you haven't figured it out today we are
talking about skin, but we'll also be talking about things
like anti aging, so whether that's actually a thing. Can
you reverse the hands of time? And what the heck
do you do with all of these ingredients. I don't
know if you've gone to a chemist recently and looked
at the wall of things that you can potentially put
it on your skin can be really overwhelming and a
(02:34):
little bit daunting. So we're going to try and get
to the bottom of that. The quick consult today is
a question about whether you need gynecological assistance if you've
never done the deed, if you've never had sex, do
you need to get checked? But next to bra in
bed or not to br in bed? That is the question.
So let's go to med school.
Speaker 3 (02:52):
Welcome to med school.
Speaker 1 (02:54):
So Mary, remember we talked a few weeks ago about
whether we're underwear to bed or not. Well, I had
someone in the DMS ask, okay, but what about a bra?
And I have had this discussion with a few of
my friends because I have a friend who wears every
night and she swears and declares that means her boobs
will be perky forever. I've never seen her not in
a bra. Yeah, so I can't tell whether that has
actually worked for her or not. So I mean, it
(03:15):
may or it may not. So there's this idea of
maybe it'll stop the girls from getting affected by gravity
over the years. But then there's another school of thought
that think wearing a bra toer bed might actually be
detrimental to your health. Yeah, so we'll get into that
in a second. Are you a two bed bra wearer
or not?
Speaker 4 (03:33):
It depends on the day and the bra that I've worn.
After I've had kids, I've kind of lost the nice
lacy bras.
Speaker 1 (03:40):
We go a bit more utilitarian after the baby. Yeah.
Speaker 4 (03:44):
Yeah, So if I feel like, oh god, it's been
a day, you know, just like you get home and
you're like, I've been restricted all day and you just
take it off and it just feels like you've got
that you wear an underwhire. I don't wear an underwire.
So all my bras are like those supported maternity ones.
They're just so comfortable. How do you give those away?
Speaker 1 (04:02):
After my kid was born, like five years after, I
still had maternity bras in the rotation, really pretty and
very comfortable. But then like if you wear them with
a single that you can see a little or it's
like quick access, like it doesn't happen to be from
your kids exactly. There you get thinking ahead.
Speaker 4 (04:20):
But most nights, especially when hubbies are eight, I'm not
wearing a bar because when he's there to get their
hands up the top situation, it's like, no, it's not
an invitation to play it's just let them breathe.
Speaker 3 (04:32):
Yeah.
Speaker 1 (04:33):
I never have been a brighter bed girly.
Speaker 3 (04:35):
Yeah.
Speaker 1 (04:36):
I'm not big, but I'm not small. Yeah, So I
don't feel like it's a problem. And the thing is
for some women. For example, I've got a friend who's
got really large boobs, and she said to me, if
I don't wear some kind of support to bed, they
will choke me to death in much less.
Speaker 4 (04:52):
It's just like rougher out a neck.
Speaker 1 (04:53):
Yeah. And then I've got another friend who said if
she goes sideways, they kind of they go to the
side and laying on and they can get kind of
pinched in there. So like there's reasons for that. There's
also people who might have piercings and things that don't
want to be let free in the bed. Like, there's
many reasons why you may yes or may not want
to wear one. But it turns out there is no
strong scientific evidence that wearing a bra to bed has
(05:15):
any major positive or negative impacts on you. So obviously,
as we've discussed, there are personal choices. If you want
to wear a brat to bed or not, that is
totally fine. The only thing I came across was that
it may make you a little bit hotter at night
to have that extra layer in that restriction, and that
can decrease your melotonin, which we know to go sleep.
But there's no large scale studies to actually support that either,
(05:38):
so that is not as yet scientifically proven. But the
biggie is those myths about wearing a bra to bed
at night increasing your risk of breast cancer or preventing
sagging long term. None of that has any scientific research
to prove at this point that that is true. There
is some suggestion wearing a bra, especially an underwire one,
(05:59):
may impact your lymphatic drainage, but again no studies prove
or disprove that that is just a theory that's being
worked on at this stage. And of course it can
cause some skin irritations if there's heat and moisture building
up under a bra. But also for those of us
who have boobs that aren't you know, perky high things,
we know skin irritations can occur even without a bra.
Speaker 4 (06:20):
That's right from the underside. I see a lot of
like contact dermatitis or have fungal infections in that area.
Speaker 1 (06:26):
And the under boob sweat can be very real.
Speaker 4 (06:31):
Do you ever sniff it. It's got a.
Speaker 1 (06:34):
How how do you like?
Speaker 4 (06:36):
Sometimes I'm like curious, I'm like, oh, I'm sweaty. I
went to what that smells like? Is that not a thought?
Speaker 1 (06:41):
Like I'm presuming you sniff a finger after touching, because
if you can get down that sniff like wow.
Speaker 4 (06:47):
It's just like, oh, I'm sweaty, and then oh wow,
that's just kind of like a.
Speaker 1 (06:51):
Sweet Is it more because of moisturizers or something.
Speaker 4 (06:53):
Maybe I'm not sure, but it's a nice sweaty smell.
Speaker 1 (06:56):
There you go, sweet stinky under boob sweat. Basically, wear them,
don't wear them. It's kind of up to you and
how you feel and what you're comfortable.
Speaker 4 (07:04):
Yea, do what works for you. Yeah yeah, But for
me when Harby in bed, I'm gonna wear it. Bro's
touching my movies.
Speaker 1 (07:10):
I need all of the things to protect me against
any more babies, as she currently incubates one as we speak.
All right, it is check up time. Next, we're talking
about skin and weather. You can actually reverse the signs
of aging and can you really take back chicken neck.
It's time for the check up. So mar in the
last one hundred years or so, has seen some pretty
(07:33):
dramatic advances in technology where it comes to skin care
and the products and services that we have in regards
to turning back the hands of time. Now, I do
want to start this conversation, though, with saying, neither you
or I actually care a single bit about what you
do or do not do yep in order to reverse
the signs of aging or allow all the things or
none of the things exactly. So, if you are Earth
(07:56):
Mother just allowing the elements freedom to do as they
wish upon your skin, more power to you. If you're
also a queen who's had stuff done in your twenties
to stop looking at a day over twenty five, or
you've had lots of other work done to look forty
when you're seventy or eighty, like Share for example, more
power to you whatever you want to do and whatever
makes you feel good. The thing is, we've been taught
(08:18):
to really harshly judge women who don't do anything and
who do everything yea, and all of the ranges between that.
So we're going to talk about it today because it
is something that we do deal with, and anti aging
doesn't always necessarily mean the way you look either, taking
care of your skin obviously is really important. So Marian,
what do you say to someone who might speak to
(08:38):
you about choosing, say, some of the more dramatic procedures,
not using creams and serums? Obviously? Do you speak to
people who are considering surgical intervention, because I understand there
are some more guidelines in place now for people who
are considering that, which is great.
Speaker 4 (08:53):
So honestly, the leaps from serums to surgery, it's not uncommon,
happens very frequently in practice. As females, we can get frustrated.
You know, we've been using our fourteen cycle skincare regimen.
Nothing's happening. Scroll past someone on Instagram and you're like,
I want that? Should I just do something bigger?
Speaker 1 (09:12):
Instagram face was a thing for a really long time
where we all essentially wanted to look like a version
of the Kardashians. I think it was like the base levels,
and that required a lot of things to be done.
Speaker 4 (09:22):
Exactly, And I'd say pause, not because you shouldn't do it,
but because it's worth doing it the right way. In Australia,
cosmetic procedures are no longer the wild West they once were.
I'm sure you've heard a lot of things in the
areas about cosmetic procedures in the past, so it's good
that we've got these regulations now. So we've seen too
many stories of botch jobs, unqualified providers and clinics that
(09:44):
value speed over safety. So the rules have changed and
here's what's new. So we have stronger guidelines in Australia
and they're there to protect you. So you need a
GP referral for most surgical cosmetic procedures. It's not gay keeping,
it's about having medical oversight and that's really important.
Speaker 1 (10:00):
Does that include oversight into people who might be suffering
from mental health disorders exactly? Contributing to yeah, exactly, because
you've got people with bodies to small fear or eating
disorders that are doing these procedures and just going to
be worsening their condition. Another part which is important just
going on that is psychological assessments are now part of
the process for certain procedures because your mental health matters
(10:24):
as much as the result. Right, practitioners must meet strict standards,
use accredited facilities, and be transparent about risks, recovery and
realistic outcomes. And yes, marketing is now being.
Speaker 4 (10:38):
Very closely watched so those flashy ads promising lunchtime nose
jobs are undiscrutiny.
Speaker 1 (10:44):
Yeah, that's the thing too. When we're talking to you
about these things, we have to be really careful in
the language that we use because the TGA monitors all
of the things that we talk about where it comes
to specially surgical procedures and now others like anti wrinkle
injections or fillers and things like that, we have to
be very careful not to be seen to be promoting them.
So if it sounds like we're talking around things, sometimes
(11:05):
that might be why, because we've got to be careful
about the language that we're using.
Speaker 4 (11:08):
Yeah, that's exactly right. So they're not hoops to jump
through their safety nets, and in the long run, they
help make sure that you're making decisions with clarity and
not just impulse. And I also wanted to talk about
cosmetic tourism because that's massive. I get a lot of patients.
Speaker 1 (11:24):
Coming in and there's lots of funny things about Turkish
teeth and a lot of men going to transplant translats
like yeahose.
Speaker 4 (11:33):
Men in the plane. Yeah sounds glamorous, like get a
new face and a beach holiday while you're at it.
But here's the reality check. Many people end up in
Australian emergency rooms with complications from overseas procedures. We're talking infections,
poor healing, implant issues, scarring that needs to be corrected,
often at your own expense. So surgery recovery, let's be real,
(11:55):
on a beach, is not really realistic. You're not going
to be sipping cocktails by the pool while you're swollen,
sore and trying not to sweat through your compression. Yeah yeah, yeah,
So just have a real think about that you are considering.
If someone's thinking about something more dramatic like surgery, i'd
encourage them to start with a great GP, especially one
with an interest in maybe dermatology, cosmetic medicine or woman's health.
Speaker 1 (12:18):
And again you can look that up online. Your gps
will all have bios, so you go and see what
their special interests are.
Speaker 4 (12:24):
They'll give you honest feedback. They'd recommend safe for alternatives
if something else exists, or refer you to a specialist
if needed. Choosing qualified practitioners really important. If you do
pursue surgery injectables, make sure they're properly credentialed. They're using
license facilities and make sure they prioritize your safety. There's
(12:45):
ongoing follow up and review. It's not like you've done
the surgery, see you and asking about that follow up
care is really important. So what happens if something goes wrong?
Who will look after you post operatively? If the answer
is vague, run that's a massive red flag.
Speaker 1 (12:59):
Yeah, when you say find someone who's properly credential because
there's people who say that they're cosmetic doctors, like what
does that mean?
Speaker 4 (13:07):
So we always recommend looking up the credentials of the
person doing the procedure. So for major surgeries in Australia,
we'd always recommend going to a plastic surgeon. So a
qualified plastic surgeon who's done training and is affiliated with
the College of Surgery.
Speaker 1 (13:26):
They're like the AFRO website. Can you go on that?
Speaker 4 (13:28):
Yeah, you can check, but they should also have their
credentials on their website. But you can also check that
as well, because you know some people do lie, which is.
Speaker 1 (13:37):
Illegal, So it's good to check reviews because sometimes there
might be complaints about except as as well, so you
need to make sure that's right to.
Speaker 4 (13:46):
And there are some doctors who don't have that plastic
surgery training but fall under that cosmetic department, and so
they identify as cosmetic physicians or cosmetic surgeons. And you know,
some are great, but obviously they don't have that expertise
training and they're not affiliated with the college. So I
(14:08):
would just kind of err on the side of caution.
Talk to your GP. It all depends on really what
you're doing as well. Before those major surgeries. We'd always
encourage patients to see a plastic surgeon with appropriate qualifications.
Speaker 1 (14:23):
Amazing, So do a little bit of research before you
rush into anything. So we are going to be continuing
this conversation about skin and anti aging. We are chatting
to dermatologists doctor Kara McDonald next to find out what
all those anti aging ingredients actually do and whether they're
doing anything at all.
Speaker 4 (14:45):
So Mariam I.
Speaker 1 (14:47):
Tasked doctor Kara McDonald, who is an amazing dermatologist who
has also just quietly posted an incredibly confronting real recently
on her socials, to give your heads up on what
your neck might end up looking like if you keep
following tanning trends, which are quite big on social media
at the moment.
Speaker 4 (15:04):
You've seen the vagina tanning trend.
Speaker 1 (15:07):
I saw anal sonning and then that turned into volver sonning,
Like you.
Speaker 4 (15:11):
Don't do these ladies on the fills with their like
legs open.
Speaker 1 (15:15):
No, don't put your dinner out in the sun.
Speaker 4 (15:17):
Please do not put your vulver out in the side.
Speaker 1 (15:21):
There's a reason it exists where it exists. I tested
her to rate out of ten a range of very
popular skin care ingredients that we commonly use in our
fight against aging. One that we hear about probably the
most might just surprise you a little bit. But I
kicked off the chat asking her how much influence our
mum and dad and their jeens have on how our
(15:42):
skin looks as we get older. There is a comment
that you will hear pretty regularly when it comes to
looking at a woman who seems to have aged gracefully,
which we obviously say tongue in cheek, because what does
age in gracefully even mean? But if we look at
someone who seems to have aged well, we always say, oh,
she's got good genes. How much does genetics play a
(16:05):
part in how our skin look?
Speaker 3 (16:08):
It's very hard to be exact and know a clear answer,
but it certainly does play a role in general. You
need all your ducks lined up to age well. We
obviously start with good genes. We can start with genes that,
for example, naturally protect us better from the sun, so
we know that skin of color actually doesn't age as
(16:30):
quickly in a sun environment like Australia as fairer skinned people.
Fair skinned people are not designed to be in the sun.
We are fair because we need to be able to
get vitamin D and the nutrients from the sun from
very small amounts of sun. So when we put fair
skinned people into a sunny environment, it's overwhelming for our skin,
(16:51):
whereas darker skinned people can tolerate the sun. So sun
makes probably the biggest difference to our skin aging. Genetics
play a huge role in our general health and skin aging,
and then all the other things we do on top
of that is sort of on the cake, I think,
but general health as well is often overlooked. You know, sleep, stress,
(17:12):
and nutrition are the three big things, and that's obviously
more environmental than genetic.
Speaker 1 (17:18):
Do Skincare regimes antiaging regimes work the same for people
who have darker skin as opposed to those who are farer.
Speaker 3 (17:26):
Yes, they do, but the needs of the skin can
be quite different. So obviously with skin care, we're trying
to target what each person's skin needs, not just be
generic in what we do. I always think of skin
care as being much better at prevention than cure, although
obviously it can correct some problems we already have. Skin
(17:48):
care is best in reducing or slowing down breaks on aging.
We just need to look at each person's individual skin
and their skin type and skin color and work out
what's best for them.
Speaker 4 (18:00):
Oka.
Speaker 1 (18:00):
Can I throw a bunch of the ingredients that we
hear about in anti aging skin care quite regularly now,
and I'd love you to rate it out of ten
for me as to how effective it is in your
opinion and what is actually supposed to do. So let's
start off with the one that we hear probably most often,
that's high luronic acid. What does it do? Out of ten?
How is it infighting the signs of aging?
Speaker 3 (18:21):
In fighting signs of aging, it's probably a four or
five out of ten. It's a humectant, so it holds
water on the skin. It adds hydration, but it's probably
a slightly overhyped ingredient because hyaluronic acid needs to be
held into the skin to be effective at all, So
on its own it doesn't do that much. It's going
to evaporate off. If we include it in a lot
(18:43):
of our other skincare products, it will actually hold that
hydration into the skin so long as it is sealed in.
But on its own it doesn't do a lot, and
in some people it can even be irritating, believe it
or not.
Speaker 1 (18:55):
Right, what about retinoids, things like vitamin A.
Speaker 3 (18:59):
So the retinoid family which includes rettin aud hide, retino
I would give it a ten out of ten. On
the whole, it is definitely the ingredient that has the
strongest evidence for reducing signs of photoaging. But most of
that does come from the prescription form, but we can
extrapolate that to the weaker forms which may be bet
are tolerated for consumers, which are available over the counter.
(19:22):
The key to a retinol or a retinoid is to
go slowly, go carefully, but go consistently. We get more
benefits with one year, two years, three years, five years
with retinols or retinoids, so stick with them rather than
swapping and changing and giving up every time you get irritation.
Speaker 1 (19:40):
What about the family of antioxidants, things like vitamin C,
vitamin E. Green tea extracts those kind of things.
Speaker 3 (19:45):
Again, I would give them a pretty high rating, probably
an eight out of ten, nine out of ten, even
for some of them. The problem with antioxidants is that
they need to be stable, and you need to look
for products that have evidence behind them. Not all antioxidants
are made equal. The ones that work well and have
good scientific data behind them work very well at reducing
(20:09):
environmental damage to the skin by mopping up free radicals.
Because of that, they can improve the appearance of the
skin and also reduce future signs of aging. But you
really need to find formulations that are scientifically proven, because
just having those ingredients in your bottle does not necessarily
do anything.
Speaker 1 (20:28):
What about nice cinamide.
Speaker 3 (20:30):
Nicinamide or this is one of our favorite ingredients. I'd
give it a nine out of ten. Nicinamide has many
proven benefits and it depends on your skin, but it
can inhibit pigmentation. It definitely helps with barrier repair, reduces inflammation,
and offers some degree photo protection as well. So the
(20:51):
good thing about nicinmid it's fiamin B three. It's tolerated
really by all skin types and all skin types will
benefit from it, so it's a great ingredient.
Speaker 1 (20:59):
What about hydroxy acids.
Speaker 3 (21:01):
So beta hydroxy acid is salacilic acid, just to differentiate that,
and it is a soluble acids, So that is a
very effective ingredient for people who have congestion or acne
prone skin because the fat soluble acid will basically track
down pores, so it's actually going to find the oily
part of the skin, track down the poor and help
(21:22):
unclog a poor So beta hydroxy acid is fabulous for
congested or acne prone skin. Alpha hydroxy acids are water
soluble and they will more be an exfoliating ingredient to
help strip off the dead, non functioning layer on the
surface of the skin, but also stimulate your own high
luronic acid, so they are again very effective. You need
(21:44):
to be careful not to overdo it because a lot
of people get in trouble with causing an irritant dermatitis
or inflammation by overdoing the acids. But used carefully, excellent ingredient,
probably a six or seven out of ten.
Speaker 5 (21:58):
What about seramides, So seramides are a natural lipid that
exists in the skin and really is or mental critically
in our skin barrier.
Speaker 3 (22:09):
People who have naturally dryer skin exmaprone skin are lacking
in seramides, So seramides are very important for those people.
They can actually replenish the natural lipids in the skin
to help improve our skin barrier and reduce the water
loss what we call transipit water loss from the skin.
So really they're acting like a barrier stopping the hydration
(22:33):
coming out of the skin and stopping the irritants from
the outside going into the skin. Nine out of ten.
Speaker 1 (22:38):
Next, I want to move away from more typical things
and look at more procedures now, so a lot of
people are now looking at laser therapy. What exactly is
laser therapy doing and is it a good option for
people if they're dealing with, say, deep wrinkles, et CETERA.
Speaker 3 (22:55):
Great question, So lasers are a big topic. What lasers
are is that they are technically a single wavelength of light,
and that wavelength of light will penetrate at a certain
level of the skin to target a specific target in
the skin. So, for example, we can have something called
a vascular laser and the wavelength of light it's essentially
(23:17):
a green light and it's looking for a red pigment,
so that's why they're very specific. They're going to basically
leave the rest of the skin alone until they find
something red, and then they're going to cook the red thing. Okay,
if you've got a pigment laser, they're more targeting brown
kind of colors, and they're going to leave alone a
lot of the rest of the skin, so they're not
going to burn or damage the rest of the skin
(23:38):
at the right settings. They're going to look for something
brown and deliver their energy into the brown pigment. So
that's why lasers are quite specifically targeting certain things in
the skin, and we need to make sure that we're
using the right laser for the right indication in each
patient and the right skin color. When you're talking about
using it for wrinkles and so on, we're looking at
(23:59):
more targets where we're often targeting, say water, because water
is obviously throughout the skin, so we can really burn
anything the skin with a laser that's targeting water, and
then we're using these lasers for a very controlled burn essentially.
So I like to describe, for example, a fractional CO
two laser, which is probably the one that's been in
(24:22):
social media a lot lately and being promoted for treating
wrinkles and fine lines and acne scarring. So if you
think about it, it's like, if you have the skin,
you're creating millions of tiny little burn holes into that skin,
so you can burn a small, deep column of skin.
But because every little burn hole you make is only
(24:42):
a fraction of a millimeter or a millimeter deep and thick,
each one of those holes heals very quickly without so
much risk of leaving a scar. They are extremely effective,
but there's a big butt here. The problem with lasers
is that it's not so much the device you're using,
it's the operator that's going to determine which results you get.
(25:05):
And the result you can get from a laser can
be anything from completely underwhelming I don't even know what
it did to causing severe complications because you've overcooked the
skin and caused a scar or a burn. So lasers
require a lot of training, a lot of expertise, experience,
nuance with different people, nuanced with different skin types. But
(25:26):
they are great when used well by the right person
in the right person.
Speaker 1 (25:31):
What's the difference between getting laser therapy and using say
an LED light mask.
Speaker 3 (25:38):
Very different, I mean huge difference. So one, an LED mask,
which is a light emitting DIDE is usually a red
or infrared light wavelength, so this is a visible light,
but it's not a laser, which has only one wavelength.
So as I was saying with lasers before is that
(25:58):
they're designed to penetrate through certain tissue to get to
a target, whereas an LED mask is a kind of
group of wavelengths of bright light, but it's not going
to do damage. Okay, So the problem with a laser
is that it delivers enough energy that it can damage something.
That's kind of the point of it. But if we're
specific enough, we're damaging the right thing. So if we're
(26:20):
treating red blood vessels broken capillories, we are actually cooking
those tiny little blood vessels under the skin so that
they disappear, whilst not delivering too much heat around it
to damage the other tissue. With a LED light, we're
actually trying to deliver energy to the skin. And it's
been shown that our mitochondria in particular can use red
(26:42):
light near infrared light as an energy source. So if
you think about LED lights, they are delivering a kind
of energy to stimulate the skin. They stimulate our mitochondria,
we hopefully produce more collagen. We definitely know we can
heal faster if we use an LED light, so they
are more a stimulation versus a laser, which is technically
(27:04):
causing damage.
Speaker 1 (27:06):
Can we talk out injectibles. So there's a lot of
people who now are talking about using injectibles as a
preventative rather than treatment for say crows feed or forehead
wrinkles or whatever. But then there's people who say, but
if you start using this stuff too young, you're actually
causing an issue down the track that you maybe wouldn't
have had had you not used injectibles. How do we
(27:28):
navigate that. Should we be using only for treatment or
should we be using as a preventative?
Speaker 3 (27:33):
Great question. I'm going to preface this with just saying
that in Australia we're limited in what we can say
about injectibles by the TGA because they are a prescription
only medication. But we can talk about them in an
educational capacity so long as we present a balanced view.
So I'm certainly going to try and do that. Let's
look at anti wrinkle injections because they're the ones that
(27:55):
most people talk about using it as a preventative mechanism.
What anti wrinkle injections do that will give us anti
aging benefit is two main things. One is that they
treat dynamic wrinkles, so they are the wrinkles we see
on our face from moving our muscles. The classic one
is our globellar line, so our frown line between our
(28:16):
brows when we frown, when we look angry, we'll create
a line there and it gives us a wrinkle over time.
In most people. Crows feet are the other ones. They
come from more smiling or squinting, and they are literally
wrinkles caused by muscle contraction. Now, if we look at
people when they're younger and they don't actually have those
(28:37):
lines yet, if they are very strong in those muscles,
or you look at their mother and they've got deep
wrinkles that they haven't been able to address because they
weren't treated early, you can certainly target those strong muscles
to try to weaken them or reduce them so that
they never develop those deep movement lines. And that is
(28:59):
very effective. But if you take away all movement in
some areas, those muscles can actually shrink down and down
over time and actually give a slightly aged appearance. So
if you look at someone that's been having muscle relaxant
injections for a long time, they sometimes have this almost shiny,
thin looking skin, and that's often because they've actually lost
(29:21):
that muscle underneath the skin. Their skin sort of has
lost its normal function, and the skin looks aged before
it's time. So I'm not against targeting strong muscles in
younger people if they are looking like causing deep wrinkles,
but I try to do it with a moderate dose
so that it's not over frozen. You don't want to
(29:42):
take away all movement. And one of the biggest problems
I see, especially in young people, is that they think
if they've got any movement at all, that's a wrinkle.
But a wrinkle is only when you see it when
you're not moving. Being able to move your forehead and
frown a little bit and have some movement that's not
a wrinkle. And so it's really important to educate that
movement is okay. So it's about trying to stop them
(30:05):
being so strong in a muscle that they're going to
have deep wrinkle they can't fix later without letting them
get frozen. Or shiny too soon. The other thing that
antirangular injections do, which is often overlooked completely, is that
they can treat the depressor muscles in the face. And
what I mean about that is that our brows when
we frown, not only do they go in and give
(30:26):
us a line, but they go down they give us
saggy eyelids. Our mouth. For example, when we frown, not
only does our mouth turn down we look sad, but
it actually gives us jows and sagging in the jawline.
When we contract the neck, it actually pulls the whole
face down and gives us sagging. So a lot of
people think that our saggy faces in our fifties and
(30:48):
beyond all due to gravity and laxity and sun damage,
but a lot of it is just due to the
strength of our facial muscles that pull down on our
face the whole time. So if you have a balanced approach,
what you should be doing is actually weakening some of
the depressor muscles that are sagging you. Especially in the
approach person who has very strong depressed muscles, your injectors
(31:11):
should be looking at do you have strong depressor muscles?
Can we target them because they actually make us look
older than our wrinkles do in later years.
Speaker 1 (31:19):
What are the side effects of anti wrinkle injections that
we need to be aware of.
Speaker 3 (31:24):
The thing about them is that they wear off, and
so it's very unlikely to ever have any cases of
permanent issue from anti wrinkle injections. The main side effects
are too much, in which case you end up with
heaviness where you don't want it, so frozen forehead but
heavy brows, can't lift your eyelids, and as I said before,
(31:45):
overdoing it so you see skin changes. But most of
the side effects are reversible and temporary at least, so.
Speaker 1 (31:53):
The same for fillers. I know a lot of celebrities
who are very filler obsessed have decided that that's no
longer a thing that they want to be, so they're
allowing them to dissolve and float away. But are there
long term implications? So mostly people get filler in their lips,
and I'm just wondering, like, over time does that stretch
your lip skin? If you do want to reverse it,
(32:13):
what is that actually doing while it's in there?
Speaker 3 (32:15):
Again, there's been a lot of negative talk about fillers.
A lot of people, you know, put off fillers, blaming
fillers for all sorts of things, saying filler here or
filler there is terrible. They had to get it dissolved.
And sadly, it's not the filler that's the problem. That
comes down to the injector.
Speaker 1 (32:32):
It's the operator again again.
Speaker 3 (32:34):
And the right amount in the right place with the
right product will extraordinarily rarely cause your problem. Most of
the problems people are having are because many injectors have
a fairly limited skill set. Often it's cheeks and lips,
and so people go and what do they get? They
get cheeks and lips, and they might look okay the
first time, and then they go back for some more
(32:56):
because they think, oh, you know, feeling a bit old again,
what do they get? They get cheeks and lips, and
then they get cheeks and lips, and it doesn't take
very long before you start to look a bit odd.
And then, of course the filler can all so cause problems.
The reason it causes problems is because there's too much
in any one place, or the wrong product or the
wrong layer. So that's when we hear about migration. We
(33:17):
hear about swelling, we hear about puffiness, we hear about
issues with overfilling, and generally it is repeated treatments in
the same area causing the problem and or the wrong
area treated in the first place with the wrong product.
Speaker 1 (33:36):
So Mariam I did speak to doctor McDonald about navigating
sunscreen because it's become quite difficult in recent times. We're
getting a lot of mixed messages about it from not
actually being the correct SPF as it's telling us it
is on the bottle. There's also this idea being spread
online that it's sunscreen that causes cancer, not prevents cancer,
(33:57):
and we're going to hear about that in an upcoming episode.
We are going to focus in a little bit more
on skin cancer itself. So spoiler alert, the benefits of
using sunscreen far outweighs any issues that they may be,
so but we'll get into that more when we speak.
Speaker 4 (34:10):
About looking forward to that chat. Bottom line is your
genes matter, but it's really the sun doing most of
the damage to your skin. So good news is you
can absolutely do something about that. And when it comes
to all these fancy treatments and procedures, remembering that it's
not so much about what's being used, but who's doing it.
And that's so important. Having a skilled practitioner with the
(34:32):
right approach will always beat the latest trendy treatment.
Speaker 1 (34:35):
Don Poorley, exactly right, Okay, Quick consult time next Today
it's from an anonymous contributor. She wants to know about
going to get her downstairs checked out if she's never
used them for sexy time with a partner. It's time, Mariam,
let's do. Let's get into today's quick consult Welcome us
(34:57):
in please.
Speaker 3 (34:58):
The doctor will see you now. Just through here to
consort room one.
Speaker 1 (35:03):
Thanks for waiting.
Speaker 4 (35:04):
How can I help you?
Speaker 1 (35:05):
Alrighty? We are taking your questions to find out what
general advice. The word general is very important there. It's
not specific to you go speak to your own doctor.
That our good doctor Marriam here can impart for you
to take your own health care into your own control
and then take it to your doctor and figure it out.
So today it is a question via our anonymous waiting room.
Speaker 6 (35:25):
I'm a forty nine year old woman who has never
had sex. I wanted to, but life just never happened.
Should I be seeing a gynecologist to check on my
health though my friends talk about getting pap smeares, etc.
Or more broadly, should I see a gynecologist and if so,
how often what can they share that's different from my GP?
Speaker 4 (35:48):
Great question. A lot of people think about it, but
never really say it out loud, So let's get into it.
Just because you haven't had sex doesn't mean you should
think about skipping follow up for your reproductive health. In Australia,
GPS your first port of core for women's health concerns,
So think cervical screening previously known as PATS, smears. Contraception, Yes,
(36:09):
even if you're not currently using it or having sex.
We use contraception for other purposes like heavy periods, painful periods, menopause,
perimenopause chats, weird periods, pelvict pain, and all the stuff
you'd be googling at midnight about your for JJ.
Speaker 1 (36:26):
This could be anything from denotitis on your volva to
clitteral adhesions that we talked about.
Speaker 4 (36:31):
A little while ago, all sorts of things.
Speaker 1 (36:33):
Yeah, you know, ovarian cancer. Like, there's a billion things
happening in there that aren't related to Heaver having had
sex before.
Speaker 4 (36:39):
Right, that's right, And most of the time, if everything's
tracking normally, you don't really need to see a gynecologist.
Often that said, gynecologists are experts for a reason. They
go deep, literally and be reachably into reproductive health. They're
the people you'd see for more complex or specific concerns
like persistent pain of normal vaginal bleeding, suspected conditions like
(37:01):
ENDO or fibroids, for instance, or if something just doesn't
feel right down there in your GP wants an expert opinion.
There's no rule that says you see a guyano on
a set schedule. It's more of a when needed kind
of thing. Your GP can absolutely help you figure that
out and when a referral makes sense. If you want
to skip the GP and go straight to the gynecologists,
(37:24):
you can just keep in mind you'll need a referral
if you want that Medicare rebate. If you're unture where
to start, here's what I'd suggest. Book a well woman.
Check with a GP, ideally one who has a special
interest in women's health. Check their bio online, bring your questions.
Ask about cervical cancer screening, remembering that we still encourage
you to do it even if you haven't had sex.
(37:45):
Oral sex also counts any concerns you've got, even if
they feel small, and whether seeing a gynecologist would be
useful for you. So whether you're twenty nine, forty nine,
sixty nine or anywhere in between, and whether you've had
sex or not, your reproductive health matters, So never too
late to check in with your friendly GP.
Speaker 1 (38:01):
Can you remember the first time you did an exam
on a woman, because I imagine it would be fascinating
to say, see how people's structures are, because not every
woman looks the same, right, So can you remember what
it's like looking in there and suddenly discovering all of that? Yeah?
Speaker 4 (38:16):
I do, but I've seen so many cervixes and vaginas
that like it's just the whole range.
Speaker 1 (38:22):
You haven't committed any of us to memory.
Speaker 4 (38:24):
No, no, but it's interesting, Like I have young patients
and then you've got ladies well and truly heading towards
seventy and things start to look different down there.
Speaker 1 (38:32):
But it's beautiful.
Speaker 4 (38:33):
It's all part of the process.
Speaker 1 (38:35):
No judgment. We're not judging your cervix, I would hope not.
Thank you so much for sending in your questions, and
thank you for spending some time with us and the
good doctor Marriam here today. We'll be back next week
to talk more skin. This time. We're talking all the
itchy and scratchy stuff, which is something I will be
very invested in as a very itchy, scratchy person in general,
So things like xmera and psoriasis and all that kind
(38:56):
of business. If you do want to chat to doctor
Mariam or myself, I mean, I can't give you any
kind of helpful advice, but we can chat. You can
do it in a few ways. We have a waiting room,
you can be AnonymOS, you can chuck in a question.
It's like our online form. The link to that is
in our show notes. Email us Well at mamamea dot
com dot au, or have a little chatski in the
(39:16):
dms of Instagram. Just so you know, this discussion is
for general information only and is not medical advice. Cosmetic
injection procedures are prescription only and must be discussed with
a qualified medical practitioner. We don't endorse or promote any
particular product or treatment. Always seek professional medical advice before
considering any procedure. Have a top stay. We'll catch you
(39:40):
for your appointment next week. Bye Bye Well is produced
by me Claire Murphy and our senior producer Sally Best
with audio production by Scott Stronik, video production by Julian Rosario,
and social production by Illimore.
Speaker 2 (39:56):
If you want to hear more about women's health, Well
is your full body health check and it drops every
week on a Thursday,
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