Beauty Series #9: Beauty Tweakments

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Welcome to Park Avenue
Plastic Surgery Class,

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the podcast where we explore controversies
and breaking issues in plastic

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surgery. I'm your co-host, Summer Hardy,

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a clinical assistant at Bass
Plastic Surgery in New York City.

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I'm excited to be here with Dr. Lawrence
Bass, Park Avenue plastic surgeon,

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educator and technology innovator.

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The title of today's episode
is Beauty Tweakments. Okay,

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Dr. Bass, another episode in our beauty
series. What are we talking about today?

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Treatments are small aesthetic treatments
that are easy to do. They're quick,

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minimally invasive with little
or no downtime and create a

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subtle or focused
improvement in appearance.

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This term treatments has recently come up,

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which I think is a brilliant
way to characterize them.

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Small changes that tweak your appearance
rather than making a drastic change at

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the same time.

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They're easy to do and lower in cost
than an aesthetic plastic surgery.

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So what is the role of these treatments?

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Well,

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sometimes you need a full meal and
sometimes you just need a snack.

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Sometimes you should go on a diet or
a vacation from aesthetic treatments.

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So sometimes you look good,

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but it's just nice to keep
something in check or just

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improve something a little bit,

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and that's all that's really
needed at this point in time.

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And we talk about this
a lot on the podcast.

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I've said I talk again and again
about stage of aging and so

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depending what your stage of aging is
and what previous treatments you've had,

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because if you've done a lot
of restoration previously,

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you may not need another
facelift. You need a tweakment.

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So it's got a role depending
on what's going on overall

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with your appearance.

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That makes sense. But how do I know
if tweakments are right for me?

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So as I said, it's the
stage of aging in general.

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It's what else you've done and
what's showing on you individually.

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Then you have to meet that with what
bothers you the most and what stands out

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as discordant with the other features.

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So you can fix wrinkles on
the face, but the neck, chest,

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ear lobes also show wrinkles.

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They may stand out if your
face has been all smoothed out,

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so you may need to chase
those a little bit.

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How do I decide what the options
are and which ones to pursue?

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So having a beauty plan and a good ongoing

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relationship with an experienced
full service plastic surgeon

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is a really good way to do this
because a full service plastic

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surgeon isn't just pushing a
treatment because that's all they do.

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They're not just pushing a
facelift, that's all they do.

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They want to right size
your plan at any one time.

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Got it. So what do I
get out of tweakments?

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Well, it helps you keep things fixed.

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You get that good feeling to see
maintenance and small improvements.

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It keeps you engaged with your appearance
in a constructive way so you don't get

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blindsided by any big aging
change sneaking up on you,

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and it can postpone the need
for some of the bigger fixes

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as well.

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Okay. We've talked a lot about treatments.

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Can you give me some examples of
treatments that are commonly performed?

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The big ones are things
like Botox and other

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neuromodulators like Dysport
and Daxxify, Jeuveau,

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IPL or BL treatments.

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Those are intense pulse light
or broadband light treatments.

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Those will chase pigment, redness.

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Some other light features of skin quality,

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things like microdermabrasion,

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which smooth the skin
surface and clean pores.

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There are energy-based skin lifting
treatments like Ultherapy and

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Sofwave. Things like
periorbital treatments,

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and there are a lot of
little things in this area.

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Chemical peels or laser peels,

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filler and even blepharoplasty,

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particularly the upper
blepharoplasty can be pretty short

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recovery. So maybe it falls under
the category of a tweakment.

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And we mentioned filler in the lid areas,

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but of course there are
options for the cheeks,

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the nasolabial folds and marionette lines,

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the jawline temples, areas like that.

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And importantly,

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the ear lobes because ear
lobes empty out, get wrinkly,

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and a little bit of filler
there can really make them
look youthful. There are a

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whole range of microneedling and
channeling techniques with or

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without energy and associated with that,

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a lot of regenerative treatments
are being done once you open the

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channels into the skin,

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applying platelet rich plasma or exosomes,

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which help reboot the skin's
ability to maintain itself

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in a youthful state.

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Home skin products deserve
a mention here as well.

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So I like to cycle skin products,

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which means each season you pick something
that's best suited to that season.

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It prevents the skin from
accommodating to the skin product,

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and it's a good way of maximizing
your outcome without a big

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intervention. And then there are
things like light chemical peels,

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like a red carpet peel that just gives
you that glow and helps your skin look

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its best without involving downtime.

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That's a lot of different treatments,
but they're mostly for face areas.

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Dr. Bass, are there some
treatments for body areas as well?

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There are

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are a variety of treatments
for skin smoothing with energy.

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This is something we can
do and have some progress

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with, not quite as much
as we'd ideally want,

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but because spotty skin
smoothing is so difficult,

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it's something to jump on early. And
there's also use of hyperdilute fillers,

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fillers that stimulate collagen
in and under the skin that get

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injected in hyper dilute form
in certain body areas for skin

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smoothing.

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And of course things like cellulite
treatments are also sort of a

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treatment to take some of the dimples out,

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so feel more comfortable out
in shorts or a bathing suit.

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Are there any other less common or
newer tweakments I should know about?

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So I mentioned the ear lobes,

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and this is one where whether
we're doing laser or we're doing

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filler, we really shouldn't leave it out,

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but it's not done as often as it
probably ought to be. Very easy to do,

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very little, if any recovery.

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And it can really take
an old saggy wrinkly

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earlobe and make it look plump
and youthful. That's a great one.

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Things on the nose are often omitted,

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so everyone's chasing some wrinkle
or rough texture on the face,

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but they ignore the large
pores on the nasal skin.

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They always deserve to be included.

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You can never get rid of large pores,
but you can shrink them because the pore,

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of course, is a natural structure
in the skin, unlike a wrinkle.

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So we need them there,

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but we can shrink them if we're
doing treatments for skin quality

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on the neck,

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chasing crepeness and those
wrinkles that go across from side to

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side on the bottom of the neck are
things to think about in addition to

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just the loose skin in the neck
and pigment and rough texture

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in the décolletage area
is another thing to

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chase,

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not leave out definitely a treatment
but not done as often as things on the

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face.
The hands are an area all to themselves.

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Veins show more as we
age. Tendons show more.

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We get rapy skin and age spots,

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and there's a whole range of treatments
that we may be doing elsewhere,

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for example,

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on the face that we can do on
the hands as well to help those

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changes be less evident.

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Occasionally we mentioned
the big filler areas,

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but occasionally we actually boost
the corner of the brow by building a

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little shelf of filler right
at the bony orbital rim.

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And same thing at the corner of the nose.

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There's some bone loss as we age,
particularly in our sixties and beyond,

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and sometimes we build back some
of that volume at the nasal base

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or medically what we call the piriform
aperture using a little bit of filler.

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Temples and jawline are
newer areas for filler,

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but they're specific FDA
approved fillers for jawline,

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and this is a big area to maintain
that strong even shape and to avoid the

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hollowing out in the temples,

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which most people get with aging and
can become quite pronounced in some

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individuals. Finally, on the nose,

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we can use filler for very small shape

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changes much smaller than we can
reliably produce with a surgical

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intervention.

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So I'm a big advocate for
rhinoplasty over liquid

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rhinoplasty or use of fillers
in the nose in large amounts.

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But the need to just blunt
very small features or

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make very small refinements and
shape is something that we can do

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well with fillers that is
sometimes less reliable with an

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actual rhinoplasty surgery.

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It sounds like there are
a lot of options overall.

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What are the downsides of treatments?

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So there are not a lot of downsides
if they're properly applied,

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but they'll only focus on the
individual feature and in the

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predictable amount. So it's kind
of an evolutionary improvement.

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It's not transformational. In
reality, that's a better approach.

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It just helps you to stay looking
good by pushing little things back in

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place when they start to show rather
than waiting for everything to

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fall apart. On the other hand,
if a major fix is in order,

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opting for a treatment will
be predictably inadequate.

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So it goes back to that question,
do you need a snack or a full meal?

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Be realistic with yourself about
this and use a full service

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plastic surgeon as your reality check.

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They'll tell you whether it's just a
little focal energy blast for a little

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tighten up or it's time
for a full lift. Also,

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they trickle away a portion of your
beauty budget doing tweakments.

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So if you're saving for a big fix,

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you'll get there sooner if you hold
off on little things that are less

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important at the moment.

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It's also a truism that most people
don't have the budget to chase literally

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everything possible,

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and that may be more aesthetic medicine
than you want to fit into your schedule,

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or even that may be healthy for your face.

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At some point it becomes too much
of a good thing. So overusing,

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tweakments, just like underusing them,

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leaves you not looking your best
and maybe with your face not

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in the best shape.

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So Dr. Bass,

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can you summarize what our listeners
should know about beauty tweakments?

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A lot of small features
can be telltales of age.

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If you've chased the major issues
or you don't yet need those big

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items,

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keeping the small details in place
will help you look your best.

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Treatments can be fun.

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They're quick and easy and
relatively inexpensive to do,

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and they noticeably improve your
appearance when used in the proper

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circumstances.

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They're just the thing when you need
a little beauty boost and when you're

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smoothing facial wrinkles,

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leaving out some areas lets them
stand out like a sore thumb,

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a wrinkly neck or chest, hands
or ear lobes or giveaways.

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When the rest of the face looks smooth
and you're not really as young as the

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major features,

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project features around
the eyes have a big impact.

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It's a small area,

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but where people look most of the time
when they're interacting with you.

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Botox and other neuromodulators
are still the king of small feature

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improvements,

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creating an overall better
and more pleasing appearance,

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the most popular patient
pleasing treatment of all time.

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The ultimate tweakment.

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Thank you Dr. Bass for sharing these
fun small beauty hits or treatments that

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everyone can enjoy.

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Thank you for listening to the Park
Avenue Plastic Surgery Class podcast.

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