Season 2 Ep. 20 - Healthy or Perfect? What Are You Chasing?

What are you chasing in the treatment room? Are you wanting skin health or perfect skin? Seems like a reasonable ask - can't I just have perfect skin? 

Tune into this episode where Sam discusses the chase for healthy over perfection. She share her own personal experience with this chase and why it lead to unhealthy expectations.

Chasing perfection will always lead to failure. But, chasing healthy will set realistic expectations and allow you and your provider success in the treatment room. Thankfully, there is a shift in the aesthetics community and more providers  and patients understand the importance of chasing healthy skin. What are you chasing? Healthy skin or Perfect skin?

Transcript

SPEAKER_00 0:08

Hey y'all, welcome to this introvert. I'm your host, Sam Bazil. I wanted to talk today a little bit about a topic that I think is near and dear to a lot of providers' hearts. And perhaps maybe in aesthetics, we kind of tend to get away from this and the pursuit of being perfect. And I want to talk about perfect versus healthy. And how do we get back to healthy? Or how do we get to healthy? So I'll just share this. You know, my start to aesthetics was um maybe a little bit different than most. I can't assume that my experience is the same as everyone's. So I won't. Um maybe you guys started out being super focused on skin health and being, you know, the healthiest version of you, but that was not my start in aesthetics. Um, my start in aesthetics was more about chasing perfection or chasing what was the trend or the most popular thing at the moment. Um, for example, when I started aesthetics, wellness was not part of that. It was really just Botox and fillers and lots of fillers. Okay, I got way caught up in the filler trend and stopped looking like myself. I mean, I was in my 30s and I looked like I was trying to be 30s and my 50s with all that filler because you know that's what happens. You start blowing things up and you start looking unnatural. And even the younger girls that are getting all this filler, they don't look young. They look like an older person trying to be young. It's just wild how it completely transforms your look. And that never was the goal for me. The goal for me was always just to keep up. You know, being in aesthetics, I kind of felt the pressure to look the part, play the part. Matter of fact, I'll tell you, um maybe about four years in four or five years into my aesthetics career, um, the clinic that I worked for, they started to take on wellness. They started to do weight loss. I may not say, well, no, she was doing wellness as well. She was doing like hormone replacement and stuff like that. But um, weight loss was something that she did. And um, it was a nurse practitioner and she worked with a um physician. And the physician, we, I mean, I barely had any interaction with him. It was mostly the nurse practitioner. And this has burned like to my core. I will never ever forget this. So she calls me into our office and she's like, sit down, we need to talk. And you know how, like, when you get fossiled by your boss or you think you're about to get fossiled by your boss, it's like your life starts flashing before your eyes. So, like I'm sitting there and I'm literally trying to run through everything that I've ever done, any interaction with a patient, like what is causing this sit down? Because I'm thinking, like, did someone complain about me? Like, what could have happened? Mm-mm. That was not the reason for the sit down. So she sits me down and she says, Look, um, I don't want you to take this the wrong way, but you have to understand, you know, we represent like our brand, we represent like what we do here. And, you know, you being overweight, it's not really a good look here. Um, you know, we do weight loss, so people will assume that like our weight loss treatments don't work. So I'm gonna need you to um start to take this phenomene. And I was just like, what? Like, I I I don't know. I I I was shocked, but then also a little bit embarrassed and shamed. Um it wasn't a good feeling because I've battled with weight my entire life. I've always been a bigger girl, okay? Um, since I can remember, I've been larger than my classmates when I was in grade school and you know, high school, I tried to get it under control. Then I just stopped eating completely to try and like get myself it just I've always had a very unhealthy relationship with food and weight. And I think finally, you know, in my late 40s, I'm in a relationship with it where it's good, it's healthy, and that's what I just want to focus on being healthy, not so much chasing that like perfect trend. So anyway, my start to aesthetics wasn't exactly the outlook that maybe some of you have or have had, especially those of you that have started in aesthetics recently. Like, I think aesthetics takes a whole new mold now. I think currently more people are focused on healthy rather than perfect. And I want to kind of just open that door for a minute, just in case you are a provider or a patient that is not focused on the healthy aspect of it. And maybe you're focused more on chasing perfection. Let me be the first to tell you, as someone who went through it, you will never be perfect. You're never gonna get there. Maybe you might fix something, you know, with your skin or your loss of volume or whatever it is. You maybe you'll fix it and you'll etch it and it's beautiful and it's great, but then you're gonna focus on something else and you're gonna say, I don't necessarily love the way that looks, and then that's gonna be an issue. And then before you know it, you're spiraling on this perfection chase that you're never ever going to achieve. We as human beings are not perfect. There was only one perfect human that walked this earth, and sadly it will never be any of us. And I know some people struggle with that, but as someone who did and always wanted people to perceive me as perfect, and you know, it's silly. And I would be the first to tell you um find something about yourself that you value that is not superficial, that's not a look or something that, you know, is a physical thing. Find something about yourself that you absolutely love, that you know makes you special. And that is what you need to focus on. That's what you need to give your energy to because chasing the perfect look is never gonna be, you're never gonna be a perfect human. It it just is what it is. So, with that said, because we're never going to be perfect, setting those expectations in the treatment room seems like something that you'll never achieve as a provider. So we can't achieve it as a patient, we can't achieve it as a provider. So, what do we achieve? What do we focus on? Focus on being healthy, focus on skin health. And thankfully, the the company that I work for, um, the skincare company that I work for, that is their mission. And that has been their mission eight years ago when I started, before it was cool, right? They focus on getting skin healthy. And it doesn't matter if I treat someone that has aging concerns, pigment, acne, rosacea. My goal is only to get their skin as healthy as it can possibly be. Notice I didn't say get their skin perfect or get their skin perfectly smooth and all these things. Listen, there is a map, okay, if you will, of how we are supposed to treat and get the skin healthy. So one of the things is to have skin that is smooth, firm, and tight. Okay, that's a goal. Will every single person achieve that? No, I mean we age, we can't stop the clock, so eventually we're gonna get there. But that's a great place to start when you're looking at a patient's skin. Is the skin smooth, firm, tight? If it's not, what can we do to try and get it as best as we possibly can? Can we do things to boost collagen, to increase fibroblast activity? Next, skin that is even in color, right? Sometimes for people that's not even a concern. You know, I met someone who was full of melasma and she's like, Well, what would you recommend for me? And I like, I went straight for the hydroquinone. I was like, girl, we need to get rid of all that. And she's like, I can't believe you would say that. Like, I love my freckles. I would never want my freckles to go, but I don't want my freckles to go. But can you get rid of this pigment patch here? I'm like, no, girl, that's not how this works. When I put cream on your face, that cream's not gonna go. Okay, well, we're gonna leave this one, this one. Oh, we're just gonna attack this one. Don't worry about that. So, anyway, talk to the patient, find out what bothers them. But the definition of healthy skin does include even in color. And why is that part of having healthy skin? Because your skin, when you were a baby, was even in color. And that's at the end of the day, kind of the goal when we want to achieve healthy skin, what we're aiming for. It doesn't mean where we're gonna end up, it just means what our aim is, what are we going for? So, smooth, firm, and tight, skin that is even in color, skin that is free of disease. So, if you have any disease present in the skin, we need to treat it. That is a must. That is an important part of having healthy skin. Now, the unfortunate part of that is some of these issues are not curable. There's not something that I can do to make it poof be gone. But there are things that we can do in clinic to treat the signs and symptoms. And that's what I want to do to try to get your skin as healthy as I possibly can. Now, another thing that we should be going for, skin should be tolerant to the surrounding environment. So I want skin that is strong and I want skin that is tolerant. So, how do I do that? Well, I need to make sure that my barrier, my skin's outer layer, the first line of defense, is super, super strong. So if they have a weaker compromise barrier, that is gonna be my goal. I'm gonna make sure that that patient's skin is very, very strong, can tolerate the environment, can tolerate the treatments. And if it can't, then that's gonna be my goal. I'm gonna work on that before I do anything else. I'm not gonna injure it with microneedling, I'm not gonna injure it with a laser, I'm not gonna injure it with a chemical peel. I'm probably not gonna injure it with anything, okay? Other than maybe I'd do like a hydrofacial or a diamond glow, whatever it is y'all do out there. I would do something like that, or maybe I would do like a mild AHA peel, but I certainly would not be doing like injury treatments on skin that is weak, unhealthy. So there's a little roadmap to try and get the skin healthy. Now, like I said, the reason that that's so important is I am setting an expectation for the patient. I'm letting the patient know I'm not here to erase your pores, I'm not here to erase your wrinkles, I'm not here to reverse your rosacea or your acne. What I'm here to do is get your skin as healthy as it possibly can. And when you set those expectations up front with the patient, they understand your goals, they appreciate your treatment, they understand your treatment, and also they don't have unrealistic expectations about what you can and can't deliver. Because I think that sometimes happens. Like if we don't set those realistic expectations, understand first, they don't understand. Patients don't understand what goes on in the skin. They also don't understand the day-to-day, they don't understand what these treatments are designed to do because some of these treatments are like pricey. So they look at the price and they expect way more than what that treatment can do. And unfortunately, that's just the price of these treatments because the lasers are astra friconomical. They're expensive. So if we don't charge that price, we can't afford to even have this laser here. Now, just because this laser is expensive, it does not mean that it's gonna cure cancer. Okay. Although I feel like with the price it should, but it doesn't. Okay. This is what it can do. This is what my goal is, and this is what it's gonna take to get there. It's just that simple. Set those realistic expectations up front so that way they can be happy with treatment, they stay compliant, they understand where you're going. And also, too, I think it's just a way to keep the patient's mind and expectations healthy. And listen, worst case scenario, you they want to puff up every wrinkle with filler, they want to do all these like ridiculous things, and you say no. No, as a provider, that is not my goal for you. My goal for you is to get your skin healthy. Worst case scenario, they piece out and they go somewhere else that'll blow up their face. Great, thank you. Because now that's not my work walking around and people going, Whoa, who the hell did that? Who looked at you and said you needed more filler and didn't need to be dissolved? Listen, I look, I I know what that's like. I okay, TED Talk with Sam. Here's where I'm like super vulnerable. So I, besides, I've already told y'all about my issue with food being overweight, but I don't necessarily love certain things about the way that I look, and it has always just bothered me. Like, one thing is my nose. I cannot stand how large my nose is, but it's a genetic thing. Like it comes from my dad's side, the family. All of the baziles have it. It's just it's a large Italian nose. We just got it. Okay, so I don't necessarily love it. So that's one thing that I cannot stand. Number two, I hated how paper thin my lips are, and then I got that from my mother. Okay. So I had these little bitty tiny lips, and anytime I would wear lipstick, like lipstick would just run up every single wrinkle. So I went and I got lip filler, couldn't do anything about my nose, but I figured if I would at least make my lips bigger, it would make my nose look a little bit more proportionate. You can't have big eyes, big nose, and then these little tiny lips. You look silly. So I figured, let me just do that. Let me make things more proportionate. Well, I started with the little bit, and I was like, okay, well, I don't necessarily think I see that big of a difference, but I do notice that my lipstick is not running through the lines of my lips. So let me ride with this and see. Well, any of you who have ever had lip filler and you loved it, you know what happens next. You get the filler itch and you just cannot stop. And that's what happened. And I worked in a med spot, and guess what would happen? Like if someone came in and they didn't want the rest of their syringe or whatever, I was like, hey, I'll take it. You know what I mean? Or if there was something, I know this is terrible, but like if there was filler that was like near expiring, okay, put it in there, get it in there. So then my lips started to get so out of control. And so honest talk now, um, I have a complex with getting them completely dissolved because I am so like scared to see myself back the way that I did when I didn't have any lips. So what I did was I dissolved the top first because the migration up top was out of control. Like it was all the way up to like right under my nose. And it just looked absolutely silly. So I did it in steps. I really need to do underneath here still. But um, I'm scared. I don't want them all to go away at one time. So I did the top. Um, I still need to do a little bit more because I can still see like a little bit more migration, like kind of right above that line, that vermilion border that really does need to go. But that's something that I have to do. But more than anything, I really need that bottom lip. And I did not wear lipstick today. So if you're not listening and you're actually watching, you could see what I'm talking about. Because when I wear lip gloss or lipstick, I feel like it kind of hides where that migration is a little bit. Um, but when I don't have anything on, it's very evident where my lip line ends and where the filler starts. So this is this is just something that we go through. We go through this addiction. It is, it's a form of addiction. You get addicted to the look, you get addicted to that feeling. I don't know if y'all know what I'm talking about, but if you do have issues with addiction, you know. It gives you like a dopamine reaction, like a, I don't know if it's dopamine serotonin, I'm not a psychiatrist, but you get with my, it just gets you like all hyped up and like it gets you like that like excited type of feeling. I don't know, I don't know what it is, but it's a high. Like it feels like a high. And that's how I would get when I would get lip filler. Like I felt like it was like um, like oh, look at me. Like I'm so like I feel good about myself again. Like because you get in a downslope and then you're like you get a little filler and you're like, ooh, I feel good about myself. It is so unhealthy and sick. So that's why I feel like I am thrilled with where we are as an aesthetics community. I feel like more and more providers are out here in pursuit of healthy rather than being in pursuit of perfection. And if you're not, if you are a provider that allows the patient to chase perfection, I would ask you to just sit back and think about those patients and think about what's best for them, what's best for their skin, what's best for their face, what's best for their family, what's best for their future and their mental, because it it gets out of control. And at some point you have now lost control. You don't have any more control. And continuing to just blow things up, or continuing to over-treat the skin and do all these treatments over and over when they're not ready for them, or maybe the skin is not healthy or prepped or ready, you're gonna start to do long-term damage to their skin. You're gonna do long-term damage to their mental health, and you are now a part of that decline, that down slope. And I would encourage you, do you don't want to be involved in that? You don't want to be a part of that because it's it's yuck. It's not a good, not a good thing. So achieving healthy skin is pretty simple. You just want to try and create a plan that addresses those definitions of healthy skin that we talked about. But what about having a healthy treatment plan? What does that look like? We kind of touched on it a little bit, but I want to dive in a little bit deeper. There's something that I'm realizing while I'm out here mentoring other aestheticians and providers that we're not doing as a community that I think we all need to just get together and start doing it because here's the deal. I understand that when a patient comes in, and let's say they want a laser or they want a chemical peel, they have psyched themselves up, they've got it in their mind, they've saved up their money, they are ready. They want to do that treatment the second that they walk in your clinic. And they're gonna be unhappy if you say, No, your skin's not exactly ready. Okay. But I would want to encourage you to do what's right for the health of the patient's skin and not necessarily what's best for their mental at the time and your pocketbook. Because what's best for their mental right now is not what's best for their mental long term. Because as a provider, what happens when you injure unhealthy skin? Think about that. Because that's essentially what you're doing. You're doing exactly that. If a patient comes in and their skin barrier is compromised and weak, their skin is unhealthy and it cannot tolerate those treatments. What happens if their skin is extremely unhealthy and they have melasma or they're full of pigment? What's gonna happen when you injure their skin with microneedling, because that's injuring the tissue, chemical peel, because that's injuring the tissue, laser, because that's injuring the tissue. What do you think is gonna happen if you do one of those treatments? Their skin is going to react in a defense mode, and you're probably gonna deal with something called post-inflammatory hyperpigmentation or PIH. Worst case scenario, if the skin is extremely damaged, if the skin is extremely unhealthy, you're gonna deal with scarring, you're gonna deal with disease flare-ups, you're gonna deal with unpredictable healing. And whenever a patient pays for a treatment, they're paying for something in an assuming that they're gonna see a nice result. They're not assuming that they're gonna have a disease flare-up, they're not assuming that they're gonna have post-inflammatory hyperpigmentation, they're not assuming that you're gonna cause extreme sensitivity in their skin or weaken their skin even further or cause more damage. So, what I would encourage you to do is if you are not a provider that is preconditioning the skin, I would encourage you to look into that. I would consider at the very least preconditioning for six weeks prior to the treatment. And why are we recommending six weeks? Because that's about one keratinocyte maturation cycle, but in healthy skin. So if the skin is unhealthy, that maturation cycle is extremely delayed. So, like I said, minimum of six weeks getting their skin healthy. What does that look like, Sam? What are we doing in that six weeks to get their skin healthy? Well, first, I would build a treatment plan with skincare and make sure that that skincare is doing three things. Number one, you are doing something to strengthen the barrier. So you have something in their protocol that is working on strengthening skin barrier. Okay, that's number one, strengthen the barrier. Number two, you need to speed up the keratinocyte maturation cycle. It is unhealthy, so that maturation cycle is delayed. So we need something that is going to make it go faster. What does that? A retinoid. And when you're prepping or preconditioning the skin, sorry folks, but no reaction retinols ain't gonna cut it. We got to get something to make it move. So I would use a tretinoin or I would use a retinol 0.5 or higher. So get it going, get a good, healthy keratinocyte maturation cycle. Number three, if they are prone to pigment, which the majority of the population is, I would ensure that you have a pigment suppressor in that lineup. Preferably my go-to is hydroquinone. I understand some of you, that's not your thing. So if it's not, just make sure it is a really good pigment suppressor. Because this is the deal. We, you know, all have these little melanocytes. And those of us that have pigment disorder, those melanocytes react and they produce too much pigment too fast. So it's like a hyperactive melanocyte. So if you suppress that melanocyte for at least six weeks prior to treatment, that little melanocyte is suppressed. It's calm. So when it is triggered from that injury treatment, it is not likely to wake up and start producing all of this pigment. So that's your three that you need to make sure you're preconditioning your patient with skin barrier strength, keratinocyte maturation cycle speed up. So we're speeding up exfoliation, and we are suppressing melanocytes. We are suppressing tyrosinase. So that is your goal with preconditioning. Do that to get the skin healthy. If the skin is healthy prior to treatment, guess what's gonna happen? You are going to see a beautiful result and at the very least, predictable healing. That's the goal. If their skin is unhealthy, they're not going to heal well. If they don't heal well, you're not gonna see really great results. So that's my that's my ask. Okay. I I just with everything that's been kind of happening lately, especially with me kind of going into the treatment rooms and seeing how many people are just, they had no idea what preconditioning was. They had no idea what getting the skin healthy was. They have no idea why we're getting the skin healthy prior to treatment. One esthetician told me, well, why would I take the time to do that? Isn't that laser gonna get her skin healthy? Ma'am. Okay. We've got to go back to the basics of skin health to get their skin there. Okay. All right, guys. I hope that was helpful. Um, I hope this TED Talk was not too heavy for your for your for your day. But I think sometimes we just need that little reminder that the chase of perfection should never be the goal, but the chase of healthy should always be your goal in treatment. All right, guys. Y'all have a good one. Take care. Bye, y'all. Think of the skintrovert as your aesthetics roundtable, not a training manual. This podcast is for professional education and discussion. It's not medical advice. Your scope of practice matters, regulations vary, and your license always leads. To continue the conversation, follow the skintrovert on Apple, Spotify, or any platform that you listen to your podcast.