Speaker 1 (00:07):
You are listening to The La Jolla Cosmetic Podcast.

Monique Ramsey (00:14):
Welcome everyone to The La Jolla Cosmetic Podcast. I'm your hostess, Monique Ramsey. And there has been a lot of buzz about a new procedure that we have at the center. It's called Ellacor. And so we're gonna tell you today all about that procedure, but I have some very special guests with us in the podcast studio. Not just one, but two of them. And first, we'll introduce Dr. Brahme, Johan Brahme, our very own plastic surgeon in our surgery center. Welcome back, Dr. Brahme.

Dr. Brahme (00:45):
Nice to be here and excited to talk about this.

Monique Ramsey (00:49):
And then we also have a special guest with us straight from Boca Raton, Florida. Dr. Jason Posner. He's a plastic surgeon and longtime investigator and researcher for laser and energy device companies. And he's really an innovator in the aesthetic space and has done some clinical trials on this particular device. So we invited him here to today to talk with us about that Ellacor technology, what it is. And thank you for being here, Dr. Pozner.

Dr. Pozner (01:19):
Thank you Monique and Johan for the invite. Really appreciate it.

Dr. Brahme (01:22):
Absolutely.

Monique Ramsey (01:23):
So we're gonna start at the beginning. So Dr. Pozner, can you just kind of help our audience understand what is Ellacor and how it works?

Dr. Pozner (01:33):
Sure. So, you know, I think when people hear about a lot of technology, I think they get very confused because a lot of these things sound alike. And when you start to describe something, they're like, oh, well that's the same as so-and-so, and this is a uniquely different device than the other devices out there. And we'll talk about the FDA approval on this a little bit because it's a little different than what we use it for. So when we talk about devices that are needling devices, and I understand you guys have a a Morpheus device and we have a that and a couple of other different ones. So those are needles that go into the skin to help create a little burn zone of energy that creates some secondary tightening. And those are insulated generally where the tip is exposed. But those are solid needles.

(02:21)
So you're putting a solid needle in and when you put a solid needle in, well the whole kind of closes up right away. There's, there's, and you rely on the skin inflammation to kind of help tighten. So this is a uniquely different device in which it's a hollow needle. And basically you're taking out a small punch of skin with each needle incursion into the skin. And they did a very nice study. This device was designed in Mass General by the two founders were Rox Anderson, who is one of the famous dermatologists in inventing fractional lasers and CoolSculpting and most of the things that we use today. And Jay Austin, who is a plastic surgeon and chairman of the, uh, of the department at Mass General. And they had rocks, did an early study where they looked at different size holes and they kind of looked at, well, what's a hole that's gonna cause a scar and what's a hole that's gonna not cause a scar?

(03:14)
And they kind of came to the conclusion that when the hole was over half a millimeter, the potential for scarring was higher than it was under half a millimeter. So they designed these needles, they're about four-tenths of a millimeter on four 10 microns around the size of a 22 gauge needle that we use all the time in, in medicine. And they take out little punches. So if you could imagine if you had some cleats on your feet that were hollow and you walked on a golf course and every time you did, you took out a piece of the golf course. That's how this device works. And it's just very rapid and, and in use, it looks like a sewing machine. 

Monique Ramsey (03:49):
And how much excess skin can it remove?

Dr. Pozner (03:54):
So currently the device is, has different settings on it and I, you know, I've been using the maximum setting on it for, for everybody cuz I think that's good. And, and they were limited a little bit by the fda and this might change later as we get more experience with this device. So, so I'm a cutting edge guy. I like new technology as is, as Dr. Brahme if he put took on this technology. So I, I think all the kinks aren't completely worked out with this and that, I think we have a lot to learn, but currently the max setting is 8%. So that's what I set the device at is 8% of this skin surface area being removed. So when I did a face and neck today, I took out 24,000 cores of their face.

Monique Ramsey (04:38):
Wow.

Dr. Pozner (04:39):
That's a lot. Maxed out the tip.

Monique Ramsey (04:41):
Yeah. And that was for the face and neck together.

Dr. Pozner (04:44):
I did the face and neck. Now the FDA approval is for the face, not the neck yet. So when we do the neck, it's off label. Just like Botox, it was approved for this area, but we used it everywhere else. So that's well within our, uh, legality and in our practice to be able to use it on any area. In fact, we've used it off the face on some arms and legs as well. 

Monique Ramsey (05:05):
I was about to say, my mind is going crazy with <laugh>. Where else we can go and Dr. Pozner who, like what kind of patient would benefit the most from this treatment? Is there an age range or men, women, everybody.

Dr. Pozner (05:18):
I think we're still identifying best patient, but if you would ask me, it's someone who is not yet ready for a facelift. So, you know, early forties, mid forties, maybe early fifties, although the FDA studies were in very older patients with a lot of wrinkles and they saw some significant results. One of the other groups that we've been very interested in using it on and we've treated a bunch of these patients is those patients, patients who've had a facelift and complain of a little laxity because usually the jowl area, no matter how much you pull them, they're gonna end up with a little bit of redundancy there in the future. And if you pull 'em so tight that it's gone, then they look like the joker and you don't want those patients in your, in your practice. And also neck laxity, everyone seems to over time re get a little recurrence. So we've done a bunch of post facelift patients who to see if we can improve them as well. So I think that's the two groups. But again, in my mind of fantasy with this, I would start treating everybody at 30 and you get one a year, so you'd never need a facelift.

Monique Ramsey (06:20):
There you go. Now Dr. Brahme, how did the elior technology catch your attention and what made you, you know, really be the champion to bring it to La Jolla Cosmetic for our patients?

Dr. Brahme (06:32):
Well, you know, we see so many things come through the non-invasive treatments and you know, some of them are good and some of 'em are bad. And some of the these uh, uh, machines are gathering dust in closets, very expensive machines gathering dust in closets. But when I heard about this, I thought, you know, this is, this is something that is so needed in a zone that is so difficult to treat and it just has so many potential uses. And like Dr. Pozner said, the lower face here, no matter how tight you make people when they come back at six months or a year, this is the area that they don't like. And I had had a patient just I think the day before or something like that who I'd been spending weeks talking to about this area and, and she was, you know, she wanted a facelift or she wanted maybe some laser or something.

(07:29)
And then the rep came in for Ellacor and I said, you are the patient for this. And she was actually there the first day she was a train training patient. And she is so thrilled because this, you know, like Dr. Pozner said, I think that as a stand alone procedure in the early patient who's not ready for a facelift, but who has some little stuff there that they want to get rid of. And then also for the patient who, who is coming back a year after and saying, oh, I love it, but God, you know, can we do something here? And now we can. And you know, Dr. Poner has a lot more experience with with this than I do, but I am shocked at how well patients heal. And these little hollow needles really don't leave a scar. They really don't leave a scar.

Monique Ramsey (08:26):
It's amazing.

Dr. Brahme (08:27):
Yeah. And so I was so on bo board with this from looking at the, the micrographs that they have, you know, they have, uh, pathology samples that show that there's no damage. And what really bothers me about RF technology, heating technology, laser technology is that it is an injury to the skin and that you, you, you rely on the scarring afterwards to really give the effect. And you know, in more pigmented patients you have a higher risk of hyperpigmentation and all that kind of stuff. But with this it is removal. Yeah, there's some scarring and I think that you see the permanent result a little bit down the line, but it's removal and there's no injury, no chemical injury, no thermal injury. I thought it was beautiful and I was really excited that we were gonna be, you know, one of the first practices in the country together. So.

Monique Ramsey (09:29):
Yeah, you were saying before we started one of the first 50 in the country?

Dr. Pozner (09:34):
They were very limited with the launch. Yeah, they were very limited and and they only launched it to experienced plastic surgeons and dermatologists. They were not selling to everybody. So they, they sold it to people who they thought would have a good result and would be able to use the technology appropriately because they did not want a bad launch.

Monique Ramsey (09:51):
Yeah, that makes a lot of sense. And so this micro coring that they call it, how is that different from other non-surgical laser or energy treatments? It's just that it's removing the skin.

Dr. Brahme (10:06):
It's strictly removal and so that needles are hollow and they're attached to suction. And so it's basically like the, the cleat, the cleats on the, on the shoes, you know, you just remove a very, very skinny little core and you can set it to a different density and like, uh, Dr. Pozner said it, it's 8% right now. And um, you know, the interesting thing was when, when I was learning how to do it on that first day when we had doing a, we were doing office staff, is that it is definitely operator dependent and you definitely have to have that certain feel and there is a learning curve and you get better with every patient. You, you treat it, it, it, it's not an easy, it's not an easy thing to do. I wouldn't put this in the hand of somebody who's not very well trained and, and surgically inclined because it does take a a real touch.

Dr. Pozner (11:10):
I agree. I agree. I mean the patients are very comfortable during the procedure. So we always ask, I mean, I think the standard questions that patients give us is, okay, you know, how long does the procedure take? Of course this is gonna hurt and what and what's my healing time and what can I expect? And I agree with Dr. Brahme that you're taking out skin. This is not, this is a mechanical injury. It's taking out skin. And we were involved with the company very early on disclosure. I did invest a small amount of money in the company back in the day, less than the cost of a machine by the way, a lot less. But, um, we did one of their early clinical trials. And it's interesting, the clinical trial we did was we took 10 patients and we tattooed a one one centimeter square on their lateral cheek and then we treated them at 10% den.

(11:58)
This was manual at the time. We waited a month, we measured the square and then we did a, I did a facelift on all 10 patients and we sent out that specimen for histology. So lo and behold, we took out 10% and when we measured it, the skin shrank 10% and pretty much in that one direction. So we took out 10%, you got a 10% shrinkage. Now when you're doing 24,000 cores, we're not getting that total amount of shrinkage. It you lose a little bit in a larger areas. But in this small area we did lose 10%. And when we looked at the histology, it was normal, beautiful, normal skin with no scar. So it was exactly what Dr. Brahme said, this is no injury and the skin is normal, but looks relatively rejuvenated under the microscope.

Monique Ramsey (12:43):
And what are the benefits to the patient? You kind of alluded to it, Dr. Brahme of not using an energy based, you know, thermal energy. So what is kind of the benefit of not having that part of the equation?

Dr. Brahme (12:56):
Well, you know, in my mind, you know, every skin rejuvenating modality that we have relies on an injury to the skin that you then have to have collagen to contract and heal to give you your intended result. You either injured the skin with a chemical, so it's a chemical burn or friction with a friction burn for dermabrasion or thermal burn with a laser. So it's an injury to the skin that you then let the collagen sort of rearrange and tighten. This is not an injury like that. This is a different injury. This is just a removal. So you're not injuring any surrounding tissues at all. You're just removing a little bit, you know, plucking a hair out. And it is, um, and that was very attractive to me because I don't like to rely on the body's sort of like, is this gonna heal well? Is is is it gonna turn dark? You know, is it gonna be a little scarring there? It's a little more unpredictable. I think this is safer and I think that it in the areas that, that we're gonna be using it, it's gonna be more effective. That's what excited me about it. And I'm still excited.

Dr. Pozner (14:16):
I'm still excited too. I mean I think there's a role for all of these different devices in our, in our practice and, and we have the continuum, I I kind of view this as the right side. This is the more aggressive side. This is the plastic surgeon tool that they're using. We have other tools that we delegate to our staff in our, in our practice ultrasound energy and, and microneedling energy. But I think this is the more aggressive, better result tool. And that's why it appeals to plastic surgeons. Cause they, you take out skin, it shrinks and you get a result.

Dr. Brahme (14:45):
Right. And, and you know, we're starting to sign up patients to do it during their facelift and also as a standalone alone procedure. And you know, it really was pretty comfortable for the patients. You know, you, you, you put some, you put some blocks in and yeah, we give them a, we give 'em a Xanax too, but you know, <laugh>. Yeah. But, but

Dr. Pozner (15:05):
I, I think we should belabor this point a little bit because I think this is a question that we get asked all the time. Does it hurt? The answer is absolutely not. We, we are very efficient at doing blocks. We've both been around the block three or four times <laugh> and no, you do get a block, which is you do get needles in your face. And we do give them, we give them an MKL melt, which is, we like that a little better than Xanax, which is midazolam, ketamine and odansetron Zofran. I'll give you the recipe, I'll show you where to buy that. It's awesome. It's awesome. And we do pronox with it.  So it just takes the edge off while you're getting the needles. And once you get the needles, we wait 10 minutes. You don't feel anything. I mean I literally did one a couple hours to go and she was, she was comfortable. We actually had someone from the company watching us today and the patient didn't even blink once during the whole procedure.

Dr. Brahme (15:52):
Wow.

Monique Ramsey (15:54):
That's awesome. Now Dr. Pozner, tell me about your involvement in developing this technology. Like where did that start?

Dr. Pozner (16:03):
You know, as with Dr. Brahme, it appealed to me. You took out skin, you have to shrink. It made a lot of sense to my plastic surgery brain, you know, so it, it made sense to me and that's why I got involved. And we did a second F D A study with them at all. And then I was also involved on the F D A side, reviewing some of the other centers. We had a grade, some of the other centers studies for the F D A. So the F D A, when they look at this technology, they kind of didn't know what to do with it when they went for their clearance because it's not a microneedling device, it's not a surgery device, you know, and they have different divisions. It's not a laser. So the FDA put them in with the microneedling devices even though they're different.

(16:45)
But that's how the FDA said, well it's close enough to this that we're gonna put it in this group. So to get through the fda, they had to prove that improvement in wrinkles. Even though I, my concept of this is a tightening device, they had to go into the wrinkle reduction pathway. So they had a few centers and we were reviewing the photos, we had to grade the photos and it does fix wrinkles. And that's why around the mouth, many surgeons are using this during a facelift instead of micro instead of dermabrasion or laser resurfacing to get some improvement. So we could debate that if you want. Yeah. But it does, it does improve wrinkles as well as tighten the skin. So that is one of the effects. And when you look at the histology or the skin under a microscope, it is better skin. It is younger, better skin that looks more normal and more youthful. So you would expect that to face some of the wrinkles as well. So you get tightening and wrinkle improvement.

Monique Ramsey (17:39):
And what is the kind of the treatment protocol for a patient in thinking about leading up to the procedure and then afterwards and kind of how has that evolved over time?

Dr. Pozner (17:51):
Well, when, when we first got it, again, it was in limited, limited numbers that was introduced. So, you know, there were, we, we had the person train us to do this and basically I do nothing like the way I was trained at all. They said don't overlap and put this on the skin and do this. I mean that lasted maybe five minutes for me before I started changing things. Well I mean we had done a couple of studies so we knew what we can get away with. So, you know, in terms of, of the treatment protocol for the patient, there's really nothing that they need to do pre-treatment for this. I could say they could continue their skincare if you want to stop your re a a couple of days before, I don't think that's neither here nor there. You know, the patients come in, we clean off their skin, we take photographs, all the makeup has to be off.

(18:35)
We often give them a little medication as we just said in products. We block them, we do the procedure. It's a little bloody. I mean when you put 24,000 holes in your face, <laugh>, um, it, it's a little bloody. And some people are a little bloodier than others. But I, I have actually pictures on my phone. I did this, I had this done to myself. I've had a couple of treatments and when you wash your face off and wash the blood off, you leave the office kind of pink. You don't look bloody when you leave. You look kind of pink cuz we wash your skin. And our current protocol, which might not be the same in a week or two or a month, is to just use soap and water and a little peroxide on your face for the first two days. We don't want to get anything in the holes.

(19:14)
That's what we're currently using the last 50 cases. We've done that. And then after two days we use a mild moisturizer and after seven days we let the patients resume their normal skincare and then of course use sunblock. So in terms of recovery, I look at this as a couple of days. I did my significant other, I did her on a Friday at like 6:00 PM and she was in the gym with makeup on, on Sunday afternoon. So 36 hours later. On one of my treatments I did it. I was out to dinner the next night. I was, and all of the treatments I went to work the next day, you know, a little rough. So I consider this about a three day recovery. So that, that's sort of where we are. That seems to be about the median. If it's a man, it heals a little faster. If it's someone who's really red skin, a lot of blood vessels, they might bleed a little bit more.

Monique Ramsey (20:04):
Yeah. Why is it that men heal faster? What is, is there 

Dr. Brahme (20:07):
Thicker skin? 

Monique Ramsey (20:08):
Ah.

Dr. Brahme (20:08):
Yeah. 

Dr. Pozner (20:09):
Thicker skin. Yeah. More and the hair follicles better blood supply. And usually a laser too. I think the men heal a day or so quicker on a laser resurfacing.

Dr. Brahme (20:18):
But women look better. 

Monique Ramsey (20:19):
and <laugh> it's just not fair. Um, <laugh>. And were there any surprises in your clinical research as you did this? That that popped up?

Dr. Pozner (20:31):
No, no. When we were involved with, with the studies, I mean it was, it was interesting and I've always thought that the younger patients would heal better, but they did show some good results in the older patients. Cause what Dr. Brahme said was, was important. When you do an injury to a patient, they have to do their, their collagen, their body needs to respond to heal with this, they just kind of have to close the holes and everybody closes the holes. No one, no one looks like a porcupine or they're reverse bunch of, bunch of holy patients. Everyone heals within a couple of hours. Those holes close fast. 

Monique Ramsey (21:02):
Oh.

Dr. Brahme (21:02):
Yeah. Really fast. They do. Oh yeah. I mean, and they're closed within, you know, before they leave the operating room. Yes. There's, there's a little, there's a little red spot there from the trauma, but the holes are all closed. I mean, it doesn't, you don't have to wait for that to happen. That happens immediately.

Dr. Pozner (21:20):
And, and this is a much easier recovery for the patient than a a dermabrasion. Oh yeah. Or a deep laser resurface sink. Much easier recovery. I mean they really, 48 hours they can be out and about with makeup on. Again, I looked at three days. There's pictures of me driving a convertible with a hat on with my top down. Yeah. Probably not a smart idea. But I did that and, and and didn't get any pigment.

Dr. Brahme (21:41):
And you know, with, with the other treatments with the peels and lasers and so on, there's always an inflammatory component and so there's a lot of oozing and you gotta clean that and you gotta cover it and you gotta keep it moist with this, you know, you wash your face and you Yeah. Clean away the blood and you're good to go.

Dr. Pozner (22:01):
Yeah. 

Monique Ramsey (22:02):
Wow. 

Dr. Pozner (22:02):
And there's not much swelling. 

Dr. Brahme (22:03):
Tes.  Very little swelling.

Dr. Pozner (22:05):
So one of the cases on me, I try, I tried everything. So I tried using tumescent anesthesia like you would do with liposuction. Don't do that <laugh>. It hurt. It hurt. And I was swollen for a good couple of days. The way we were talking about just regularly blocking the patient is, is better.

Monique Ramsey (22:25):
And that that normal block is what they would get if they go to the dentist. Right? Pretty much, pretty much the same thing for people for thinking about it. So why can't someone who has darker skin do this treatment? Or why might they not? Like what could happen?

Dr. Pozner (22:41):
Oh, I think they can, I think this is good for darker skin people. We haven't proved it yet. I haven't seen enough darker skin people done this. And, and, and generally, you know, darker skin people have better skin. They, you never see darker skin people with wrinkles. You'll see a little sagging, but you know, the skin's a little thicker. I think it's definitely appropriate. You might need to change some of the parameters. You might need to go a little deeper. You might need to go a little less density and darker skinned people may get a little bit of pigment that's temporary and might need to be treated. But again, it's definitely a, a, a good treatment. I I don't think it's ex excluded in darker skinned people. I think we just haven't done enough of them to give you a good clear answer.

Dr. Brahme (23:20):
Yeah, I think that's true. I I think that, you know, when you start using this, you start using it in safe patients and you use it safely and, and judiciously and you know, the more you learn, the more aggressive you get and, and the more experience you get, the, the more fun you can have with this tool.

Monique Ramsey (23:39):
Now I thought I read something about fillers. So a lot of women especially will get different fillers in their face or biostimulators or you know, they have fillers around their mouth. Do they have to wait for that to dissolve or what are the precautions around maybe something else in that area?

Dr. Brahme (23:58):
I don't see any reason because that, that's very deep dermal and so I don't think it's gonna interfere at all. I mean maybe if they had silicone injections, you know, we live close to Mexico and we do see that kinda stuff. But I don't think I'd treat that patient anyway, so.

Dr. Pozner (24:15):
I wouldn't do filler the same day. I'd wait, you know, a week or two. But you know, if they had filler a week before Botox a couple days before, I wouldn't care. Yeah.

Monique Ramsey (24:22):
Oh. And so I'm assuming, cuz we haven't talked about the forehead, but it is, is that not an area that you would do? Just because it's so thin up there right?

Dr. Brahme (24:32):
It's very thick. Yeah, it's thick skin.

Dr. Pozner (24:34):
We've done some foreheads.

Monique Ramsey (24:36):
Oh really? Well I'm thinking about like the bones right there, you know, versus the cheek.

Dr. Brahme (24:40):
Yeah. But the skin is very thick.

Dr. Pozner (24:41):
Yeah. Skin's thick. You can do forehead heads. One of the other things is, um, lip lips with it. It's very good. You could get a nice little lip lift out of it that they, people have been showing that. So, you know, instead of getting a surgical scar and for a lip lift, if you do your upper lip, you will get some raise out of it.

Dr. Brahme (24:57):
Yeah. I'm a big fan of the lip lift. I do, I do a ton of them.

Monique Ramsey (25:01):
Yeah.

Dr. Pozner (25:01):
That's great. So if you have a patient who might not who, who's marginal for lip lift, who needs like a millimeter or so, I think that something you can do. And we're, we've been treating the lip on everybody now.

Dr. Brahme (25:12):
No, that that's a good idea.

Dr. Pozner (25:13):
We just, we just go right across.

Monique Ramsey (25:15):
Like around the lips, not in the lips?

Dr. Pozner (25:17):
I, I did the vermilion border too. You can't hurt anybody, you can't mess anybody up with this. You really can't. It's very safe. Yeah.

Monique Ramsey (25:24):
Oh, that's so good to know.

Dr. Brahme (25:25):
Yeah, I mean imagine if you just had a little, you know, hypodermic needle that you stick in in somebody's skin to, to numb them up. This is the same thing. It's, it's a very, very skinny needle.

Monique Ramsey (25:36):
Oh, interesting.

Dr. Pozner (25:37):
It's bigger than a Botox needle, but not as big as a needle you might use for blood draw.

Dr. Brahme (25:41):
Right.

Monique Ramsey (25:41):
Mm. And how much time is the, if this were done on its own, just a standalone procedure? How long does that treatment take?

Dr. Pozner (25:49):
So I, I got this cuz I've been measuring everybody <laugh>. So, so when you max out the tip, which is about 24,000 cores, it takes about a thousand, when you get good at it, I'm not saying first timer, but it's about a thousand cores a minute. So a full face takes me 25 minutes, 24 minutes after I've blocked them. So processes come in, get photos, clean your makeup off first, then get photos, block, wait 10 minutes and then treat. So the figure the patient's in the office for an hour.

Monique Ramsey (26:19):
Okay.

Dr. Pozner (26:20):
And treatment is under, under 30 minutes.

Monique Ramsey (26:22):
That's like the lunchtime peel in a way. 

Dr. Brahme (26:24):
Yeah. It's it's not long. 

Monique Ramsey (26:25):
He's just gonna go home.

Dr. Pozner (26:26):
You, you're not going to lunch afterwards. You're not going out for a Martini afterwards.

Monique Ramsey (26:29):
No, I know. But I mean, but you know, for an hour. That's, that's nice. And if, yeah. You know, anybody's wondering if you could fit that in in your day. Yeah. It'd be easy to find an hour to fit that in. Now when do the results start to appear? Is that something you have to wait a while see? Or what are you finding?

Dr. Pozner (26:45):
I think you see them pretty quickly within a couple of weeks. I think the best results are at three months. That's what we seem to be showing from our patients. But one of the best results I have is on my office manager on her jowl. She looks amazing. And, and the photos I have on her were three weeks and she didn't think there was any result. She says, I don't think it did anything. And I showed her her pictures. She's like, holy cow, I want another one now. It looks amazing. I mean, it really looks better than a facelift. Cause I had done some work on her neck and not her face and she just had a little fold here and it was completely, completely gone.

Dr. Brahme (27:18):
Wow. Wow.

Dr. Pozner (27:19):
And then don't forget, don't forget bald guys. You know, us bald guys, we can't really hide these scars too well. So, you know. 

Monique Ramsey (27:25):
Right. 

Dr. Pozner (27:25):
For someone who's a little a man who, who's looking for some improvement, it's not gonna give you a facelift result. And maybe if I do enough of them, but, um, you know, it's definitely an option for people who can't hide scars.

Dr. Brahme (27:36):
Yeah.

Monique Ramsey (27:37):
Good point. Now, Dr. Pozner, you said you've had the treatment yourself. I and how many have you? I had, you've had a couple.

Dr. Pozner (27:44):
I've had four. I've had four.

Monique Ramsey (27:46):
Now is this something that most people would do in a, in a series?

Dr. Pozner (27:51):
You know, I don't think we know yet. The, the FDA trials were two treatments. Okay. I think, I'm not sure, maybe some of them were three. Mostly two. So I tell the patients I'm not a big selling of series to patients. I go do one, see if you like it and if you like it, we can do another one. Maybe we could work on price for, if you want to do more than one, we could work on the price with you a little bit. But, you know, I don't like to sell a series of these. I say do one, see what happens, see what, see what you think. But I, I'm figuring, you know, I, I figure two, and it depends on the patient. Are you really trying to get a home run facelift result? Maybe you need four or five, but if you're looking for prevention, maybe one.

Dr. Brahme (28:26):
Yeah.

Monique Ramsey (28:27):
And is that like, let's say the patient said, yeah, I want a home run result. How many weeks in between treatments might you

Dr. Pozner (28:36):
We, we've waited a month. We've waited a month between treatments, so I did mine exactly month, month, month, month. But again, you haven't seen the, the total results from the first one yet.

Monique Ramsey (28:46):
So anything else that we didn't cover? I wanna make sure that we've kind of covered all the bases for both of you. And

Dr. Pozner (28:54):
I wanna know when Dr. Brahme's gonna get one.

Dr. Brahme (28:56):
Oh, I am, I'm just looking for somebody to do it. Maybe I'll come and visit you <laugh>.

Dr. Pozner (29:00):
Yeah, we do. You know, I gotta tell you the, the best one I did was when I did it myself. Just have someone block you. But I, I always like, you know, it's funny that we, I'm joking around, but I like to try everything and, and I think that, that when we try it, you know how the healing is and the, the best thing you can tell a patient is, look, I did it. Here's my photos, here's my wife's photos.

Dr. Brahme (29:18):
I had a facelift like, uh, six years ago and I'm starting to see a little bit right here. And I'm, I, I think I'm a perfect candidate.

Dr. Pozner (29:26):
And you know, for someone who's just looking for just a little here, you don't have to do your whole face and neck. You can just do the cheek out here. And you'll be amazed that you should do it on a Monday and go to work the whole week. Uh, you'll have a million people asking, what do you do <laugh>?

Dr. Brahme (29:42):
The nice thing that that I also noticed is that, you know, when we, uh, looking at the patients now at three weeks out, you can't tell where the treatment started and stopped. There is no demarcation at all. So they look, they look, that's huge. Looked perfectly smooth. And that was one of my concerns when I, we started.

Dr. Pozner (30:01):
I always say that this is very nice. I don't know what you guys are charging, but it's a very reasonably priced procedure. The patients seem to be very happy with the results so far. So, um, you know, it's a win-win.

Dr. Brahme (30:13):
Yeah.

Dr. Pozner (30:13):
For everybody. I think, listen, these, this is a nice advance in plastic surgery.

Dr. Brahme (30:16):
Yeah, I agree. I was very excited about this.

Monique Ramsey (30:19):
Well, we are, uh, just for our audience, we do have a little special going on because we just introduced this treatment in our surgery center. So we will put in the show notes a link to that special. Because I love the fact that kind of anybody could be a candidate and whether it's a man or a woman or you know, what they're trying to fix, whether it was after a facelift years later or if they're trying to kind of keep the facelift off to the side in the future.

Dr. Pozner (30:49):
And it's a natural looking result. Yeah. That's the one thing we get. I'm sure you get it in California. Nobody wants to look like the joker. Nobody wants to be pulled. This will give you a very natural result. And, and in my early experience, the more treatments you do, the better results you get. It's additive.

Dr. Brahme (31:05):
Yeah.

Monique Ramsey (31:06):
Great. Well thank you both. Thank you Dr. Pozner for helping out on a late night after clinic and Dr. Brahme for joining us again.

Dr. Brahme (31:16):
Thank you for having us.

Monique Ramsey (31:17):
Yeah, it was really fun. And I, I can't wait to kind of see where this technology goes because clearly the more people who start to play with it, I'm sure that, you know, we might maybe see the arms or other places on the body. So that's neat.

Dr. Pozner (31:31):
Thank you for inviting me. This was really fun.

Dr. Brahme (31:33):
This was fun.

Monique Ramsey (31:34):
Oh good. Thanks.

Dr. Pozner (31:35):
Thank you.

Monique Ramsey (31:35):
Thank you so much.

Speaker 1 (31:42):
Take a screenshot of this podcast episode with your phone and show it at your consultation or appointment or mention the promo code PODCAST to receive $25 off any service or product of $50 or more at La Jolla Cosmetic. La Jolla cosmetic is located just off the I-5 San Diego Freeway in the XiMed Building on the Scripps Memorial Hospital campus. To learn more, go to lj csc.com or follow the team on Instagram @ ljcsc. The La Jolla Cosmetic Podcast is a production of The Axis, t h e a x i s.io.