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Welcome to Aesthetics Unscripted.
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I'm your host, Kim, and your regenerative aesthetic obsessed host here with Dr.
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Richard Baxter of Phase Plastic Surgery and Longevity Clinic.
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I'm so honored and pleased and excited to have him here with us because there's a lot to unpack.
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There's so many layers to Dr.
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Richard that I think you, the viewer, are going to have a great time with us.
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So thank you, Dr.
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Richard, for joining us today.
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I am so excited to be here.
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We do have a lot to talk about, and uh so it's gonna be a great, a great day.
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Thank you.
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I'm going to, well, I know a lot about you, but please, can you uh take a moment to let your self shine?
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Tell the viewers who are you?
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And I know, like I said, you're a plastic surgeon, but you're so much more than that between tango dancing and your uh early career in art.
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So if you could just let us know all about that and all about you, please.
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Oh, thank you.
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So the yeah, the tango dancing is something that kind of takes over in a lot of ways if you're not careful.
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But I did just get back from Buenos Aires where I was dancing and going to a plastic surgery conference.
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So that was a win-win.
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Uh, I've been in uh practice here in the Seattle area for many years.
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Um, and having this background uh in art, I actually started college as an art major.
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Um, I think that really informed my approach to things in terms of creative problem solving, seeing things different.
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Uh, and and that that I think got me involved very early on in some kind of innovative approaches that just needed uh they needed a different solution.
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And um so over the years I became uh more involved in doing um re-revision surgeries, you know, just things that were kind of needed these solutions, and um, and so now I do entirely aesthetics, but a lot of it is still revision uh surgery.
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And then over the past uh several years I've gotten really pretty obsessed in longevity medicine.
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Uh it's it's something that is kind of coming into its own.
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The science is starting to catch up to the hype, but there, you know, just like with anti-aging, which is what we used to call longevity medicine, the hype tends to kind of get ahead of the real science.
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And so uh my real focus is looking for the evidence and trying to trying to follow evidence-based uh treatments.
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And there's some exciting things there.
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Absolutely.
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Uh there, like you said, there is so much to talk about.
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Um, one of my passions and my ultimate respect goes to the most evolved in my mind, the most evolved plastic surgeons that can do revision repair.
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So for our viewers, that's your classic botched job.
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And uh you can't just or you shouldn't just go to just anyone.
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Uh, for example, here on your phase plastic surgery, you have this pendant.
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I find this a spectacular and beautiful revision here.
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And I'm so impressed because this wasn't just a double bubble, but as it points out, there was uh severe transformation issues with this.
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Can you explain this case?
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So animation deformity is what happens when implants are placed under the muscle, and the muscle, when it contracts, it distorts the breast.
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And that can contribute to what we call a double bubble.
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Um, but still a lot of surgeons just have a blind spot about that.
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They were trained to do it a certain way, and when it when this happens, they just don't see it.
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And so a lot of the patients get very frustrated because they're not getting an answer from their own plastic surgeon, and and they consult around.
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And when I first got involved in this particular type of surgery many years ago, it was a patient who she was actually a fitness model.
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Uh, and so this was a real significant um problem for her.
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Uh, she had seen 10 plastic surgeons already, and uh and and we came up with this solution, and so she's been one of my biggest advocates uh for all these years.
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Um, but it's just a matter of kind of seeing a problem in a way and saying, well, what's really going on here?
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And um I still to this day I think a lot of plastic surgeons just don't want to deal with it.
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So the patients come from all over.
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When it comes to breast implants, what with a new patient?
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What is your advice?
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And I know you have a multiple surgeon and a large staff practice there at phase.
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Uh, again, very admirable, and uh the reviews are excellent.
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Uh, how do you approach that when you have a new patient coming in uh seeking implants?
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Because I know as the years have gone by, breast implants themselves have evolved for the better.
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There's still controversy.
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Do you really want to do it?
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We'll talk about uh fat transfer and alternatives like L clay afterwards, but when it comes to the the actual breast implant, where do you stand on that right now?
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Well, I think implants are safe.
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I think um there are a lot of controversies and um kind of conflicting evidence.
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Um I don't know how much of that I want to get into, but I assume if a patient is here asking about breast augmentation with implants, they're already willing to kind of uh accept that.
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Um and so we talk about what are their goals.
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Um particularly for like athletic women, this is where these animation deformity issues come into play, and you want to design the operation in the first place to minimize that.
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And um so that's kind of been another special interest of mine.
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We are able now to do probably the majority of our implants in what's called the subfascial plane, so it's above the muscle, but with that extra little layer uh what's called the fascia, and that gives the implant a little bit more support.
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Um we used to be hesitant to do that because without the muscle coverage, you could see the implant more, it would look fake, it could do uh have issues with rippling.
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But now we have better implants that can do really well in the subfascial plane, and then we just minimize that whole uh we just eliminate that whole question of animation deformity and and uh minimize the rippling.
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So we go to that a lot.
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Um and if they do need a little coverage, then I do what's called a split muscle, which uh also prevents the animation deformities and maintains muscle function, which is also important.
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Very impressive.
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Uh thank you for that.
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I'm learning with every word that comes out of your mouth.
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Uh so let's talk about fat transfer.
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I have some aesthetic patients that over the years have had fat transfer for breast enhancement, um, for balancing asymmetry, and also just for volumization.
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And it's been very positive for me to see and for them to experience that over the years.
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Uh one patient in particular I can think of did this about 10 years ago, and she still retains about 80% of that volumization.
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So I think that's great.
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Uh, what are what are the things that make you a candidate for fat transfer, and what would you be cautious about when it comes to that and offer an alternative?
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Yeah, so the main um thing has to do with volume.
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I think you know, there are limits to how much fat you can put in and expect it to take.
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Once it takes, it is living tissue just in a new part of your body.
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You know, it's your own fat, it's just moved to a different location.
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Um but you can only put so much in.
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Each little particle of fat that you inject has to be surrounded by healthy tissue in order to survive.
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And if you overwhelm the recipient site, the breast tissue, with too much fat, then you're gonna get more of it die.
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Um so uh you know, there are just practical limits to how much you can put in and expect it to be a good long-term result.
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Now, sometimes patients are willing to stage it and do multiple sessions to get to where they want to be.
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Um, and you know, that's that's multiple operations when you could do with one.
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Um the other trade-off is that an implant you have a known volume, uh, and that volume is what you get permanently.
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Whereas with fat grafting, there's always variability.
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You know, that 80% take you got is a really good number.
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Uh I think we can get reasonably close to that more often now.
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Um, but um not everybody's gonna get that.
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And so then you're gonna have to deal with you know how much how much you can really um accomplish.
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I think you mentioned cases of asymmetry or just kind of balancing things out or fine-tuning shape, things like that.
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It works really, really well.
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So, Dr.
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Baxter, the bane of everyone's existence from your chair and my chair as providers seems to be these viral TikTok trends or social media trends.
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So, how do you have your staff and yourself, how do you deal with that?
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And when it comes to genuine surgical options versus all this hype and all this craziness and these filtered pictures that patients will bring in, uh how do you deal with it?
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It's a problem both for the surgeons and for the public at large considering doing these things because they, you know, there's a great temptation as a surgeon to kind of keep up with that and to kind of put content out that is going to draw patients in.
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Um, but if you get into, you know, things that are just unrealistic, uh, there are ethical issues there.
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Um and for the public, they're looking at these things and they're thinking, this is this is just crazy.
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Why don't I do this?
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So we just try to, you know, fortunately for me, I'm I'm established enough in my practice that I don't get a lot of people of kind of superficial interest that way.
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Uh they may see something and then they'll come, and then we we have to spend some time with them and really show them what is realistic and and what to expect.
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Um, you know, our injectables practice is more feeded, more fed by that.
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Um but um, you know, fortunately I don't see it as much in my facelift um practice.
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I think those patients are um just a little more skeptical about all of that and not sort of on the trend of the moment kind of thing.
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Oh, that's fantastic.
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It's good to hear.
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Uh you've uh earned the right to be shielded from a lot of that craziness.
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But I'm sure in your med spa, and as you said, in your injectable side of the practice, they're probably getting bombarded every day.
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So it's like, please, everyone out there, get a grip.
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A lot of these pictures are filtered, they're not real, it's not realistic.
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You might not even have the same facial structure, your bone structure, your muscles.
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You can talk to someone like Dr.
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Richard Baxter and his very educated staff, and they can help explain to you why these things are not good for you, or how you might be able to achieve a little bit, right?
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And keep it natural without looking crazy.
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That's kind of an important point right there.
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In this corner of the country, people are more interested in natural looking results.
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I think in a lot of areas it's um uh you know status symbol to look done.
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And and so people see these extreme results, and that's actually what they want.
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Um, so if that's what they're really looking for, they're probably not gonna come to me anyway.
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Right.
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I understand that.
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And that again, you've earned those stripes.
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So uh very, very commendable and uh admirable for sure.
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When it comes to the patient that is like a new patient, um how for the for the practitioners out there that are watching, can you give a little bit of advice?
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Because I know this is a big subject.
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Um if it's possible to give uh a quick advice when it comes to a patient that is maybe obsessed with a particular viral trend versus body morphic disorder or body dysmorphic.
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Yeah, I mean, that's always been here and um probably more of an issue now.
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And I think we just have to, you know, you develop a sense for who's who's gonna be just obsessed.
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And you're not doing them a favor by operating on them or doing a procedure that you know is not gonna meet that standard that they have that they're expecting.
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You're not doing yourself a favor because you know you're gonna end up having to do all that hand holding afterwards and all that talking, and and you really do just have to be willing to say no sometimes.
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And it's hard in a very competitive industry to do that.
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Um you know, maybe you just kind of hang on to them in the injectables and aesthetic services uh for a while uh and until you can be convinced that they're ready.
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But um I think bottom line is you just have to be willing to say no sometimes.
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Absolutely, I agree with that, and thank you for that.
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Uh you mentioned a very deep passion for longevity.
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Uh I got actually got into aesthetics for a selfish reason first, that are not 18 anymore.
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And as you have said, the the longevity industry is leaping forward, and I'm also excited about it.
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We've gone from PRP to PRP and PRF, and now we're we're all the way accelerated into masenchymal stem cells, or depending on what the FDA tells us, we can call them acellular matrix or what have you, and peptides, and all these alternatives to a healthier lifestyle.
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Um, for me in particular, I'm always a little shocked to see how much of the general public doesn't understand your aesthetic, how you look, has everything to do with what you're putting in, what you're putting on, uh your lifestyle, your sleep patterns, your hydration.
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They don't understand this full picture.
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So I would love to hear how you feel about longevity and where do you see it going with things in particular like peptides?
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Yeah, so you know, the you kind of hit on a key point there, which is that your your skin appearance, uh, your skin health informs your systemic health and vice versa.
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So you can't have healthy, beautiful skin unless you have good overall health.
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And so all those things that fit into health uh contribute to that.
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Um, you know, just on a practical basis, I do all these procedures on a day-to-day basis to make people look younger.
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But you know, after a while you start to wonder, well, how can I really address the aging process itself?
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Because this facelift that I'm doing or whatever it is is not permanent.
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I've set back the clock, uh, but you know, the clock will keep ticking unless we find some other ways to do it.
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And um, you know, I had this interest in kind of wine and health and got down this long road with resveratrol, and uh everybody thought that was the final answer, which it was not, but it did kind of open the door to a lot of research that um about aging itself and the aging biology and the genes involved in it and how we could start to impact those directly.
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And as that science progressed, then I thought, okay, I'm just gonna put all this together and see what's what's there.
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So um it's a fascinating field.
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It's really based on AI and not generative AI that we're all familiar with, but just AI to identify to analyze massive data sets.
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So the fundamental principle behind longevity medicine is to measure biological age.
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And you do that by analyzing banked data sets.
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So they're they're called biobanks, and they're all these kind of massive anonymized banks of health data and samples.
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And so um you can run analyses on those from you know 10, 15, 20 years ago, and say, okay, now find train the AI program to find what was in those samples that predicted the health outcomes of those people, how long they lived, what diseases they got, and that's what determines biological age.
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Um and it's a process that's called epigenetics, it's measuring gene expression, and so there are a number of those biological age clocks, and that's that's the fundamental idea.
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So we use that information to then develop interventions for longevity that are testable.
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You can test them because you can measure the effect on biological age.
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And the regenerative medicine part fits into that because if we're keeping people healthier longer, um you still have to address all that damage that's accumulated to your tissues over your lifetime, and and that's where the regenerative medicine part of it comes in.
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Absolutely.
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I've been obsessed with the blue zones and uh as you've said, epigenetics, to me, it's all like and and I love it.
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I mean, every step we move forward with is uh treating, getting closer to treating the cause, not just the symptom.
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And I do seem to find that is more prevalent in other countries, not bashing our country here in the US.
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Uh, you know, proud and happy to be born and raised here and have freedom of speech.
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However, we do what we seem to be behind the eight-ball when it comes to things like this, like stem cell therapies and peptide therapies, and um, as you said, using AI to do more extensive studies.
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And I'm so happy to see that we're moving forward finally on our front as well.
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Um, when it comes to patients self-dosing with peptides, I feel like this has already become a rampant thing and it scares me.
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So, how do you feel about that?
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I'm just um pretty dismayed because um peptides are essentially drugs, and even though there are ways that you can acquire them without going through a physician, um, you're not doing any testing to kind of see whether it worked or not.
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Um, somebody's just kind of, oh, this TikToker said, you know, this glow peptide is great, try that.
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Well, you don't really have any idea what it is and what you're doing, and maybe there's a better formulation or something that'll work better for you.
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Um, I do think peptides have have a role to play, and I I use them a lot in in my practice.
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It's it is in a tricky area in terms of the regulations because so many of them are just naturally occurring molecules, they exist in your body already anyway, or they're slightly modified from that.
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But they're not approved as drugs, and they probably many of them never will be, um, because the process of drug approval and the testing and clinical trial work you have to do is so costly.
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You know, it costs millions and millions of dollars.
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Uh, like a total new drug development is like like a half a billion dollars to get a new drug.
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Um, and if somebody's investing that kind of money in a peptide that we can already buy, um, there that's not going to happen.
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So the onus is on us as longevity medicine providers to really track what we're doing and and provide high quality care and and be honest about it.
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Um so uh it's it's an interesting area.
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I think they're powerful things, but they really have to be used right and they have to be used uh intelligently.
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There you go, intelligently, absolutely.
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Um, when it comes to a new patient coming to you, let's say I'm a new patient and I've got a decent budget and I'm very interested in longevity.
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I want to live as long as I can and thrive while I'm doing it.
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So I'm going to walk into phase plastic surgery and um, correct me, phase plastic surgery and or would you just call it phase plastic surgery?
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Well, we call it phase plastic surgery and longevity.
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I'm trying to, you know, at some point spin the longevity part of it out as a completely separate entity.
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Uh, but right now it's kind of all in one because a lot of the longevity patients have come from the plastic surgery practice.
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Yeah, so we first do, you know, basically in intake history and physical, because the practice of longevity medicine has all these tiers at the and the foundation of it is the lifestyle stuff.
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And a lot of people just think that's the whole thing, you know, that's sleep hygiene and exercise and diet and uh stress management and socialization.
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Those are all really important things, but that's just the foundation.
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Um, and then above that you have more medical type interventions, and uh some of these things that's where peptides fit in, for example.
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Um, a lot of patients use metformin, uh, rapamycin.
00:20:25.359 --> 00:20:30.960
There are things in that category that really do have to be managed medically and more carefully, I think.
00:20:31.119 --> 00:20:39.920
And then there's an upper tier, uh, which is the kind of really high-tech biomedical stuff, and that's like uh plasma exchange, hyperbaric oxygen.
00:20:40.000 --> 00:20:45.759
Um, again, hyperbaric has to be done in a really specific way if it's going to benefit longevity.
00:20:45.839 --> 00:20:50.400
It's not just kind of go to a wellness clinic and get your your uh hyperbaric.
00:20:50.640 --> 00:20:52.240
But so it has all those tiers.
00:20:52.319 --> 00:21:00.720
But the starting point then is we kind of figure out where you are in terms of lifestyle and what you're doing now, and then we want to do a biological age test.
00:21:00.960 --> 00:21:11.440
Um, and the the two best ones are ones called True Diagnostic, which is an epigenetic test, and it's kind of the gold standard across the industry because it's so comprehensive.
00:21:11.680 --> 00:21:15.200
They're literally measuring a million different sites on your DNA.
00:21:15.359 --> 00:21:25.680
And uh so that's that's where we start, and it gives a really detailed uh picture of how you're aging and what specific things we can we can start doing in your case.
00:21:25.839 --> 00:21:29.279
And the other one that's really interesting is called glycan age.
00:21:29.519 --> 00:21:37.440
And this is one that's kind of hard to explain, but it's your immunoglobulin G molecule and the different sugar molecules that attach to it.
00:21:37.519 --> 00:21:44.240
And it turns out that that is highly sensitive to how you're aging and and the different patterns of it.
00:21:44.319 --> 00:21:55.440
And one of the things that came out of that, for example, is um the the fact that menopause accelerates aging and hormone replacement then offsets that.
00:21:55.680 --> 00:21:59.759
So hormone replacement therapy has been so controversial for so many years, and I think.
00:22:00.160 --> 00:22:07.200
Women have been so poorly served by that that misinformation because you know we've been forcing them to age faster.
00:22:07.440 --> 00:22:16.000
So this is one of the tests that really is um sensitive to that in particular, uh, but it's also one that kind of responds better.
00:22:16.160 --> 00:22:20.079
So you have you have good feedback on whether what you're doing is actually helping or not.
00:22:20.400 --> 00:22:21.839
So that's an incredible journey.
00:22:22.079 --> 00:22:27.519
And uh I would love to see you expand your clinics all across the country and beyond.
00:22:27.680 --> 00:22:41.920
I actually wish you were here in New York City because we do we have touched on the beginning of longevity services, um, but it's it infantile and very small compared to what you've already established at phase.
00:22:42.240 --> 00:22:46.720
And if you were here, I would be like begging you to have a sit-down five-minute meeting.
00:22:46.799 --> 00:22:50.480
And do you think there's a way we can partner up or what can we do?
00:22:50.640 --> 00:22:52.319
How can we collaborate?
00:22:53.200 --> 00:22:54.880
So it would be awesome.
00:22:55.200 --> 00:22:56.000
Yeah, absolutely.
00:22:56.160 --> 00:23:08.960
So I wish you the best with that because it's obvious that phase plastic surgery and longevity, you know what you're doing, you've earned your stripes, you research everything that you're providing on your menu.
00:23:09.200 --> 00:23:18.559
And I think to age well and to age naturally and to age beautifully and to do enhancements that work for each individual, uh, what a spectacular place to go.
00:23:18.880 --> 00:23:19.440
Well, thank you.
00:23:19.599 --> 00:23:21.279
Yeah, I I uh I agree.
00:23:21.440 --> 00:23:23.279
It all it all fits together.
00:23:23.440 --> 00:23:30.000
Um, and even having having a procedure to help you look younger might actually help you live longer.
00:23:30.240 --> 00:23:32.319
And that's that's kind of a fascinating thing.
00:23:32.400 --> 00:23:38.000
There's it's part of it is psychological, but it resets what's called your time horizon.
00:23:38.160 --> 00:23:41.200
And uh there's some fascinating work being done around that.
00:23:41.359 --> 00:23:43.519
So uh that all fits in as well.
00:23:43.839 --> 00:23:45.279
Can you expand on that a little bit?
00:23:45.440 --> 00:23:46.240
Time horizon.
00:23:46.319 --> 00:23:50.880
It sounds like um Harry Potter with the time turner or jumping into a spaceship.
00:23:51.440 --> 00:23:57.759
Well, it's basically the the idea that how long you believe you will live informs how long you live.
00:23:58.000 --> 00:24:11.279
And so when you do proactive things that have that make you look younger, and it often marks a kind of uh effort to do other things that are healthy, um, then there's evidence that you do actually live longer.
00:24:11.440 --> 00:24:20.319
Um, it's a hard thing to test specifically, uh, but there's a a center at Stanford that's doing a lot of work on that, and it's just to me absolutely fascinating.
00:24:20.640 --> 00:24:36.960
That is fascinating because we've all heard, uh, whether you are a practitioner or you're part of the general public, we've heard for many, many years now that the power of positive thinking when it comes to health, when you're battling uh diseases such as cancer, that it's actually a real thing.
00:24:37.440 --> 00:24:38.480
It is a real thing, yeah.
00:24:38.880 --> 00:24:40.079
And we're taking that further.
00:24:40.160 --> 00:25:03.680
And in my experience, in my lifetime, I've met uh three different gentlemen, each one of them 100 years old, randomly, because I moved around a lot for work and they were like a next-door neighbor, they did not know each other, they were not from the same parts of the country, and randomly each one of them popped into a conversation, uninvited, and said, you know, I get asked often, what's my secret?
00:25:03.839 --> 00:25:14.880
Because these gentlemen were not in wheelchairs, they were not drooling out of the corner of their mouth, they were not like mentally lost, they were very sharp and they were still mobile, and they all said the same thing.
00:25:15.039 --> 00:25:19.119
I've never fixated on my age as a chronological number.
00:25:19.279 --> 00:25:21.680
I've always thought young and my body followed.
00:25:21.839 --> 00:25:27.680
And I always found that profound that the three different people told me that same exact thing, and I didn't even ask them.
00:25:28.000 --> 00:25:30.720
Yeah, so they knew their biological age was younger.
00:25:30.880 --> 00:25:34.880
It didn't matter to them what the number was, they just felt biologically younger.
00:25:34.960 --> 00:25:36.960
And some people do just age more slowly.
00:25:37.200 --> 00:25:47.359
You know, there's one of the studies um that they did with the true diagnostic data and another big data set um uh called the Dunedin Pace from New Zealand.
00:25:47.599 --> 00:25:54.480
But what they did was they selected um a group of people uh who were all the same chronicological age.
00:25:54.559 --> 00:26:10.559
They were all 35 years old, but they they put picked the ones whose number said they were aging slowly, the ones who were aging kind of on par with their their calendar age, and the ones who were aging more quickly, and then they took their images of them, the men and the women, and made a composite.
00:26:11.039 --> 00:26:14.720
And you can just look at the ones who were aging slowly and they looked young.
00:26:15.519 --> 00:26:21.920
You know, their that number just kind of randomly selected showed that they were actually they looked younger.
00:26:22.240 --> 00:26:25.839
And uh and you know, so that reflects through every tissue in your body.
00:26:26.000 --> 00:26:31.759
If you uh are aging slowly in terms of appearance, then you're also healthier and better muscle mass and so forth.
00:26:32.000 --> 00:26:34.720
So I I think that's absolutely fascinating how all that works.
00:26:35.119 --> 00:26:35.839
Okay, Dr.
00:26:35.920 --> 00:26:39.759
Richard, I would like to bring up your latest book.
00:26:40.000 --> 00:26:44.880
And I know that ties directly into longevity, and it's gonna be super exciting.
00:26:44.960 --> 00:26:46.240
So please share with us.
00:26:47.039 --> 00:26:47.759
Well, thank you.
00:26:47.920 --> 00:27:05.200
I I wrote this book called Biohacking Longevity, and it was just kind of the notes I was taking as I was studying this over uh the first few years I was taking this deep dive into it, and I realized that patients needed to sort of guide to all this stuff because there's so much out there they're being bombarded with.
00:27:05.680 --> 00:27:11.279
And the idea of it is um here's what works, here's what might work, here's what doesn't work.
00:27:11.759 --> 00:27:17.599
And and I update it constantly so the book is not published in print form, it's on my website, just download it.
00:27:17.680 --> 00:27:19.359
It's called biohacking longevity.
00:27:19.759 --> 00:27:23.359
Yeah, every couple of months I update it because it's happening so quickly.
00:27:23.519 --> 00:27:30.960
So um you can go in there and say, Oh, I heard about uh you know methylene blue, everybody's you know, there's a big thing everybody's talking about with that.
00:27:31.039 --> 00:27:31.839
Well, does that work?
00:27:32.240 --> 00:27:36.319
Probably doesn't do very much uh and not a hundred percent safe.
00:27:36.559 --> 00:27:39.839
So I'll just put that in there and talk about what the data is.
00:27:40.079 --> 00:27:47.359
Uh another one that I have a little bit of a peeve about right now is uh people are doing what are called NAD infusions.
00:27:47.759 --> 00:27:53.359
And these wellness clinics and IV uh drip clinics and and um and a big deal.
00:27:53.440 --> 00:27:55.759
And the first time I heard about it, I thought, what the heck are you doing?
00:27:55.839 --> 00:27:56.720
That doesn't work.
00:27:57.119 --> 00:27:59.119
And um and it doesn't.
00:28:00.000 --> 00:28:06.079
So the idea is that NAD is this molecule that your cells need for metabolism, and it's really important in aging.
00:28:06.240 --> 00:28:09.680
It has to be in your cells, in the mitochondria in your cells.
00:28:10.160 --> 00:28:13.440
When you infuse the NAD molecule, it doesn't get there.
00:28:13.759 --> 00:28:18.240
It has to get broken down into precursors, then go through the cell membrane and get in there.
00:28:18.559 --> 00:28:25.200
And so people are spending uh hundreds of dollars per session to do this, and it's really not doing them any good.
00:28:25.359 --> 00:28:31.599
And in fact, when it's circulating in your bloodstream, it's a marker of inflammation and probably doing more harm than good.
00:28:31.759 --> 00:28:40.799
So there are better ways to get NAD into your cells, but if you're going to an IV clinic, you're just wasting your money and probably doing more harm than good.
00:28:40.960 --> 00:28:44.480
So I talked a little bit about that as well as some better options.
00:28:44.640 --> 00:28:46.799
So wow, that's really huge news.
00:28:46.960 --> 00:28:50.880
I mean, that should be on the front of every media outlet going right now.
00:28:50.960 --> 00:28:53.599
Um, so I'm I'm astounded by it.
00:28:53.759 --> 00:28:56.480
I'm gonna have a talk with my doctor about that too.
00:28:56.799 --> 00:29:01.839
Like, like, hey, because we don't here at IT intelligence treatment, we don't do IV drips.
00:29:02.240 --> 00:29:09.440
Um, but on the super, super slow push, depend she does do a health intake and the whole uh blood testing and everything first.
00:29:10.079 --> 00:29:14.799
But you know, that NAD is um available depending on the patient.
00:29:15.039 --> 00:29:31.599
And I'm going to definitely be reading your book, and I'm gonna make sure she reads your book as well, and we'll move forward based on you know clinical evidence that just what you're sharing right now to me sounds like it absolutely makes sense, and it's not something that we should be doing.
00:29:31.680 --> 00:29:34.319
So let's you know pump the brakes on that for the moment.
00:29:34.640 --> 00:29:36.480
Yeah, I mean there are better alternatives.
00:29:36.960 --> 00:29:39.839
Well, it has been spectacular sitting with you.
00:29:40.000 --> 00:29:42.640
I legitimately could listen to you all day long.
00:29:42.720 --> 00:29:44.880
Um hopefully in the future, I'd love to have you back.
00:29:44.960 --> 00:29:51.119
I'd love to talk to you more in the future about things like um things with having to do with longevity.
00:29:51.440 --> 00:30:02.880
And um uh one of my peeves right now is how our beloved industry calls everything having to do with machines um except CO2 laser not invasive.
00:30:02.960 --> 00:30:06.319
And we all know a lot of what we're doing actually is invasive.
00:30:06.480 --> 00:30:11.279
And then there's there's my Soma cell that's actually truly not invasive, but that's all for another day.
00:30:11.440 --> 00:30:21.039
I would love to have you back and discuss that and and follow along with your book because I'm I'm just shocked that you have a digital book that you are updating all the time.
00:30:21.200 --> 00:30:24.480
I mean, what an incredible resource, and thank you for that.
00:30:24.640 --> 00:30:25.519
I really appreciate that.
00:30:26.000 --> 00:30:26.400
My pleasure.
00:30:26.480 --> 00:30:27.920
It's my own kind of passion.
00:30:28.960 --> 00:30:31.359
Absolutely, along with the tango dancing and art.
00:30:32.000 --> 00:30:32.319
Yes.
00:30:32.960 --> 00:30:34.559
And plastic surgery, of course.
00:30:34.720 --> 00:30:35.680
So let's not leave that.
00:30:37.119 --> 00:30:40.160
Okay, so for us, please drop your comments.
00:30:40.319 --> 00:30:42.720
We want to hear your questions, we want to hear your comments.
00:30:42.960 --> 00:30:49.440
If you haven't subscribed yet, please subscribe and check out phase plastic surgery and longevity.
00:30:49.599 --> 00:30:54.000
If you're in the Seattle area, I'm gonna say this is definitely the place to go.
00:30:54.240 --> 00:30:54.880
But Dr.
00:30:55.039 --> 00:30:59.119
Richard Baxter, you're a rock star, you're a superstar, and an icon.
00:30:59.279 --> 00:31:06.000
Can you please let everyone know how they can find you on your social, on your website, uh, where are you located in Seattle?
00:31:06.319 --> 00:31:08.079
Yeah, so we're just north of Seattle.
00:31:08.160 --> 00:31:13.599
Um, the website is uh drbaxter.com, easy to remember, or phasebs.com.
00:31:13.839 --> 00:31:16.079
And it's been an absolute joy on my end.
00:31:16.160 --> 00:31:25.839
Uh, next time we'll talk about um uh microplastics toxicity and how to get microplastics out of your body and plasma exchange to make you biologically younger.
00:31:26.160 --> 00:31:26.640
Well, Dr.
00:31:26.720 --> 00:31:30.720
Baxter, please have a wonderful day and keep tangoing.
00:31:30.799 --> 00:31:32.240
And I would love to have you on again.
00:31:32.319 --> 00:31:40.400
Like you said, we'll talk about microplastics and and just um, you know, we'll get after that entire part of how we're poisoning ourselves and how to get rid of it.
00:00:03.120 --> 00:00:05.280
Welcome to Aesthetics Unscripted.
00:00:05.360 --> 00:00:11.679
I'm your host, Kim, and your regenerative aesthetic obsessed host here with Dr.
00:00:11.759 --> 00:00:15.919
Richard Baxter of Phase Plastic Surgery and Longevity Clinic.
00:00:16.079 --> 00:00:20.800
I'm so honored and pleased and excited to have him here with us because there's a lot to unpack.
00:00:20.960 --> 00:00:22.800
There's so many layers to Dr.
00:00:22.960 --> 00:00:26.960
Richard that I think you, the viewer, are going to have a great time with us.
00:00:27.120 --> 00:00:28.320
So thank you, Dr.
00:00:28.399 --> 00:00:29.600
Richard, for joining us today.
00:00:29.920 --> 00:00:31.280
I am so excited to be here.
00:00:31.359 --> 00:00:35.359
We do have a lot to talk about, and uh so it's gonna be a great, a great day.
00:00:35.600 --> 00:00:35.920
Thank you.
00:00:36.079 --> 00:00:42.960
I'm going to, well, I know a lot about you, but please, can you uh take a moment to let your self shine?
00:00:43.119 --> 00:00:45.119
Tell the viewers who are you?
00:00:45.359 --> 00:00:53.920
And I know, like I said, you're a plastic surgeon, but you're so much more than that between tango dancing and your uh early career in art.
00:00:54.159 --> 00:00:58.240
So if you could just let us know all about that and all about you, please.
00:00:58.560 --> 00:00:59.039
Oh, thank you.
00:00:59.119 --> 00:01:04.159
So the yeah, the tango dancing is something that kind of takes over in a lot of ways if you're not careful.
00:01:04.319 --> 00:01:09.040
But I did just get back from Buenos Aires where I was dancing and going to a plastic surgery conference.
00:01:09.120 --> 00:01:10.400
So that was a win-win.
00:01:10.560 --> 00:01:14.319
Uh, I've been in uh practice here in the Seattle area for many years.
00:01:14.560 --> 00:01:20.719
Um, and having this background uh in art, I actually started college as an art major.
00:01:20.879 --> 00:01:28.239
Um, I think that really informed my approach to things in terms of creative problem solving, seeing things different.
00:01:28.640 --> 00:01:37.840
Uh, and and that that I think got me involved very early on in some kind of innovative approaches that just needed uh they needed a different solution.
00:01:38.079 --> 00:01:54.879
And um so over the years I became uh more involved in doing um re-revision surgeries, you know, just things that were kind of needed these solutions, and um, and so now I do entirely aesthetics, but a lot of it is still revision uh surgery.
00:01:55.120 --> 00:02:01.200
And then over the past uh several years I've gotten really pretty obsessed in longevity medicine.
00:02:01.359 --> 00:02:04.879
Uh it's it's something that is kind of coming into its own.
00:02:05.040 --> 00:02:15.919
The science is starting to catch up to the hype, but there, you know, just like with anti-aging, which is what we used to call longevity medicine, the hype tends to kind of get ahead of the real science.
00:02:16.000 --> 00:02:22.960
And so uh my real focus is looking for the evidence and trying to trying to follow evidence-based uh treatments.
00:02:23.120 --> 00:02:24.879
And there's some exciting things there.
00:02:25.280 --> 00:02:25.840
Absolutely.
00:02:25.919 --> 00:02:28.479
Uh there, like you said, there is so much to talk about.
00:02:28.639 --> 00:02:39.520
Um, one of my passions and my ultimate respect goes to the most evolved in my mind, the most evolved plastic surgeons that can do revision repair.
00:02:39.680 --> 00:02:42.800
So for our viewers, that's your classic botched job.
00:02:43.280 --> 00:02:47.439
And uh you can't just or you shouldn't just go to just anyone.
00:02:47.680 --> 00:02:51.919
Uh, for example, here on your phase plastic surgery, you have this pendant.
00:02:52.159 --> 00:02:56.479
I find this a spectacular and beautiful revision here.
00:02:56.639 --> 00:03:06.719
And I'm so impressed because this wasn't just a double bubble, but as it points out, there was uh severe transformation issues with this.
00:03:06.879 --> 00:03:08.159
Can you explain this case?
00:03:08.400 --> 00:03:17.599
So animation deformity is what happens when implants are placed under the muscle, and the muscle, when it contracts, it distorts the breast.
00:03:17.680 --> 00:03:20.479
And that can contribute to what we call a double bubble.
00:03:20.560 --> 00:03:24.000
Um, but still a lot of surgeons just have a blind spot about that.
00:03:24.080 --> 00:03:28.479
They were trained to do it a certain way, and when it when this happens, they just don't see it.
00:03:28.639 --> 00:03:36.800
And so a lot of the patients get very frustrated because they're not getting an answer from their own plastic surgeon, and and they consult around.
00:03:36.879 --> 00:03:45.680
And when I first got involved in this particular type of surgery many years ago, it was a patient who she was actually a fitness model.
00:03:45.919 --> 00:03:50.159
Uh, and so this was a real significant um problem for her.
00:03:50.319 --> 00:04:00.319
Uh, she had seen 10 plastic surgeons already, and uh and and we came up with this solution, and so she's been one of my biggest advocates uh for all these years.
00:04:00.479 --> 00:04:05.840
Um, but it's just a matter of kind of seeing a problem in a way and saying, well, what's really going on here?
00:04:06.080 --> 00:04:12.080
And um I still to this day I think a lot of plastic surgeons just don't want to deal with it.
00:04:12.240 --> 00:04:13.919
So the patients come from all over.
00:04:14.400 --> 00:04:18.000
When it comes to breast implants, what with a new patient?
00:04:18.160 --> 00:04:19.600
What is your advice?
00:04:19.759 --> 00:04:26.079
And I know you have a multiple surgeon and a large staff practice there at phase.
00:04:26.560 --> 00:04:30.879
Uh, again, very admirable, and uh the reviews are excellent.
00:04:31.040 --> 00:04:35.920
Uh, how do you approach that when you have a new patient coming in uh seeking implants?
00:04:36.079 --> 00:04:40.959
Because I know as the years have gone by, breast implants themselves have evolved for the better.
00:04:41.120 --> 00:04:42.639
There's still controversy.
00:04:42.879 --> 00:04:44.160
Do you really want to do it?
00:04:44.240 --> 00:04:53.600
We'll talk about uh fat transfer and alternatives like L clay afterwards, but when it comes to the the actual breast implant, where do you stand on that right now?
00:04:54.000 --> 00:04:55.920
Well, I think implants are safe.
00:04:56.079 --> 00:05:02.079
I think um there are a lot of controversies and um kind of conflicting evidence.
00:05:02.160 --> 00:05:12.800
Um I don't know how much of that I want to get into, but I assume if a patient is here asking about breast augmentation with implants, they're already willing to kind of uh accept that.
00:05:12.959 --> 00:05:16.639
Um and so we talk about what are their goals.
00:05:16.800 --> 00:05:28.319
Um particularly for like athletic women, this is where these animation deformity issues come into play, and you want to design the operation in the first place to minimize that.
00:05:28.560 --> 00:05:32.879
And um so that's kind of been another special interest of mine.
00:05:33.120 --> 00:05:47.519
We are able now to do probably the majority of our implants in what's called the subfascial plane, so it's above the muscle, but with that extra little layer uh what's called the fascia, and that gives the implant a little bit more support.
00:05:47.839 --> 00:05:57.199
Um we used to be hesitant to do that because without the muscle coverage, you could see the implant more, it would look fake, it could do uh have issues with rippling.
00:05:57.360 --> 00:06:10.240
But now we have better implants that can do really well in the subfascial plane, and then we just minimize that whole uh we just eliminate that whole question of animation deformity and and uh minimize the rippling.
00:06:10.319 --> 00:06:11.839
So we go to that a lot.
00:06:12.000 --> 00:06:22.560
Um and if they do need a little coverage, then I do what's called a split muscle, which uh also prevents the animation deformities and maintains muscle function, which is also important.
00:06:22.959 --> 00:06:23.839
Very impressive.
00:06:23.920 --> 00:06:24.800
Uh thank you for that.
00:06:24.959 --> 00:06:27.759
I'm learning with every word that comes out of your mouth.
00:06:28.079 --> 00:06:30.240
Uh so let's talk about fat transfer.
00:06:30.399 --> 00:06:40.800
I have some aesthetic patients that over the years have had fat transfer for breast enhancement, um, for balancing asymmetry, and also just for volumization.
00:06:41.199 --> 00:06:48.560
And it's been very positive for me to see and for them to experience that over the years.
00:06:48.800 --> 00:06:55.600
Uh one patient in particular I can think of did this about 10 years ago, and she still retains about 80% of that volumization.
00:06:55.920 --> 00:06:57.600
So I think that's great.
00:06:57.680 --> 00:07:05.600
Uh, what are what are the things that make you a candidate for fat transfer, and what would you be cautious about when it comes to that and offer an alternative?
00:07:05.920 --> 00:07:08.879
Yeah, so the main um thing has to do with volume.
00:07:08.959 --> 00:07:13.839
I think you know, there are limits to how much fat you can put in and expect it to take.
00:07:14.079 --> 00:07:17.680
Once it takes, it is living tissue just in a new part of your body.
00:07:17.920 --> 00:07:21.279
You know, it's your own fat, it's just moved to a different location.
00:07:21.600 --> 00:07:24.480
Um but you can only put so much in.
00:07:24.720 --> 00:07:29.920
Each little particle of fat that you inject has to be surrounded by healthy tissue in order to survive.
00:07:30.079 --> 00:07:36.480
And if you overwhelm the recipient site, the breast tissue, with too much fat, then you're gonna get more of it die.
00:07:36.879 --> 00:07:44.000
Um so uh you know, there are just practical limits to how much you can put in and expect it to be a good long-term result.
00:07:44.160 --> 00:07:50.160
Now, sometimes patients are willing to stage it and do multiple sessions to get to where they want to be.
00:07:50.319 --> 00:07:54.879
Um, and you know, that's that's multiple operations when you could do with one.
00:07:55.120 --> 00:08:03.120
Um the other trade-off is that an implant you have a known volume, uh, and that volume is what you get permanently.
00:08:03.199 --> 00:08:06.160
Whereas with fat grafting, there's always variability.
00:08:06.319 --> 00:08:09.439
You know, that 80% take you got is a really good number.
00:08:09.680 --> 00:08:14.000
Uh I think we can get reasonably close to that more often now.
00:08:14.160 --> 00:08:17.519
Um, but um not everybody's gonna get that.
00:08:17.680 --> 00:08:23.439
And so then you're gonna have to deal with you know how much how much you can really um accomplish.
00:08:23.600 --> 00:08:30.240
I think you mentioned cases of asymmetry or just kind of balancing things out or fine-tuning shape, things like that.
00:08:30.319 --> 00:08:31.600
It works really, really well.
00:08:31.920 --> 00:08:32.480
So, Dr.
00:08:32.639 --> 00:08:43.360
Baxter, the bane of everyone's existence from your chair and my chair as providers seems to be these viral TikTok trends or social media trends.
00:08:43.600 --> 00:08:47.600
So, how do you have your staff and yourself, how do you deal with that?
00:08:47.840 --> 00:08:58.159
And when it comes to genuine surgical options versus all this hype and all this craziness and these filtered pictures that patients will bring in, uh how do you deal with it?
00:08:58.399 --> 00:09:12.399
It's a problem both for the surgeons and for the public at large considering doing these things because they, you know, there's a great temptation as a surgeon to kind of keep up with that and to kind of put content out that is going to draw patients in.
00:09:12.559 --> 00:09:19.039
Um, but if you get into, you know, things that are just unrealistic, uh, there are ethical issues there.
00:09:19.200 --> 00:09:24.399
Um and for the public, they're looking at these things and they're thinking, this is this is just crazy.
00:09:24.559 --> 00:09:25.679
Why don't I do this?
00:09:25.919 --> 00:09:35.279
So we just try to, you know, fortunately for me, I'm I'm established enough in my practice that I don't get a lot of people of kind of superficial interest that way.
00:09:35.360 --> 00:09:43.679
Uh they may see something and then they'll come, and then we we have to spend some time with them and really show them what is realistic and and what to expect.
00:09:43.840 --> 00:09:48.720
Um, you know, our injectables practice is more feeded, more fed by that.
00:09:48.799 --> 00:09:55.039
Um but um, you know, fortunately I don't see it as much in my facelift um practice.
00:09:55.200 --> 00:10:04.000
I think those patients are um just a little more skeptical about all of that and not sort of on the trend of the moment kind of thing.
00:10:04.480 --> 00:10:05.600
Oh, that's fantastic.
00:10:05.679 --> 00:10:06.399
It's good to hear.
00:10:06.480 --> 00:10:11.440
Uh you've uh earned the right to be shielded from a lot of that craziness.
00:10:12.080 --> 00:10:18.799
But I'm sure in your med spa, and as you said, in your injectable side of the practice, they're probably getting bombarded every day.
00:10:18.960 --> 00:10:23.039
So it's like, please, everyone out there, get a grip.
00:10:23.200 --> 00:10:26.399
A lot of these pictures are filtered, they're not real, it's not realistic.
00:10:26.559 --> 00:10:30.960
You might not even have the same facial structure, your bone structure, your muscles.
00:10:31.120 --> 00:10:33.120
You can talk to someone like Dr.
00:10:33.200 --> 00:10:43.759
Richard Baxter and his very educated staff, and they can help explain to you why these things are not good for you, or how you might be able to achieve a little bit, right?
00:10:43.919 --> 00:10:46.879
And keep it natural without looking crazy.
00:10:47.279 --> 00:10:49.279
That's kind of an important point right there.
00:10:49.440 --> 00:10:54.480
In this corner of the country, people are more interested in natural looking results.
00:10:54.639 --> 00:10:59.679
I think in a lot of areas it's um uh you know status symbol to look done.
00:10:59.840 --> 00:11:04.399
And and so people see these extreme results, and that's actually what they want.
00:11:04.559 --> 00:11:09.120
Um, so if that's what they're really looking for, they're probably not gonna come to me anyway.
00:11:09.600 --> 00:11:10.000
Right.
00:11:10.159 --> 00:11:10.960
I understand that.
00:11:11.120 --> 00:11:13.840
And that again, you've earned those stripes.
00:11:14.080 --> 00:11:20.000
So uh very, very commendable and uh admirable for sure.
00:11:20.240 --> 00:11:31.759
When it comes to the patient that is like a new patient, um how for the for the practitioners out there that are watching, can you give a little bit of advice?
00:11:31.919 --> 00:11:33.919
Because I know this is a big subject.
00:11:34.080 --> 00:11:48.240
Um if it's possible to give uh a quick advice when it comes to a patient that is maybe obsessed with a particular viral trend versus body morphic disorder or body dysmorphic.
00:11:48.720 --> 00:11:53.200
Yeah, I mean, that's always been here and um probably more of an issue now.
00:11:53.360 --> 00:11:58.639
And I think we just have to, you know, you develop a sense for who's who's gonna be just obsessed.
00:11:58.720 --> 00:12:08.240
And you're not doing them a favor by operating on them or doing a procedure that you know is not gonna meet that standard that they have that they're expecting.
00:12:08.480 --> 00:12:18.240
You're not doing yourself a favor because you know you're gonna end up having to do all that hand holding afterwards and all that talking, and and you really do just have to be willing to say no sometimes.
00:12:18.399 --> 00:12:21.759
And it's hard in a very competitive industry to do that.
00:12:22.080 --> 00:12:33.600
Um you know, maybe you just kind of hang on to them in the injectables and aesthetic services uh for a while uh and until you can be convinced that they're ready.
00:12:33.759 --> 00:12:37.840
But um I think bottom line is you just have to be willing to say no sometimes.
00:12:38.320 --> 00:12:40.799
Absolutely, I agree with that, and thank you for that.
00:12:41.039 --> 00:12:44.960
Uh you mentioned a very deep passion for longevity.
00:12:45.120 --> 00:12:51.120
Uh I got actually got into aesthetics for a selfish reason first, that are not 18 anymore.
00:12:51.360 --> 00:12:59.120
And as you have said, the the longevity industry is leaping forward, and I'm also excited about it.
00:12:59.200 --> 00:13:18.000
We've gone from PRP to PRP and PRF, and now we're we're all the way accelerated into masenchymal stem cells, or depending on what the FDA tells us, we can call them acellular matrix or what have you, and peptides, and all these alternatives to a healthier lifestyle.
00:13:18.159 --> 00:13:33.840
Um, for me in particular, I'm always a little shocked to see how much of the general public doesn't understand your aesthetic, how you look, has everything to do with what you're putting in, what you're putting on, uh your lifestyle, your sleep patterns, your hydration.
00:13:34.000 --> 00:13:36.000
They don't understand this full picture.
00:13:36.320 --> 00:13:44.799
So I would love to hear how you feel about longevity and where do you see it going with things in particular like peptides?
00:13:45.679 --> 00:13:57.279
Yeah, so you know, the you kind of hit on a key point there, which is that your your skin appearance, uh, your skin health informs your systemic health and vice versa.
00:13:57.440 --> 00:14:01.759
So you can't have healthy, beautiful skin unless you have good overall health.
00:14:01.919 --> 00:14:06.559
And so all those things that fit into health uh contribute to that.
00:14:06.799 --> 00:14:13.039
Um, you know, just on a practical basis, I do all these procedures on a day-to-day basis to make people look younger.
00:14:13.279 --> 00:14:18.639
But you know, after a while you start to wonder, well, how can I really address the aging process itself?
00:14:18.879 --> 00:14:22.639
Because this facelift that I'm doing or whatever it is is not permanent.
00:14:22.720 --> 00:14:29.200
I've set back the clock, uh, but you know, the clock will keep ticking unless we find some other ways to do it.
00:14:29.360 --> 00:14:53.519
And um, you know, I had this interest in kind of wine and health and got down this long road with resveratrol, and uh everybody thought that was the final answer, which it was not, but it did kind of open the door to a lot of research that um about aging itself and the aging biology and the genes involved in it and how we could start to impact those directly.
00:14:53.679 --> 00:14:59.759
And as that science progressed, then I thought, okay, I'm just gonna put all this together and see what's what's there.
00:14:59.919 --> 00:15:03.039
So um it's a fascinating field.
00:15:03.120 --> 00:15:13.360
It's really based on AI and not generative AI that we're all familiar with, but just AI to identify to analyze massive data sets.
00:15:13.840 --> 00:15:20.080
So the fundamental principle behind longevity medicine is to measure biological age.
00:15:20.240 --> 00:15:24.960
And you do that by analyzing banked data sets.
00:15:25.200 --> 00:15:31.759
So they're they're called biobanks, and they're all these kind of massive anonymized banks of health data and samples.
00:15:32.000 --> 00:15:51.919
And so um you can run analyses on those from you know 10, 15, 20 years ago, and say, okay, now find train the AI program to find what was in those samples that predicted the health outcomes of those people, how long they lived, what diseases they got, and that's what determines biological age.
00:15:52.080 --> 00:16:02.320
Um and it's a process that's called epigenetics, it's measuring gene expression, and so there are a number of those biological age clocks, and that's that's the fundamental idea.
00:16:02.480 --> 00:16:10.720
So we use that information to then develop interventions for longevity that are testable.
00:16:11.440 --> 00:16:15.519
You can test them because you can measure the effect on biological age.
00:16:15.679 --> 00:16:29.279
And the regenerative medicine part fits into that because if we're keeping people healthier longer, um you still have to address all that damage that's accumulated to your tissues over your lifetime, and and that's where the regenerative medicine part of it comes in.
00:16:29.679 --> 00:16:30.320
Absolutely.
00:16:30.559 --> 00:16:39.440
I've been obsessed with the blue zones and uh as you've said, epigenetics, to me, it's all like and and I love it.
00:16:39.600 --> 00:16:48.159
I mean, every step we move forward with is uh treating, getting closer to treating the cause, not just the symptom.
00:16:48.639 --> 00:16:57.039
And I do seem to find that is more prevalent in other countries, not bashing our country here in the US.
00:16:57.120 --> 00:17:01.600
Uh, you know, proud and happy to be born and raised here and have freedom of speech.
00:17:01.759 --> 00:17:15.440
However, we do what we seem to be behind the eight-ball when it comes to things like this, like stem cell therapies and peptide therapies, and um, as you said, using AI to do more extensive studies.
00:17:15.839 --> 00:17:21.920
And I'm so happy to see that we're moving forward finally on our front as well.
00:17:22.079 --> 00:17:29.200
Um, when it comes to patients self-dosing with peptides, I feel like this has already become a rampant thing and it scares me.
00:17:29.440 --> 00:17:31.279
So, how do you feel about that?
00:17:31.680 --> 00:17:46.640
I'm just um pretty dismayed because um peptides are essentially drugs, and even though there are ways that you can acquire them without going through a physician, um, you're not doing any testing to kind of see whether it worked or not.
00:17:46.799 --> 00:17:51.680
Um, somebody's just kind of, oh, this TikToker said, you know, this glow peptide is great, try that.
00:17:51.839 --> 00:17:58.880
Well, you don't really have any idea what it is and what you're doing, and maybe there's a better formulation or something that'll work better for you.
00:17:59.039 --> 00:18:05.759
Um, I do think peptides have have a role to play, and I I use them a lot in in my practice.
00:18:06.000 --> 00:18:17.759
It's it is in a tricky area in terms of the regulations because so many of them are just naturally occurring molecules, they exist in your body already anyway, or they're slightly modified from that.
00:18:18.000 --> 00:18:30.160
But they're not approved as drugs, and they probably many of them never will be, um, because the process of drug approval and the testing and clinical trial work you have to do is so costly.
00:18:30.640 --> 00:18:33.039
You know, it costs millions and millions of dollars.
00:18:33.200 --> 00:18:38.559
Uh, like a total new drug development is like like a half a billion dollars to get a new drug.
00:18:38.799 --> 00:18:45.519
Um, and if somebody's investing that kind of money in a peptide that we can already buy, um, there that's not going to happen.
00:18:45.680 --> 00:18:55.599
So the onus is on us as longevity medicine providers to really track what we're doing and and provide high quality care and and be honest about it.
00:18:55.759 --> 00:18:58.799
Um so uh it's it's an interesting area.
00:18:58.880 --> 00:19:04.720
I think they're powerful things, but they really have to be used right and they have to be used uh intelligently.
00:19:05.200 --> 00:19:07.759
There you go, intelligently, absolutely.
00:19:07.920 --> 00:19:18.079
Um, when it comes to a new patient coming to you, let's say I'm a new patient and I've got a decent budget and I'm very interested in longevity.
00:19:18.400 --> 00:19:22.079
I want to live as long as I can and thrive while I'm doing it.
00:19:22.559 --> 00:19:31.759
So I'm going to walk into phase plastic surgery and um, correct me, phase plastic surgery and or would you just call it phase plastic surgery?
00:19:32.000 --> 00:19:34.559
Well, we call it phase plastic surgery and longevity.
00:19:34.720 --> 00:19:39.920
I'm trying to, you know, at some point spin the longevity part of it out as a completely separate entity.
00:19:40.000 --> 00:19:46.720
Uh, but right now it's kind of all in one because a lot of the longevity patients have come from the plastic surgery practice.
00:19:46.960 --> 00:19:58.720
Yeah, so we first do, you know, basically in intake history and physical, because the practice of longevity medicine has all these tiers at the and the foundation of it is the lifestyle stuff.
00:19:58.880 --> 00:20:08.880
And a lot of people just think that's the whole thing, you know, that's sleep hygiene and exercise and diet and uh stress management and socialization.
00:20:09.119 --> 00:20:12.319
Those are all really important things, but that's just the foundation.
00:20:12.559 --> 00:20:21.039
Um, and then above that you have more medical type interventions, and uh some of these things that's where peptides fit in, for example.
00:20:21.200 --> 00:20:25.119
Um, a lot of patients use metformin, uh, rapamycin.
00:20:25.359 --> 00:20:30.960
There are things in that category that really do have to be managed medically and more carefully, I think.
00:20:31.119 --> 00:20:39.920
And then there's an upper tier, uh, which is the kind of really high-tech biomedical stuff, and that's like uh plasma exchange, hyperbaric oxygen.
00:20:40.000 --> 00:20:45.759
Um, again, hyperbaric has to be done in a really specific way if it's going to benefit longevity.
00:20:45.839 --> 00:20:50.400
It's not just kind of go to a wellness clinic and get your your uh hyperbaric.
00:20:50.640 --> 00:20:52.240
But so it has all those tiers.
00:20:52.319 --> 00:21:00.720
But the starting point then is we kind of figure out where you are in terms of lifestyle and what you're doing now, and then we want to do a biological age test.
00:21:00.960 --> 00:21:11.440
Um, and the the two best ones are ones called True Diagnostic, which is an epigenetic test, and it's kind of the gold standard across the industry because it's so comprehensive.
00:21:11.680 --> 00:21:15.200
They're literally measuring a million different sites on your DNA.
00:21:15.359 --> 00:21:25.680
And uh so that's that's where we start, and it gives a really detailed uh picture of how you're aging and what specific things we can we can start doing in your case.
00:21:25.839 --> 00:21:29.279
And the other one that's really interesting is called glycan age.
00:21:29.519 --> 00:21:37.440
And this is one that's kind of hard to explain, but it's your immunoglobulin G molecule and the different sugar molecules that attach to it.
00:21:37.519 --> 00:21:44.240
And it turns out that that is highly sensitive to how you're aging and and the different patterns of it.
00:21:44.319 --> 00:21:55.440
And one of the things that came out of that, for example, is um the the fact that menopause accelerates aging and hormone replacement then offsets that.
00:21:55.680 --> 00:21:59.759
So hormone replacement therapy has been so controversial for so many years, and I think.
00:22:00.160 --> 00:22:07.200
Women have been so poorly served by that that misinformation because you know we've been forcing them to age faster.
00:22:07.440 --> 00:22:16.000
So this is one of the tests that really is um sensitive to that in particular, uh, but it's also one that kind of responds better.
00:22:16.160 --> 00:22:20.079
So you have you have good feedback on whether what you're doing is actually helping or not.
00:22:20.400 --> 00:22:21.839
So that's an incredible journey.
00:22:22.079 --> 00:22:27.519
And uh I would love to see you expand your clinics all across the country and beyond.
00:22:27.680 --> 00:22:41.920
I actually wish you were here in New York City because we do we have touched on the beginning of longevity services, um, but it's it infantile and very small compared to what you've already established at phase.
00:22:42.240 --> 00:22:46.720
And if you were here, I would be like begging you to have a sit-down five-minute meeting.
00:22:46.799 --> 00:22:50.480
And do you think there's a way we can partner up or what can we do?
00:22:50.640 --> 00:22:52.319
How can we collaborate?
00:22:53.200 --> 00:22:54.880
So it would be awesome.
00:22:55.200 --> 00:22:56.000
Yeah, absolutely.
00:22:56.160 --> 00:23:08.960
So I wish you the best with that because it's obvious that phase plastic surgery and longevity, you know what you're doing, you've earned your stripes, you research everything that you're providing on your menu.
00:23:09.200 --> 00:23:18.559
And I think to age well and to age naturally and to age beautifully and to do enhancements that work for each individual, uh, what a spectacular place to go.
00:23:18.880 --> 00:23:19.440
Well, thank you.
00:23:19.599 --> 00:23:21.279
Yeah, I I uh I agree.
00:23:21.440 --> 00:23:23.279
It all it all fits together.
00:23:23.440 --> 00:23:30.000
Um, and even having having a procedure to help you look younger might actually help you live longer.
00:23:30.240 --> 00:23:32.319
And that's that's kind of a fascinating thing.
00:23:32.400 --> 00:23:38.000
There's it's part of it is psychological, but it resets what's called your time horizon.
00:23:38.160 --> 00:23:41.200
And uh there's some fascinating work being done around that.
00:23:41.359 --> 00:23:43.519
So uh that all fits in as well.
00:23:43.839 --> 00:23:45.279
Can you expand on that a little bit?
00:23:45.440 --> 00:23:46.240
Time horizon.
00:23:46.319 --> 00:23:50.880
It sounds like um Harry Potter with the time turner or jumping into a spaceship.
00:23:51.440 --> 00:23:57.759
Well, it's basically the the idea that how long you believe you will live informs how long you live.
00:23:58.000 --> 00:24:11.279
And so when you do proactive things that have that make you look younger, and it often marks a kind of uh effort to do other things that are healthy, um, then there's evidence that you do actually live longer.
00:24:11.440 --> 00:24:20.319
Um, it's a hard thing to test specifically, uh, but there's a a center at Stanford that's doing a lot of work on that, and it's just to me absolutely fascinating.
00:24:20.640 --> 00:24:36.960
That is fascinating because we've all heard, uh, whether you are a practitioner or you're part of the general public, we've heard for many, many years now that the power of positive thinking when it comes to health, when you're battling uh diseases such as cancer, that it's actually a real thing.
00:24:37.440 --> 00:24:38.480
It is a real thing, yeah.
00:24:38.880 --> 00:24:40.079
And we're taking that further.
00:24:40.160 --> 00:25:03.680
And in my experience, in my lifetime, I've met uh three different gentlemen, each one of them 100 years old, randomly, because I moved around a lot for work and they were like a next-door neighbor, they did not know each other, they were not from the same parts of the country, and randomly each one of them popped into a conversation, uninvited, and said, you know, I get asked often, what's my secret?
00:25:03.839 --> 00:25:14.880
Because these gentlemen were not in wheelchairs, they were not drooling out of the corner of their mouth, they were not like mentally lost, they were very sharp and they were still mobile, and they all said the same thing.
00:25:15.039 --> 00:25:19.119
I've never fixated on my age as a chronological number.
00:25:19.279 --> 00:25:21.680
I've always thought young and my body followed.
00:25:21.839 --> 00:25:27.680
And I always found that profound that the three different people told me that same exact thing, and I didn't even ask them.
00:25:28.000 --> 00:25:30.720
Yeah, so they knew their biological age was younger.
00:25:30.880 --> 00:25:34.880
It didn't matter to them what the number was, they just felt biologically younger.
00:25:34.960 --> 00:25:36.960
And some people do just age more slowly.
00:25:37.200 --> 00:25:47.359
You know, there's one of the studies um that they did with the true diagnostic data and another big data set um uh called the Dunedin Pace from New Zealand.
00:25:47.599 --> 00:25:54.480
But what they did was they selected um a group of people uh who were all the same chronicological age.
00:25:54.559 --> 00:26:10.559
They were all 35 years old, but they they put picked the ones whose number said they were aging slowly, the ones who were aging kind of on par with their their calendar age, and the ones who were aging more quickly, and then they took their images of them, the men and the women, and made a composite.
00:26:11.039 --> 00:26:14.720
And you can just look at the ones who were aging slowly and they looked young.
00:26:15.519 --> 00:26:21.920
You know, their that number just kind of randomly selected showed that they were actually they looked younger.
00:26:22.240 --> 00:26:25.839
And uh and you know, so that reflects through every tissue in your body.
00:26:26.000 --> 00:26:31.759
If you uh are aging slowly in terms of appearance, then you're also healthier and better muscle mass and so forth.
00:26:32.000 --> 00:26:34.720
So I I think that's absolutely fascinating how all that works.
00:26:35.119 --> 00:26:35.839
Okay, Dr.
00:26:35.920 --> 00:26:39.759
Richard, I would like to bring up your latest book.
00:26:40.000 --> 00:26:44.880
And I know that ties directly into longevity, and it's gonna be super exciting.
00:26:44.960 --> 00:26:46.240
So please share with us.
00:26:47.039 --> 00:26:47.759
Well, thank you.
00:26:47.920 --> 00:27:05.200
I I wrote this book called Biohacking Longevity, and it was just kind of the notes I was taking as I was studying this over uh the first few years I was taking this deep dive into it, and I realized that patients needed to sort of guide to all this stuff because there's so much out there they're being bombarded with.
00:27:05.680 --> 00:27:11.279
And the idea of it is um here's what works, here's what might work, here's what doesn't work.
00:27:11.759 --> 00:27:17.599
And and I update it constantly so the book is not published in print form, it's on my website, just download it.
00:27:17.680 --> 00:27:19.359
It's called biohacking longevity.
00:27:19.759 --> 00:27:23.359
Yeah, every couple of months I update it because it's happening so quickly.
00:27:23.519 --> 00:27:30.960
So um you can go in there and say, Oh, I heard about uh you know methylene blue, everybody's you know, there's a big thing everybody's talking about with that.
00:27:31.039 --> 00:27:31.839
Well, does that work?
00:27:32.240 --> 00:27:36.319
Probably doesn't do very much uh and not a hundred percent safe.
00:27:36.559 --> 00:27:39.839
So I'll just put that in there and talk about what the data is.
00:27:40.079 --> 00:27:47.359
Uh another one that I have a little bit of a peeve about right now is uh people are doing what are called NAD infusions.
00:27:47.759 --> 00:27:53.359
And these wellness clinics and IV uh drip clinics and and um and a big deal.
00:27:53.440 --> 00:27:55.759
And the first time I heard about it, I thought, what the heck are you doing?
00:27:55.839 --> 00:27:56.720
That doesn't work.
00:27:57.119 --> 00:27:59.119
And um and it doesn't.
00:28:00.000 --> 00:28:06.079
So the idea is that NAD is this molecule that your cells need for metabolism, and it's really important in aging.
00:28:06.240 --> 00:28:09.680
It has to be in your cells, in the mitochondria in your cells.
00:28:10.160 --> 00:28:13.440
When you infuse the NAD molecule, it doesn't get there.
00:28:13.759 --> 00:28:18.240
It has to get broken down into precursors, then go through the cell membrane and get in there.
00:28:18.559 --> 00:28:25.200
And so people are spending uh hundreds of dollars per session to do this, and it's really not doing them any good.
00:28:25.359 --> 00:28:31.599
And in fact, when it's circulating in your bloodstream, it's a marker of inflammation and probably doing more harm than good.
00:28:31.759 --> 00:28:40.799
So there are better ways to get NAD into your cells, but if you're going to an IV clinic, you're just wasting your money and probably doing more harm than good.
00:28:40.960 --> 00:28:44.480
So I talked a little bit about that as well as some better options.
00:28:44.640 --> 00:28:46.799
So wow, that's really huge news.
00:28:46.960 --> 00:28:50.880
I mean, that should be on the front of every media outlet going right now.
00:28:50.960 --> 00:28:53.599
Um, so I'm I'm astounded by it.
00:28:53.759 --> 00:28:56.480
I'm gonna have a talk with my doctor about that too.
00:28:56.799 --> 00:29:01.839
Like, like, hey, because we don't here at IT intelligence treatment, we don't do IV drips.
00:29:02.240 --> 00:29:09.440
Um, but on the super, super slow push, depend she does do a health intake and the whole uh blood testing and everything first.
00:29:10.079 --> 00:29:14.799
But you know, that NAD is um available depending on the patient.
00:29:15.039 --> 00:29:31.599
And I'm going to definitely be reading your book, and I'm gonna make sure she reads your book as well, and we'll move forward based on you know clinical evidence that just what you're sharing right now to me sounds like it absolutely makes sense, and it's not something that we should be doing.
00:29:31.680 --> 00:29:34.319
So let's you know pump the brakes on that for the moment.
00:29:34.640 --> 00:29:36.480
Yeah, I mean there are better alternatives.
00:29:36.960 --> 00:29:39.839
Well, it has been spectacular sitting with you.
00:29:40.000 --> 00:29:42.640
I legitimately could listen to you all day long.
00:29:42.720 --> 00:29:44.880
Um hopefully in the future, I'd love to have you back.
00:29:44.960 --> 00:29:51.119
I'd love to talk to you more in the future about things like um things with having to do with longevity.
00:29:51.440 --> 00:30:02.880
And um uh one of my peeves right now is how our beloved industry calls everything having to do with machines um except CO2 laser not invasive.
00:30:02.960 --> 00:30:06.319
And we all know a lot of what we're doing actually is invasive.
00:30:06.480 --> 00:30:11.279
And then there's there's my Soma cell that's actually truly not invasive, but that's all for another day.
00:30:11.440 --> 00:30:21.039
I would love to have you back and discuss that and and follow along with your book because I'm I'm just shocked that you have a digital book that you are updating all the time.
00:30:21.200 --> 00:30:24.480
I mean, what an incredible resource, and thank you for that.
00:30:24.640 --> 00:30:25.519
I really appreciate that.
00:30:26.000 --> 00:30:26.400
My pleasure.
00:30:26.480 --> 00:30:27.920
It's my own kind of passion.
00:30:28.960 --> 00:30:31.359
Absolutely, along with the tango dancing and art.
00:30:32.000 --> 00:30:32.319
Yes.
00:30:32.960 --> 00:30:34.559
And plastic surgery, of course.
00:30:34.720 --> 00:30:35.680
So let's not leave that.
00:30:37.119 --> 00:30:40.160
Okay, so for us, please drop your comments.
00:30:40.319 --> 00:30:42.720
We want to hear your questions, we want to hear your comments.
00:30:42.960 --> 00:30:49.440
If you haven't subscribed yet, please subscribe and check out phase plastic surgery and longevity.
00:30:49.599 --> 00:30:54.000
If you're in the Seattle area, I'm gonna say this is definitely the place to go.
00:30:54.240 --> 00:30:54.880
But Dr.
00:30:55.039 --> 00:30:59.119
Richard Baxter, you're a rock star, you're a superstar, and an icon.
00:30:59.279 --> 00:31:06.000
Can you please let everyone know how they can find you on your social, on your website, uh, where are you located in Seattle?
00:31:06.319 --> 00:31:08.079
Yeah, so we're just north of Seattle.
00:31:08.160 --> 00:31:13.599
Um, the website is uh drbaxter.com, easy to remember, or phasebs.com.
00:31:13.839 --> 00:31:16.079
And it's been an absolute joy on my end.
00:31:16.160 --> 00:31:25.839
Uh, next time we'll talk about um uh microplastics toxicity and how to get microplastics out of your body and plasma exchange to make you biologically younger.
00:31:26.160 --> 00:31:26.640
Well, Dr.
00:31:26.720 --> 00:31:30.720
Baxter, please have a wonderful day and keep tangoing.
00:31:30.799 --> 00:31:32.240
And I would love to have you on again.
00:31:32.319 --> 00:31:40.400
Like you said, we'll talk about microplastics and and just um, you know, we'll get after that entire part of how we're poisoning ourselves and how to get rid of it.
