Ask San Francisco-based dermatologist Jason Emer, MD to list his favorite skincare products and he can go on and on … and on. It is clear that he knows his stuff, and truly appreciates what the right products can bring to the table.
Emer often recommends the very same products that he uses on himself to his patients. Of course, there is more to his practice than his stellar product picks. He is widely sought for his expertise in lipocontouring, body sculpting, and fat transfer. Another niche of Emer is “sports dermatology” or the treatment of various skin conditions that are caused or worsened by sports-related overuse or injury. He also caters to growing numbers of male patients who are looking to prevent skin cancer, improve their appearances, and turn back the hands of time through neuromodulation, facial fillers, lasers, and skin tightening devices. When he is not seeing patients, Emer is lecturing across the globe and running clinical trials that will help advance the field of dermatology.
Emer spoke to Beauty in the Bag about his practice, his background, and, of course, his product picks. Here’s what he had to say:
What is sports dermatology?
Sports and physical exercise can be associated with a wide variety of skin problems. Sports dermatology is the prevention, diagnosis, and treatment of skin conditions related to athletics. For example, sports-related skin conditions can result from mechanical trauma or from exposure to environmental and infectious agents. Making the appropriate diagnosis requires familiarity with characteristic clinical presentations, which may not be initially apparent to dermatologists unfamiliar with skin problems related to athletic activities.
How did you become interested in sports dermatology?
My lifetime involvement in athletics and physical exercise influenced my interest in taking care of patients with similar backgrounds who had concerns for preventative skincare/health.
What is the biggest trend you are seeing in your practice today?
I am increasingly observing men of all ages presenting to the office not only for skin cancer prevention visits but also for preventative anti-aging treatments including aesthetic peels, fractional laser, neurotoxins, and fillers. I have had an increase in men desiring body contouring procedures such as abdominal and flank liposculpting, breast (gynecomastia) surgery, sweat reduction treatments, eyelid surgery, skin tightening procedures, and laser hair removal. Men appear to be less ashamed of their desire for a more attractive appearance than in the past.
What are your go-to skincare products?
To be honest, it depends on what skin conditions, if any, we are trying to treat. However, for the majority of my patients interested in anti-aging and preventative skincare treatments I recommend a daily glycolic cleanser. My go to cleanser is either Jan Marini Bioglycolic Face Cleanser or Dermaceutic Foamer 15. These cleansers are non-irritating and help enhance normal skin exfoliation, which improves the penetration or benefit of the other products applied to their skin. All my patients are recommended to have a vitamin A/retinol containing product at bedtime. My favorite prescription agent is a tretinoin gel (Atralin), approved for the treatment of acne, but has anti-aging properties by exfoliating the skin more rapidly and supplying moisture through its fish oil additive. Some physicians also believe topical retinoids are skin cancer prevention agents—the jury is still out. My favorite non-prescription product is SkinMedica Retinol Complex or Glo Therapeutics Retinol CS, which also contains 5% glycolic acid. These products refresh and brighten the skin, giving it a glowing, softer appearance. In the morning, I recommend a vitamin C containing product to help decrease skin pigmentation and supply extra sun-protection factor. My patients have gotten great results from the Obagi Professional-C serum products or SkinCeuticals CE Ferulic or Phloretin CF. Other products I love, recommend, and use myself include:
- SkinMedica’s TNS essential serum for anti-aging.
- DNA Youth Recovery Facial Serum from PrecisionMD for its anti-oxidant properties and DNA repair capabilities, reversing the signs of aging such as wrinkling and textural changes.
- SkinMedica’s Lytera Skin Brightening Complex or Pigment Gel HQ free from PCA skin care for improvement of skin tone and texture, without the use of hydroquinone ,which many consumers are afraid of and sometimes is irritating.
- Jan Marini BioShield for post-procedural (peels, lasers, microdermabrasion) skincare that is not greasy, primarily because of its silicone-based formulation, and has skin growth factors to promote faster wound healing and decreased recovery times.
- EltaMD Laser Balm is formulated with petrolatum, wax, and paraffin, and is a fantastic humectant. It is ideal for those who like greasy products and feel they are more protective and hydrating, especially for more aggressive procedures
- Nia24 Intensive Recovery Complex or SkinMedica’s Redness Relief Calmplex for facial, neck, or chest redness. Especially great after laser procedures and for those patients with very sensitive, easily-irritated skin.
- Dermalogica Daily Microfoliant is an exfoliating rice-based powder formula that micro-exfoliates dead skin cells, leaving the skin smoother, softer, and brighter.
- EltaMD UV Aero is a zinc sunspray that makes applying sunscreen easy, plus its non-greasy and transparent (no residue).
- Headhunter Products that are non-irritating and easy applying sunscreen facial balm and sticks products that fit easily into your bag. Perfect for the person on the go!
What is your most popular treatment these days?
Neuromodulation with Botox, Dysport or Xeomin is my most common non-invasive cosmetic procedure. Coming in a close second are soft tissue fillers and fractional laser (Fraxel) treatments. Body contouring procedures such as liposuction/lipocontouring of the abdomen, flanks, arms, and neck, and upper eyelid surgery (blepharoplasty) are my most common invasive procedures.
When is your busiest time of year and why?
I am quite busy all year round. However, liposuction/lipocontouring procedures such as abdominal etching is most common 3-6 months before the “beach” months and more aggressive laser procedures such as carbon dioxide resurfacing are less popular in the summer months.
Before calling New York City home, board-certified dermatologist Jennifer MacGregor worked at one of Washington, DC’s most prestigious dermatology groups and directed the Laser and Cosmetic Dermatology Center for Georgetown University. She joined New York’s thriving downtown Union Square Laser Dermatology Group in the summer of 2012, a practice that prides itself on having the latest lasers and treatment technologies—the office boasts over 25 lasers and energy devices in their treatment rooms. MacGregor and her colleagues are always the first to test and evaluate the latest equipment, sometimes helping assist with their development or working in clinical trials that lead to FDA approval. MacGregor is an expert in Ultherapy and when it comes to cosmetic procedures she always makes sure her patients look natural and healthy, not as if they had work done.
Here Dr. MacGregor talks with Beauty in the Bag on her background and treatment philosophy.
Tell us a bit about your background. How did you get started in the beauty business?
My interest in dermatology started while working in a cancer research laboratory. In medical school, I chose to specialize in dermatology because of the unique mix of medicine, surgery, pathology, procedures, and aesthetics. The focus is on treating skin conditions, but I have realized through practice that helping people achieve healthy, clear skin and their best appearance possible is an important component.
What is your treatment philosophy?
I usually start with prevention and address overall skin health along with the aesthetic. For younger patients, I may focus on skin health first followed by the aesthetic component. Some patients who come in to see me and already have healthy skin, I may just work with them on keeping it healthy
What is your signature procedure?
Ooh, do I have to choose one? I find combination procedures improve the skin in the most natural way. For early sun damage, I like to combine vascular laser (for redness and capillaries) with low density non-ablative resurfacing that treats uneven skin tone, pores, and fine lines. It’s a great way to rejuvenate the skin with little downtime. And in patients with loose or sagging skin, I find non-invasive skin tightening combined with a few well-placed filler injections can provide a remarkable natural-looking lift with virtually no recovery.
New and better lasers are constantly being introduced. What technology do you find particularly useful or exciting?
An exciting trend that continues to gain popularity is combining antioxidant topical serums (such as SkinCeuticals CE Ferulic) with low density non-ablative resurfacing lasers. The microscopic channels created by the laser can potentially deliver ingredients deep into the skin. This is great for repairing sun-damaged skin and for overall skin quality as well as treating fine lines, texture, pigmentation, and pores. Down the road, we may see this combined technique to be used with fillers, which would allow the filler particles to penetrate deeper into the skin.
Besides technology, what other innovations that are in the pipeline are you excited about
We will see further improvements in non-invasive fat removal, such as injectables, in the coming years. Our current devices are also advancing and becoming more effective, particularly for the hard-to-treat stubborn pockets of fat.
These days, women have so many great anti-aging products to choose from. What are your must-haves?
A must-have, of course, is a broad spectrum SPF 30. Beyond that a topical antioxidant serum and topical retinoids (both prescription or one that you can find over-the-counter) if skin can tolerate it.
Who is your beauty inspiration?
I would have to say Meryl Streep. She is a naturally beautiful, timeless, talented, and successful woman that always projects strength and confidence. She is aging with such grace and elegance and still looks amazing.
Why do you love what you do?
I have been blessed with an incredible career that allows me to help people with a variety of skin issues, but also to help people to look their personal best. We all want to look natural and healthy and this is closely tied to an overall sense of psychological well being. Even if I had all the money in the world, I would still want to do it.
Dubai has become a focal point for cosmetic surgery thanks, in large part, to the successful rebroadcasting of such reality TV shows as Dr. 90210 throughout the Middle East. While many US cosmetic surgeons frequently make sojourns to Dubai to help keep pace with increasing demand, Hassan Galadari, MD, an assistant professor of dermatology at the United Arab Emirates University in Dubai, is a local dermatologist who maintains a thriving cosmetic practice together with his father at Galadari Derma Clinic in Dubai. Trained in the US, Galadari graduated from the Boston University/Tufts University dermatology program and completed a cosmetic dermatology fellowship in the University of California, San Francisco. He is licensed by the medical board of California.
Galadari spoke to Beauty in the Bag about his practice, his beliefs about beauty, and what men and women in Dubai really want out of cosmetic surgery. Here’s what he had to say:
How do you define beauty?
Beauty is not an easy thing to define. The way I look at it though, it is anything that makes you feel good, whatever senses it might entice. If a cologne makes you feel good, then its beautiful. If you’re on a vacation and you feel good, then without knowing where you have been, I can tell that you’re in a beautiful place. Beauty’s definition is different from one person to the other and I sincerely believe it is in the eye of the beholder. A computer engineer can see the code and would consider it beauty, while an architect may be fascinated by a structure such as the Burj Khalifa and see it as beautiful. There are, however, universal definitions of beauty, where a majority can see the beauty of a person, place or thing.
What is your signature procedure?
I enjoy performing minimally invasive procedures such as injectables. Fillers (and toxins to a lesser extent) have this instant gratification going for them, where patients can literally see the transformation in front of them. When done right, you can chip away time and that person looks at least five years younger. The trick is to never do too much that others can see what you’ve done. I tell patients that anyone can inject, but the right doctor will inject in such a way where no one can tell that anyone has had anything done.
So what do the people of Dubai really want when they pursue cosmetic surgery?
Women and men want to look good and naturally by doing so, feel good. The major thing that women want in this part of the world is for clear, smooth skin. Given that people here are of type 4-5 skin, there are some pigmentary discrepancies and women want to have a unified skin tone. The fair skinned individuals want to tan and the naturally tanned, want to be fairer. This is about the same anywhere else in the world. Unfortunately people are never too comfortable in their natural skin.
Do any of these ideals really come from reality shows like Dr. 90210 as the US media has alleged?
Media greatly affects people’s perceptions about beauty. Not so much reality shows, but the media in general. I have witnessed this change as time went by. At first, people ridiculed cosmetic procedures, now they have become much more accepting of them. Unfortunately, the “made up” look is still a thing. You could say it has become akin to social status. Women would assume that they wear a Rolex watch, a Hermes Birkin bag, and naturally a bit of Botox and some filler in the lips.
What does male plastic surgery in Dubai look like?
As for men, since beards are a big thing here in Dubai and the Middle East in general, laser hair removal to define the beard line is extremely popular. From all procedures, men seem to start with this first and then perhaps move on to other procedures such as peels and neuromodulators once they’re comfortable.
A lot of US doctors fly into Dubai and provide plastic surgery. Does this affect your practice?
There is no major problem when that happens, but it does become an issue when complications arise and naturally they do, no matter how good the doctor is. Out of principle, and this is something I learned during my training, is that I never touch other people’s blunders, because patients have a way of associating you with it even though your intention is to help. In the cosmetic field, patient loyalty and satisfaction is key. There should be a lot of hand holding and TLC all the time and especially when things go wrong. Visiting doctors do not provide that. They come, perform the procedure and are gone. People are drawn in out of the allure of being injected by an American doctor, though the local talent may be better or even “American” or “Western” trained. I never consider such doctors as competition. A good doctor will draw his patients even if there are other doctors around him. Just look at NYC. There is practically a cosmetic dermatology office every other block on the Upper East Side.
How did you get started in the beauty business?
One might say I was exposed to the world of dermatology at a young age, since my father is also a very well established dermatologist here in Dubai. I’ve always had this friendly and silent competition with him. I always wanted to be a step better and only my mother realized that. I thought, what better way to do so than at his own game and his own field?
The reason why I got into cosmetic dermatology is because I enjoyed seeing the beauty in everything. I would stare at a car and attempt to get into the designer’s head and think what he or she were thinking to come up with this. The same would go for a painting, a house, even watches and bags. I always tried to make sense of the design and see the beauty there.
What sets you apart from others in your space?
I like to think that I appreciate natural beauty. I find it an extra challenge to perform a procedure on a patient and make them look good, feel good, yet not have others see them and tell that they’ve had something done. That’s the challenge and I really enjoy it. I avoid and have turned down patients who want that extra filler in their lips because I do not want to be the doctor who’s made those duck lips or high cheeks. It’s never been about the money. I’m also a perfectionist and I’m hard on myself when it comes to what I do.
Are any procedures especially challenging?
The challenge is not really the procedure but the outcome. It’s a challenge to create something that can be looked at and considered to be natural. There are certain procedures where the margin of error is tighter and those areas involve the lips and the area underneath the eye. Being overzealous in those areas can change the person entirely.
Who is your beauty inspiration?
I would say the world. Earth. Nature. God is the most inspirational designer out there when it comes to beauty. You look at things in nature and you can’t help but feel inspired. The arid desert, the ragged mountains, the forest and the water. You look at these things and the way all the elements in a given frame gel together in harmony, you cannot help but feel in awe. I try to focus on that with my work. I want the eyes to be in harmony with the mouth and ears in the landscape of the face.
What is your beauty mantra?
“God is beautiful and He loves beauty.” Each person has a natural beauty inside them and sometimes you need to make that person look beautiful in order for them to achieve their hidden potential. This is not superficial thinking. This is the truth that has been proven many times in research in psychology and the way people view themselves. People who deny that, deny science and the human element.
Why do you love what you do?
I don’t see what I do as work. If you enjoy it so much, then it stops being that. I find it quite fulfilling. I work with my father and see him everyday so it becomes an extension of family. I enjoy interacting with people, knowing them, and helping them. What I find even more important is that imprint you leave behind when your interaction concludes. There is a saying that when a person passes on, only three things remain: an ongoing charity, knowledge where people benefit, and good people’s thought of you. I would like to leave in good graces and to touch as many people as possible.