#13 – Brett Kotlus, M.D.: How to look younger while we live longer

A less potent, over-the-counter form of Vitamin A, suitable for those new to retinoids or with sensitive skin, often found in moisturizers.

A potent form of vitamin A that acts like a hormone, promoting collagen synthesis and increasing skin cell turnover. It's one of the few things proven for anti-aging and acne, available by prescription.

The form of vitamin C thought to penetrate the skin best and be most effective when stabilized in topical products.

A powerful antioxidant and cofactor for collagen synthesis, recommended for topical application (preferably with Vitamin E) to protect against UV damage and reverse existing sun damage.

Recommended to be used in conjunction with topical Vitamin C for improved efficacy in skincare.

Trichloroacetic acid peels, a type of chemical peel that can be strong and effective, with different strengths depending on the desired depth of skin resurfacing.

A procedure using a pen with small surgical needles to create channels in the skin, often combined with PRP to drive it into the skin; also known as 'vampire facial'.

Podcast mentioned by Dr. Kotlus in reference to Peter Attia's appearance, jokingly suggesting he might want a pectoral implant to look 'beefier' on camera.

A type of chemical peel with higher risk but also higher benefit, requiring EKG monitoring during the procedure due to potential cardiac arrhythmias.

A 5-alpha reductase inhibitor drug that blocks the conversion of testosterone to DHT, a hormone responsible for hair loss.

A popular neurotoxin used to reduce wrinkles, which Dr. Kotlus advocates using in a nuanced way to maintain natural expressions rather than completely smoothing lines.

A topical treatment for hair loss.

A specific brand of hyaluronic acid paste filler recommended by Dr. Kotlus for under-eye injections due to its properties.

An FDA-approved botulinum toxin type A product, similar to Botox and Dysport, used for cosmetic purposes.

A chemical sunscreen ingredient that Dr. Kotlus recommends avoiding due to its potential hormonal disruptive effects, especially for children.

A 5-alpha reductase inhibitor drug that blocks the conversion of testosterone to DHT, a hormone responsible for hair loss.

An FDA-approved botulinum toxin type A product, similar to Botox and Xeomin, used for cosmetic purposes.

Former U.S. President, mentioned as an example of someone who visibly ages without pursuing cosmetic procedures, highlighting varying personal approaches to appearance.

Two famous researchers from MIT and Harvard known for their groundbreaking work on growing tissues, including the 'ear in the mouse' paper.

Host of The Drive podcast, interested in longevity, performance, and critical thinking.

Actor mentioned in reference to his character in 'Fletch' and the 'ball bearing' scene, used as an analogy for how stem cells are sometimes perceived as a universal cure-all.

A New York City-based eye and facial plastic surgeon specializing in cosmetic and reconstructive surgery of the face, particularly around the eyes. He is known for his nuanced approach to subtle, long-lasting aesthetic changes.

Actress mentioned in the context of 'Spock brows' or 'over-arched' eyebrows, an unintended result of poorly done Botox.

A specialized field that is a cross between ophthalmology and plastic surgery, focusing on procedures around the eyes and face.

An energy device that uses radiofrequency to stimulate collagen synthesis and contraction for skin tightening.

A technology used by Dr. Kotlus to design and create custom surgical instruments from stainless steel, with potential future applications in bio-printing organs, tissues, and personalized implants.

A common type of fractional laser used for skin resurfacing to improve texture, reduce wrinkles, and diminish brown spots by burning the skin surface in dots.

Also known as stromal vascular fraction, it is a 'soup' of stem cells found between fat cells, which Dr. Kotlus uses in a sense as a stem cell treatment, believing it supports fat grafts.

A common type of fractional laser (carbon dioxide laser) used for skin resurfacing to improve texture, reduce wrinkles, and diminish brown spots by burning the skin surface in dots.

A low-grade, very safe laser with minimal risk, often performed by aestheticians or nurses, for general skin improvement.

Considered a biologic, laboratory-derived FGF has shown promise as an injectable for facial volumization with long-lasting results in studies conducted in Asia.

Mentioned as a good brand for medical-grade skincare products, including sunscreens.

Mentioned as a good brand for medical-grade skincare products, including sunscreens.

A moisturizing cream with SPF 15 that Peter Attia has used and likes due to its odorless and non-greasy nature.

A social media platform where Dr. Kotlus shares before-and-after photos of his work, particularly around the eyes, and engages with his audience.

Mentioned as a good brand for medical-grade skincare products, including sunscreens.

A first-generation energy device that used radiofrequency for facial rejuvenation through skin tightening, though Dr. Kotlus described being "underwhelmed" by these technologies generally.

A treatment involving extracting a patient's own blood, spinning it to concentrate platelets, and then applying or injecting it to promote healing, collagen building, and potentially hair growth.

Gel fillers, such as Restylane, that are biocompatible and reversible, used to restore volume in areas like the lips and under eyes.

A skin tightening device that uses focused ultrasound to stimulate collagen synthesis and contraction; Dr. Kotlus expressed being "underwhelmed" by such technologies.

An FDA-approved device for cryolipolysis that suctions and freezes fat cells to reduce subcutaneous fat non-surgically; considered effective.

A film referenced for a scene where Chevy Chase's character talks about 'ball bearings' as a cure-all, used as an analogy for the sometimes exaggerated claims made about stem cells.

One of the two organizations that certified Dr. Kotlus's fellowship training in oculoplastic and reconstructive surgery.

An organization that provides recommendations for sun protection, including sunscreen use, especially for children.

Cited for its pioneering use of 3D (and 4D) printed implants for infants with tracheomalacia, where implants grow with the patient.

One of the two organizations that certified Dr. Kotlus's fellowship training, indicating his qualification in cosmetic surgery.

The U.S. Food and Drug Administration, which approves botulinum toxin products like Botox, Xeomin, and Dysport, as well as cosmetic devices.