Dr Lee interview by Head & Neck Facial Plastic Surgeon, Rich Castellano
Transcription
Dr. Castellano:
...coming, so we are... That's perfect. Let me start this one more time.
Dr. Castellano:
Hello, hello. All right, we're live, we're good. Perfect. We're on Facebook and we're on YouTube.
Dr. Castellano:
Hello, everyone, Dr. Rich Castellano here, the Smile Doctor, Wall Street Journal bestselling author of The Smile Prescription. We are here today with Dr. Lee.
Dr. Castellano:
Thank you so much for joining our program today.
Dr. Lee:
You're welcome.
Dr. Castellano:
Dr. Lee has so many accomplishments and achievements. I can't fit them all in, but he's a trainer, he's won numerous awards. You're an innovator, an inventor. Thank you so much for joining us today.
Dr. Lee:
Well, thank you, Dr. Rich. I appreciate the offer to come and chitchat with you.
Dr. Lee:
Dr. Rich and I have met before, and I love his smile. He has the most incredible smile and the personality to match it. I appreciate that.
Dr. Castellano:
Thank you. You're so kind, and it takes one to know one.
Dr. Lee:
Of course.
Dr. Castellano:
We have a lot to smile about.
Dr. Lee:
I think so.
Dr. Castellano:
Why not share it?
Dr. Lee:
Sure.
Dr. Castellano:
That being said, I got to talk about this. You got your device here.
Dr. Lee:
Sure.
Dr. Castellano:
Tell us about what this is. We're at the Aesthetic Show, so we're learning about the latest developments in cosmetic and aesthetic treatment. What are we looking at here?
Dr. Lee:
First of all, you're looking at a typical syringe with Juvéderm, which is used to fill wrinkle fillers.
Dr. Castellano:
Yes.
Dr. Lee:
At the tip we have a microcannula, but what's particular, if you look closely, see this little purple attachment here?
Dr. Castellano:
Yes, I see that.
Dr. Lee:
One of the problems that we all face when we're injecting cosmetic fillers into wrinkles is that there's a substantial risk for injecting into blood vessels.
Dr. Castellano:
Yes.
Dr. Lee:
If you go into a blood vessel, you can absolutely have a catastrophe.
Dr. Castellano:
It's not good news. You want to avoid the blood vessels, absolutely.
Dr. Lee:
What happens, what has happened, is people, they have inadvertently injected and caused necrosis.
Dr. Castellano:
Not good.
Dr. Lee:
Can cause stroke.
Dr. Castellano:
We don't want that.
Dr. Lee:
There's been about a hundred cases...
Dr. Castellano:
So how does this help prevent?
Dr. Lee:
Well, yeah. Here's the thing. Everybody tells you that you have to aspirate. You have to pull back on the syringe, and when you pull back on the syringe, and you see blood flashing into the tip, you know you're in a blood vessel. Then you go in and inject. What happens is that when you actually try and do it in practice, it's not practical, because if I'm injecting... This is the typical way I inject, and I teach for... I'm on the board for Allergen and Galderma, and I teach for them, teach injection.
Dr. Castellano:
Amazing.
Dr. Lee:
When I try and inject somebody and one of my hands is this way, and one of my hands is this way to hold the skin in place, now, if I want to aspirate, look what I have to do. I have to stop what I'm doing, grab the tip, I have to release my hold, I have to grab the plunger, and I have to pull it back. Now, when I pull it back, it actually dislodges the tip of the needle of the microcannula...
Dr. Castellano:
anyone.
Dr. Lee:
When you try and advance it, you could actually be injecting into a blood vessel. That's why most of [inaudible 00:02:48] injectors don't really aspirate every time. I said, 'Well, it's crazy. Why don't we have something simple where we can pull back with minimal movement?"
Dr. Castellano:
That holds your thumb and finger, so one-handed you can pull back.
Dr. Lee:
If you watch here, the first thing I did is I looked around and said, "Well, where is it," and there isn't any.
Dr. Castellano:
There's none.
Dr. Lee:
I'm like you, I say, "Well, there isn't any. Let me put it together."
Dr. Castellano:
He invented it.
Dr. Lee:
If you see this purple thing here, this fits in all Juvéderm syringes. Now, all you have to do is when you want to pull it back, you just move your thumb...
Dr. Castellano:
Can I try that out, let me feel that?
Dr. Lee:
Absolutely, go ahead and try it.
Dr. Castellano:
I love that. This definitely, it feels very easily. I do a lot of injections, so it's definitely easy to really pull back. You know what I do, because some of the syringes only have a small tub, depending on the product. I actually do take my finger and just try and push it back here, but it's not as easy. You have to be either very skilled, or you won't get as much pressure. This, you got a holster, so you can pull that back, much better control, better safety.
Dr. Lee:
Way better. Here's the thing about it. Of course, you have a technique, you can do it with your hand, but ergonomically it's painful to keep putting that pressure, and so when...
Dr. Castellano:
I do a little massage on my hand.
Dr. Lee:
When you're treating a patient, the best thing is when you have the best tools and when it's comfortable for you, so you can focus only on the patient, not on your finger.
Dr. Lee:
Here's the other thing. You can snap it on and off in minutes. I'm going to snap it off here just like that. I pop it out here. In a matter of seconds, the syringe you're done with, you can replace it and put another one on, and literally it takes...
Dr. Castellano:
It takes you seconds to pop it right on.
Dr. Lee:
Just like that.
Dr. Castellano:
That looks like it's custom made for the Juvéderm syringe?
Dr. Lee:
That's correct.
Dr. Castellano:
It sneaks right in there.
Dr. Lee:
See it right there?
Dr. Castellano:
You can easily enough formulae that to fit on any syringe, many different types of syringes.
Dr. Lee:
The one that is out in the market now, we call it the Lee Aspirator.
Dr. Castellano:
The Lee Aspirator, I love it.
Dr. Castellano:
Hey, Gabe, thanks for joining. Good to see you.
Dr. Lee:
Hey, Gabe, nice to meet you too.
Dr. Castellano:
Can I see that? Can you break that off one more time?
Dr. Lee:
Sure. If you watch, it's very simple. You pop it.
Dr. Castellano:
This is what I love about the Aesthetic Show. You learn new things.
Dr. Lee:
It takes seconds. See that right there?
Dr. Castellano:
Let me take a look at this. I love this for the syringes. Now, can I put this on my cell phone so that I can hold it on my cell phone too? No, I'm just kidding.
Dr. Lee:
It depends on your cell phone, right?
Dr. Castellano:
That's wonderful. Thank you so much for sharing that. Now, is it available for purchase yet, or where can they get ahold of this thing?
Dr. Lee:
It's actually available right here at the Aesthetic Show. Go to the Air-Tite booth. They're the distributor.
Dr. Castellano:
Air-Tite?
Dr. Lee:
Air-Tite, A-I-R-hyphen-T-I-T-E, and you can pick it up today.
Dr. Lee:
Another thing that we have that's different...
Dr. Lee:
Jen, can you bring our book? It's in my briefcase.
Dr. Castellano:
Let's take a look at the book.
Dr. Lee:
We talk about microcannula. Microcannula look just like needles, but they're not needles, because watch. It's not sharp at the tip. It looks like a needle. It's blunt on the tip, and it's got a tiny, little extrusion port at the tip to place your filler.
Dr. Castellano:
Yes.
Dr. Lee:
I'm the national trainer for one of the microcannula company that teach doctors how to do it. The advantage is, with the microcannula, we have 80 percent, in my experience, less bruising, less pain, less swelling, less tenderness, and so the microcannula in my mind has revolutionized what we do for...
Dr. Castellano:
I love the microcannula.
Dr. Lee:
...cosmetic injectable fillers.
Dr. Castellano:
I use them a lot. What do we have here?
Dr. Lee:
Oh, no, the other book.
Dr. Castellano:
The other book? Okay. That's a great book. We got another... We got too many books. We got to figure out... We've got a whole library we're going to show you.
Dr. Lee:
It's in the back pouch, yeah.
Dr. Castellano:
This is wonderful. While she's getting that, what is it that you love the most about the Aesthetic Show?
Dr. Lee:
It's a funny thing. I like the energy that's at the Aesthetic... That's it. I like the energy that's at the Aesthetic Show. If you go around here...
Dr. Castellano:
A lot of great energy here.
Dr. Lee:
Typically, you go through, and it's all the same thing that you've seen throughout the entire year. At the Aesthetic Show, you have people that are, like Dr. Rich here, at the cutting edge of everything.
Dr. Lee:
Hello.
Dr. Castellano:
Another joining in.
Dr. Lee:
So you get to look at people that are doing things that no man or a woman has done before.
Dr. Castellano:
It's true, it's true.
Dr. Lee:
Now we're looking... and this is how science advances. Science advances not with the on label. The off label begins first, and then people like Dr. Rich here and the people that are at the show, innovate. That's how we advance and find the newest devices, the newest safety treatments, the newest ways of regenerating skin.
Dr. Castellano:
We learn from one another.
Dr. Lee:
I learn a lot from my colleagues, because otherwise you're just very insular. Here's what, the most important thing I learn is that you don't know everything. If you think you know everything, you're wrong. What I get out of this is I get to find out all the things I don't know, and I try and bring back the little medical pearls to our shop.
Dr. Castellano:
That's so true. It's so true. The smarter we get, the more you realize you don't know. There's just so much to learn. Speaking of learning, wow, this is great. Tell us, the First Book of Aesthetic Microcannula. Wonderful. Tell us about this book. This is great.
Dr. Lee:
If you look here...
Dr. Castellano:
It's beautifully put together.
Dr. Lee:
Well, thank you. First of all, if you look at the cover, that's me, and that's my patient. My patient was the lead showgirl for Jubilee in Vegas, and the reason I picked her, it's not the usual medical text where you look at it, you go, "Whoa, what's this," right? She's my patient, so of course we used her. If you look through...
Dr. Castellano:
Do they put you in the Jubilee Show too? No, I'm just kidding, no.
Dr. Lee:
I was right next to you. Weren't you in the black leotards? That was you.
Dr. Castellano:
We were, that's right.
Dr. Lee:
I was in the pink leotards. When you look through, we have different techniques...
Dr. Castellano:
Very nice.
Dr. Lee:
...of what you can do. Here's where this book came from.
Dr. Castellano:
What a great book.
Dr. Lee:
Here's a before and after of a patient. See the difference?
Dr. Castellano:
You can see before and afters. You can see techniques. You can see mapping. This is a wonderful resource. How do they get ahold of this book?
Dr. Lee:
Here's the thing. What happened is, when microcannula came out, the first thing I did was I said, "Okay, let me get all the books on it and then I want to study it so I can be any good at it." I looked around, and I couldn't find anything. Nobody had written a book on aesthetic microcannula, so I said...
Dr. Castellano:
We have one now.
Dr. Lee:
I said, "You know, I've written articles, I've published in MedEsthetics, and I've published in PRIME Magazine in Europe...
Dr. Castellano:
Let's get that. There he is.
Dr. Lee:
I said, "Well, what the heck? I'll write a book." What I did was, I didn't want a prosaic, boring book. I wanted something that clinicians can use, you can look at the pictures...
Dr. Castellano:
It's practical.
Dr. Lee:
..and it doesn't have millions of words. You can look at it and then say, "Well, I can try that technique. That makes sense to me. Instead of injecting in one direction, if I'm crosshatching it, I get a better result. It's smoother, and I think it lasts longer, and I think it looks much more natural for the patient." We have different techniques that we're illustrating.
Dr. Castellano:
Wonderful.
Dr. Lee:
The same ones we're teaching right here at the Aesthetic Show.
Dr. Castellano:
Wonderful. Because you're only one person. You can either come see him live, or you can get his book.
Dr. Castellano:
Where can people find you online? Where's the best place they can find you? Do you have videos? What's the best way people can look you up and learn more?
Dr. Lee:
We were very lucky... This book here is on Amazon-dot... Amazon picked this up. Now it's on Amazon.com. If you do a search for "microcannula,"
Dr. Castellano:
"Microcannula."
Dr. Lee:
"M-I-C-R-O-C-A-N-N-U-L-A," this will pop up, because we're the only book literally, and then... We're fortunate enough that we're actually on their bestseller list for a tiny little category called medical procedures.
Dr. Castellano:
Congratulations.
Dr. Lee:
But this is a year later, we're still on the list.
Dr. Castellano:
Congratulations.
Dr. Lee:
I will tell you, to be up front, it's not Harry Potter. We haven't sold millions of books. It's not that kind of bestseller.
Dr. Castellano:
One step at a time. Let me ask you this question. This is all very wonderful, and I am inspired when I get to meet people like you and learn from you. It's just fun. You want to do more and be more, and so thank so much for what you're doing. Where do you find your greatest challenges are now? You've achieved so much. You're teaching. Where do you feel the biggest challenges are for you, Dr. Lee?
Dr. Lee:
You know what I find fascinating. I find it fascinating to try and find better ways of doing things. To me, it's fun. You look at something and you go...
Dr. Castellano:
It is fun.
Dr. Lee:
"Well, you know, that doesn't make any sense. If I pull back, it's crazy, or we need to have something that people can follow." I'm looking at it going, "Well, why hasn't anybody done something?" To me, it's a lot of fun trying to put together something that makes more sense.
Dr. Castellano:
Wonderful.
Dr. Lee:
It doesn't mean that what we do is automatically perfect up front, and so we have to adopt, but the challenge for me is actually learning new things and... In our field, I do minimally invasive aesthetic medicine. Our website is LookYoungerMD.com.
Dr. Castellano:
LookYoungerMD.com. LookYoungerMD.com.
Dr. Lee:
You can see everything out there.
Dr. Castellano:
Hi, Andrea.
Dr. Lee:
Hi, Andrea.
Dr. Castellano:
Hi, Joanne.
Dr. Lee:
Hi, Joanne.
Dr. Lee:
Here's the thing. To me, it's so exciting when we can look at a new way of doing something and make it better for the patient, and then we have a chance at the show to present our ideas and our actual results. I think the challenge for the future is going to be cell replenishment because right now I teach for Eclipse Aesthetic with PRP, but the future is looking... I don't know what you think, but I think it's going to be this.
Dr. Castellano:
I like harvested cell therapy. It's very promising. It's still developed, so I'm excited about that as well. Another question for you, what is something that patients can do right now, people who are watching, who are saying, "If I want to do something to look better or do something for myself," what's something they can do right now?
Dr. Lee:
It depends on where you're coming from. What I would do is I would look in the mirror... Here's the thing. It's not what you or I see that bothers us, it's what you see, as the patient, when you look in the mirror.
Dr. Castellano:
Absolutely.
Dr. Lee:
Something may bother you a lot that we don't think is a big deal, but it bothers you. The important thing to remember is when you're seeing any doctor doing cosmetic treatments, it's not what they want, it's actually what you want. Let them talk all they want, but forget about it. Any good doctor that does aesthetics, you have to go to what the patient wants.
Dr. Castellano:
It starts with the patient. It starts with what the patient wants.
Dr. Lee:
The first thing is look at yourself and say, "What bothers me?" If something else doesn't bother you and the doctor wants to do it on you, my position is, don't do it. Why spend money in doing something that you don't want to do.
Dr. Castellano:
It's so true. It's so true.
Dr. Lee:
Whatever bothers you should be the first thing. Our angle is doing minimally invasive. Basically, 99 percent of our patients walk in and walk out. You don't have the surgery. You don't have the scarring. You don't have all the pain and the anesthesia.
Dr. Castellano:
People don't want surgery today. They don't want surgery.
Dr. Lee:
My love is to do things where you can go back to work after you get something done. You don't want to go to the OR. You don't want to take the chance where something happens, but you still want to look your best. You don't want to take that kind of a risk. Now we have incredible technology that I never thought we could do this, where we can actually get very close to doing some of the things that could only have been done in surgery years ago. The future's going to be in how you combine these minimally invasive techniques together.
Dr. Lee:
Right now no one has that one formula, what is the best way of combining techniques, because there's so many techniques. Our challenge, my challenge that I'm looking at here is, how do you put together the best combination to get the best result, and we were fortunate enough, we've gotten recognition and some awards, and you have too. We both won the Aesthetics Award.
Dr. Castellano:
Yes.
Dr. Lee:
You know what kind of competition that is. There's his.
Dr. Castellano:
There it is.
Dr. Lee:
Let me tell you, this is hard to get.
Dr. Castellano:
We're so proud. We're vying for another one this year.
Dr. Lee:
I may enter this year. It's so incredibly hard to get that, because now you're up against the best of the best of the best. I know some very famous people that I think highly of, they haven't won yet, so they asked me, "How did you win?" I go, "Well, I don't know."
Dr. Castellano:
It's this right here. See this? These magic hands. Look at these hands.
Dr. Lee:
Yeah, but the competition for that is so intense. I'm proud to have colleagues that are able to perform at that level, because I will tell you, not too many people can. We all want to do our best. I get a lot of joy in making our patients feel good about them self. We go through life, and you can have the most horrible day, terrible things happen, and our chance is that you come in and I can make you feel better about how you look, and we've done that much to make the world a little bit better and to make you feel a little bit better. In my mind, that's worth all the trouble that we go through.
Dr. Castellano:
Awesome. I love it. I love it. What a humble man, works so hard, achieved so much. I'm inspired. Thank you so much for doing our interview today. Before we wrap up, we have to do our proper selfie technique here. We got one before, but we got to do one on camera, where we put this... You got to turn the selfie light on.
Dr. Lee:
Oh, you've got a selfie light.
Dr. Castellano:
Yes. Big smile; one, two, three, cheese.
Dr. Lee:
Okay.
Dr. Castellano:
Thank you so much. Wonderful. Dr. Lee, look him up. He's amazing. Thank you for joining us. We have more interviews soon.
Dr. Lee:
Okay, thanks, guys.
Dr. Castellano:
Thank you guys for joining. We'll see you soon. Bye.