Episode 73 - Dr. Niccole: As Seen On The OC Housewives, ABC, E and more!

Transcript

Teri Struck: I’m Teri Struck, host of Beauty Now, a weekly podcast of beauty of the inside out. We’ve done shows on lasers, lifts, lipo, breast augs, lab band surgery, self-esteem, lashes, Dr. Perricone on skin, La La Lips with Dr. Moelleken, The Happy Body, the Iso Cleanse, many of extreme makeover doctors, veneers, and also most importantly happiness from the inside, bringing abundance into your life and more. Today we’re going to talk about getting your glow back, filling in those crevices. How do you know when you need to go under the knife? Well I’ll tell you how you’re going to know. We bring you the top experts and today we have Dr. Michael Nicolle. Welcome Dr. Nicolle.

Dr. Michael Niccole: Hello. Thank you.

Teri Struck: Well Dr. Niccole, you’re a board certified plastic surgeon, correct, in New Port Beach?

Dr. Michael Niccole: Yes ma’am. Yup.

Teri Struck: Yes. So I think you know what we’re talking about. So, you know, when we’re looking in the mirror we’re looking a little tired and you see these kind of crevices and cracks and things. What do you do when somebody comes in to you, first of all?

Dr. Michael Niccole: You know, first of all you have to determine the age of the patient. You know, some of your younger patients, 45-50 and younger, just not ready for a scalpel yet, not ready for surgery. We have, you know, a lot of things that we can suggest. There are a number of fillers today, and, you know, I don’t need to go into detail on all of the fillers, but the work horses of fillers over years – well actually over the past two years, ‘cause they have changed – Restylane and Juvederm, they last anywhere from six months to a year. So those little folds from your nose down to the corner of your mouth, those are fillers. We can soften those areas with material that plumps you up. We can plump up the lips because as we get older, you know, not only genetically, but as we start to age we see the atrophy and the disappearance of our lips. So we can enhance those, enhance the cheeks. Now with the little lines that go across the eyes, crows feet in the forehead, we have paralytic agents that we can inject, and for six months you can lose the majority of the wrinkles in your forehead. And again, you can find a 25 year old that has overreactive muscles in the forehead and in the glabella that’s just above the nose. So those areas need to be weakened, the muscle. Now again, if I get a 50 year old and just needs a brow elevation and I’m elevating the brow, then I may take out some of these muscles, which will allow the patient to have more of a permanent wrinkle removal.

Teri Struck: So you actually take out the muscles. I mean how do you do that?

Dr. Michael Niccole: Well there’s two types. In the forehead, there’s the ones that go across the forehead and then the ones between the eyebrow. Those are really strong muscles on some patients, so we can either use Botox to paralyze them or we can make little incisions in the hairline so you can’t see the scar and we can come down there and pluck out some of the, remove some of the muscle that causes those wrinkles. It’s a contraction of the muscles. Just like when you flex your bicep your muscle contracts up and you see a bulge. Well the same thing you see under the skins surface in the forehead. It’s a contraction of the muscles, so you either remove the muscle or your paralyze it with a paralytic agent.

Teri Struck: And so what’s the difference between an endoscopic brow lift and a regular brow lift? So you’re talking about if you’re going to… You wouldn’t remove…

Dr. Michael Niccole: Yeah.

Teri Struck: Do you cut them or do you remove the muscles?

Dr. Michael Niccole: You can do both. There are a number of techniques that surgeons use. A lot of them can just cauterize, which means burn, but often times they’ll regenerate if you just do that. Now there’s two types of forehead lifts; one where you make a large incision about six, about six centimeters or, you know, a certain distance behind the hairline so you don’t see the scar. You then bring the scalp forward, elevate the brow so it’s in a nice arch form. And then at that time you can remove about 40, 50, 60 percent of the muscle of the forehead and in the frown area. Now if you do endoscopic, those are just basically smaller incisions in the forehead and through a little scope, a little microscope. You go under there and you visualize the muscle and you can’t accomplish as much through endoscopic as you can open. But you can remove some of the muscles, especially in the frown area. But the creases that go across the forehead horizontally are more difficult to remove via endoscopic. But, you know, if you’re very young, anywhere, you know, 20 with genetic brow ptosis or a drooping of the eyebrows, if you’re 20 to maybe 30, 35, 40, you might want endoscopic. If you’re 45, 50, 60, you may want a conventional brow lift. So you have to almost leave that to the discretion of the surgeon, let him give you the pros and cons, and then you can make an intelligent decision what the best procedure for you.

Teri Struck: What if a younger patient has had an endoscopic brow lift, can they then go…

Dr. Michael Niccole: Yes.

Teri Struck: and have a regular one afterwards?

Dr. Michael Niccole: Oh, absolutely. If somebody’s had a brow lift, even if you’ve had an open brow lift you can still have another open brow lift or an endoscopic. Now one of the drawbacks that is believed by a lot of patients and physicians, the endoscopic will not last as long as the open brow. And that’s usually the case in my experience. Brow, endoscopic brow may last, you know, 4, 5, 6 years, where a open brow will last 10 to 15 years. But again, when you’re young and you don’t want that large scar, most younger patients are going to elect to do the endoscopic.

Teri Struck: So that’s something to look at. You know, we’re hearing a lot about this liquid facelift. Can you tell us about…

Dr. Michael Niccole: Yeah.

Teri Struck: what is the liquid facelift?

Dr. Michael Niccole: Okay.

Teri Struck: Is that just a gimmick, you know, or….

Dr. Michael Niccole: Well yes and no. It is in a way because as we get older you’ll notice the cheeks start to drop, the cheek bones, the jowling. You lose, as we get older we lose fat and you get a fat atrophy…

Teri Struck: Just not at the right places.

Dr. Michael Niccole: Yeah, exactly. That’s the problem. But as we do lose fat we, you look at youths and they’re a little plumpier, little fuller all over from the lips to the cheeks to everything. And as we get older it starts to drop. So liquid facelift is just basically taking some of these fillers, whether it’s Juvederm, Restylane, your own fat. I use a lot of the patients own fat. I love their own fat because there’s zero, zero, zero rejection, you get about a 60 percent  absorption, but you do keep a good percent of the fat. So again, you have to present all these to the patient and let them make the decision, what kind of a liquid facelift do they want? Do they, nevertheless it’s just filling the face up back to a more plumpy more youthful appearance, from the cheek bones to the lips to the folds from the nose down to the mouth and what’s called the marionette lines, those little lines below the corners of your mouth that give you that sad look. So you’ll want to plump that all up. And that basically comes into the liquid facelift. Now you could also use… You know, Botox and these paralytic agents are liquid, so they can also dissipate or erase a lot of the wrinkles. So basically you’re talking about fillers and paralytic agents to help youthilize the face. Now there’s a whole gamma of lasers that are on the market now that are incorporated in rejuvenating the face. 10 years ago, 15 years ago, 90 percent of surgeons if the patient came in with premature aging, you’re going to get the scalpel, you’re going to get surgical rejuvenation. Today that’s dropped probably maybe 40 percent, 30 percent, and a lot of these are replaced by these liquid facelifts.

Teri Struck: Liquid facelifts and then the laser too, can you do that at the same time?

Dr. Michael Niccole: Yes. Yeah, absolutely. And lasers are phenomenal. The new lasers, I mean I’ve been using Co2 lasers for, you know, 25 years in my practice. Now the old laser, we’d come down with a beam and destroy the – not destroy but shrink up and burn the tissue in that entire that hits your skin. Today that same beam comes down and it’s like pixels on a camera or pixels on your movie, on your TV. So there’s little spots all over the screen or all over the beam that comes down; thus, every one of those little dots are burned, but right immediately next to the burn is normal skin. So what it tells you is there’s less damage to that beam. Say it’s a half inch beam, instead of the entire beam burning your skin maybe 40 percent of the skin is burned. Where, so it’s a little dot, and it’s a burn, normal burn, normal. So, and it goes deeper into the skin, so it stimulates collagen formation. So the new lasers for facial resurfacing, getting rid of skin damage, conditions, especially we live in California, in New Port Beach, I see patients that have lived on the beach all their life. And in Florida, you know…

Teri Struck: Me.

Dr. Michael Niccole: same thing.

Teri Struck: I’ve lived on the beach my whole life, and I have to say, I’m a laser addict. I will go over to the Monicaya Beach and then come back and do Fractal or one of those. I love them.

Dr. Michael Niccole: Yeah.

Teri Struck: Love them.

Dr. Michael Niccole: Oh I love it. It’s probably, it has made my facelifts today superior to the ones that I did 10 years ago. ‘Cause I combined them a lot, I’ll do… But I combine my liquid facelift and my facelifts and my lasers, all of those combined, depending on the patient. Now not every patient will need all of those, but I use… I mean I think the key to going to an artist is making sure the plastic surgeon is an artist, and there are a lot of them all over the country from New York to Florida to here, so you know, call your American Society of Plastic Surgeons and, you know, find out who the board certified surgeon is in your area and see a consult because it’s amazing what we have to offer today. Technology continues and continues to change. We have even, you know, radio frequency lasers now that are good for cellulite. In the past, you know, we used Dumage and all kinds of different lasers and massaging; you name it and they’ve tried it, from chemicals to drugs. But I think that the real key in the future and right now is going to be in the forms of lasers that, the radio frequency lasers right now for decreasing cellulite.

Teri Struck: Well I want to talk about that, and we’re going to have to take a commercial break.

Dr. Michael Niccole: Okay.

Teri Struck: I do want to hear more about the lasers on cellulite because nobody likes cellulite. A lot of good information and we’ll be right back with Dr. Niccole. We’re going to take a commercial break for personallifemedia.com.

Teri Struck: I’m Teri Struck with personallifemedia.com and this is Beauty Now. We’re talking with Dr. Niccole. He’s going to keep us young. Welcome back Dr. Niccole.

Dr. Michael Niccole: Thank you.

Teri Struck: We were just talking about, you left off talking about cellulite.

Dr. Michael Niccole: Yeah, we were talking about cellulite and the different lasers that we utilize in our armament as plastic surgeons. It’s just, I mean it’s not unusual today for a plastic surgeon to have 10, 12 different lasers or a specific company that has a laser that does 5 or 6 different things. The thing that we last talked about was cellulite. And again, I’ve been fighting with cellulite as, you know, 80 percent of the women in the United States for the last hundred years and…

Teri Struck: Well even skinny women get cellulite. Even fit women get cellulite. It’s something you have to keep up on. So what’s the weapon here?

Dr. Michael Niccole: Well definitely good health, exercise, hydrating yourself, not getting overweight. Overweight has a tendency to show a little more, but nevertheless it’s one of those things that eventually we’re doomed.

Teri Struck: Finally a doctor that says the truth. It’s really true. I really do believe that these lasers can work if you do your part, exercise. When I’m going to step class and when I’m doing all my stuff, I have to say those lasers are amazing. They’ll have no cellulite. But if I start to get out of shape and don’t do my part… You got to do your part; I think that’s the thing.

Dr. Michael Niccole: Absolutely, absolutely. I see patients that come into my office all the time and, you know, 50’s, 60’s, a great shape, good hydration, hopefully not smoking. You see, you know, you’re going to see it, but much less than their counterpart, friends and other patients that are even in their 30’s that are overweight and don’t exercise, drink a lot, smoke a lot. So it’s multi factorial. It isn’t just one ideology. There’s many things that are the culprit. But nevertheless, I think breaking technologies are definitely in the laser world. And there’re different ones. They’re working on them and next month there may be a new one. Radio frequency is breaking some hurdles right now and I’ve been very impressed with the results.

Teri Struck: Which one do you have in your office?

Dr. Michael Niccole: We have a number, I mean we have a large number of lasers and there are a large number of manufacturers, so I don’t like to push one manufacturer…

Teri Struck: No, I don’t either. I just was trying to maybe give our listeners some… Because there’s people all over the country. Like what could be one that they could look for?

Dr. Michael Niccole: Well they would have to ask, because it wouldn’t, like if I had a particular brand and another doctor across the street had another brand, I think it’s the… you have to talk to your plastic surgeon and ask him what he’s utilizing. You know, is he using radio frequency? You know, next month there may be a new laser coming out that’s better than the radio frequency, so….

Teri Struck: Right, it does change all the time.

Dr. Michael Niccole: Oh my gosh, you have to have, you have to keep up yourself, but you can, you know, Google ‘cellulite’ and see what’s the best, you know, in your opinion. You know, like I say, I’ve tried everything for years and years. I’m impressed with the new lasers, and there are new ones on the horizon, but, you know, I don’t want to comment on because they haven’t had double blind studies yet and we’re still, we’re still learning, but you’re going to see a lot of new technology within the next probably year.

Teri Struck: What about your skin on your body, ‘cause I mean, you know, cellulite we’ve been hearing about, but I mean I’ve heard very little about what can you do for your arms and your legs…?

Dr. Michael Niccole: Again, back again to, you know, from peels, which are chemicals. If you have a plastic surgeon that has a good aesthetician, they have the capability of utilizing different chemicals on your body to tighten and lighten the skin. And again, it depends on, you know, what’s wrong with your skin; do you have a lot of freckles, sun damaged skin like you do on your face? There are lasers. I mean fractional lasers are used throughout the whole body today. It’s not just, you know, in the old days we just did chemical peels and lasers of the face, but today, you know, if we have discoloration in the arms, we have lasers. If you start to see aging and loss of fat, we have fat transfers that we put in the hands that rejuvenate the hands. So I think, you know, depending on what bothers you the most, you should visit, you know, a good board certified plastic surgeon and at least get a consultation and see what they have to offer you.

Teri Struck: Well, so usually if you go to a plastic surgeon they don’t offer all these things. It sounds like your practice, CosmetiCare, does offer all these things.

Dr. Michael Niccole: Yes. Yeah, and again, it depends on the pathology. When a patient comes in to New Port Beach here in O.C. – we call it O.C., Orange County – but when they come to California into our facility, we have a multi disciplinary team. I mean we have a team of people that do lasers. We have a team that does skin care. We have, you know, a eurogynocologist for, you know, vaginal type of surgery. We have a gastric band. So we have probably the best of the best. I mean…

Teri Struck: Just come check yourself in and come out a new person.

Dr. Michael Niccole: Well that’s what I like about a facility that you can go to. One facility and hopefully get everything evaluated and looked at, because again, there, you can have two 45 year olds and one has perfect skin and has a little liposuction she needs in the neck and that’s all, where her best buddy who laid on the beach for the last 10 years needs laser resurfacing. So you can’t really generalize; you have to individualize. You can’t categorize everybody needs laser or everybody needs lipo. If you have a good honest plastic surgeon I think you could, you know, you’re going to get evaluated and he’s going to tell you what the best modality, whether it’s a laser, whether it’s a filler, whether it’s a combination, and he can educate you.

Teri Struck: I think that’s the only really true thing about Nip/Tuck is that when they come in they’ll say “What don’t you like about yourself”, ‘cause that is true. It has to be that question: “What don’t you like about yourself?”

Dr. Michael Niccole: Really, really, really. Yeah, that’s really, really true. And you should get on websites. I mean I know ours is, you know, cosmeticare.com, but find a – and you can get educated there and start there with our website. But if you’re in Florida or if you’re in, you know, Montana, I mean there are a lot of good surgeons all over the country. So, you know, evaluate your website. You know, I’m sure if he has a nice website, that’s indicative of the type of work he does and he’ll, if he’s proud of his work he’s going to show you his work….

Teri Struck: Well and you mentioned something that we mention on every show. And go to personallifemedia.com and of course go down the Beauty Now list. All of our doctors are board certified. We try to pick the top experts, and we’ve actually turned down some people we’ve done research on for shows. And you brought up a really good point; make sure that they’re board certified in plastic surgery if you’re going to have a plastic surgery, you know, procedure.

Dr. Michael Niccole: Yeah, exactly. ‘Cause everybody, don’t forget, everybody calls themselves plastic surgeons.

Teri Struck: Right, ‘cause they call themselves cosmetic surgeons and…

Dr. Michael Niccole: Yeah.

Teri Struck: they can go to a weekend course, ‘cause if you ask if they’re training – and there’s lots of great doctors – but if they’re an internist or a dentist, you don’t want them doing your breast aug.

Dr. Michael Niccole: Yeah, exactly. Yeah, I totally agree there. Where, you know, it took me 12 years of training, you don’t want some guy that’s just got out of training, you know, on a weekend course to liposuction your body. I mean that’s, it’s an art along with a long learning curve.

Teri Struck: You want someone that actually went to school for that.

Dr. Michael Niccole: Yeah.

Teri Struck: So, and I want you to know, I booked you Dr. Niccole and then I turned on Orange County Housewives, ‘cause of course I’m from Orange County. And I saw the beautiful Alexis Bellino – is that how you say her name, Alexis Bellino?

Dr. Michael Niccole: Correct.

Teri Struck: And you were working on her. She looks amazing.

Dr. Michael Niccole: Yeah, very, very… And you can see her when you see her on TV, a very fit, fit lady. I mean…

Teri Struck: Oh, she makes me want to run back to the gym.

Dr. Michael Niccole: I know. Every time I see her, you’re exactly right. And I, you know, I hired her as a, we’ve become partners basically in my office, and she works as a consultant here, because she is so wonderful. I mean, just unbelievable. I mean everybody looks at her and…

Teri Struck: She looks amazing.

Dr. Michael Niccole: With a number of kids she has…

Teri Struck: And I hate to tell you, I have that same bathing suit, so tell her I hate her.

Dr. Michael Niccole: Do you really?

Teri Struck: I do.

Dr. Michael Niccole: I’m sure you look equivalent to her…

Teri Struck: I’m trying to keep up.

Dr. Michael Niccole: I’ve seen you before; you look fabulous.

Teri Struck: I’m trying to keep up, but I was dying, she had the same bathing suit.

Dr. Michael Niccole: Yeah, that’s funny.

Teri Struck: I was laughing, but yeah, no that was really funny, and she does look great. She does look great, but you know what, everybody can look great and everybody can feel good about themselves, and I really admire people too that don’t really care. You know, they don’t care about that, but if they’re listening they obviously care today, so…

Dr. Michael Niccole: Right. And I think an exciting part of my practice is because we do have Alexis as a consultant for patients that come in that want that type of a consultant to evaluate her about fitness, about beauty and what she would recommend. So there are a number of patients that feel that important. And we have, you know, patient coordinators that have been with me for, you know, 15 and some 18 years, so we have a variety of different types of consultants in our office that patients can come in to and get a wonderful consultation done.

Teri Struck: Yeah, and you have to feel really good with your consultant, and I think that you have to go in and have a repertoire and feel like you can say your worst thing and they can say, you know, whatever the procedure is. And aren’t, consults are usually free, aren’t they?

Dr. Michael Niccole: They are. I know with Alexis, they’re not. But with the other consultants in our office, they are free. But with Alexis, she charges a fee. But again, you have to understand that once you bond with one of your consultants you end up being like almost a friend with them because, you know, you will see me and then you’ll see me in surgery and then you’ll see me, you know, a couple, two or three times after surgery, but your correspondence and your repertoire with your consultant is far deeper and greater and longer I think… Not greater, but equal to your physician.

Teri Struck: I think it’s important too if you feel like they’re telling you the truth, the absolute truth. Like it would be great if they say, “You know…”, ‘cause I have girlfriends that will tell me that and I’ll say, “I don’t think you need it” and she goes into the doctor and he’ll say “I don’t think you need that”, and that’s important too.

Dr. Michael Niccole: Yeah.

Teri Struck: You get the Michael Jackson syndrome. You see people, what do you do for people that are just doing too much stuff? That’s the other problem.

Dr. Michael Niccole: Yeah, you really have to, I mean ethics wise you have to turn those away. I mean it’s not that you can’t do – I mean there’s a lot of people that would like to… Take, you know, Michael Jackson for instance, and I would’ve loved to correct his nose. I mean they kept taking more and more and more and more away where they should’ve added to. So I think an ethical surgeon has to know when to say no. I mean there’s some people where they’re…

Teri Struck: You know, what happens with that, I mean that is what’s really scary is that they don’t…

Dr. Michael Niccole: Yeah, you see it all the time, it’s just too many, too many surgeries. You know, you fall into that web where, you know, the money’s there and the patient wants it and, you know, that goes along with drugs and, you know, wanting surgery. I mean a physician ethically has to say no at the time when he truly feels it’s going to be harmful to the patient, and it’s his obligation to say “I’m sorry, you’re not a candidate.” I mean we turn away a number of patients every month. You just have to do that.

Teri Struck: And if you’re turned away, be happy. That means you look fine. You don’t need that procedure.

Dr. Michael Niccole: Yes, that’s true.

Teri Struck: We’re running out of time, I can’t believe it. I can talk to you forever. So we’ll have you back. And you can go to personallifemedia.com and we’re going to have all Dr. Niccole’s links. You’re going to be able to find his CosmetiCare practice. And you can find Dr. Niccole in New Port Beach, and you can find him on our website. And go get a free consultation from his office. It’s anything that you need, and if you don’t live close and you are in the California area you can just drop in and he’ll take good care of you. If not, look on your websites for board certified plastic surgeons, dermatologists, whatever procedure that you’re interested in, and check out Beauty Now’s shows. We have so many shows and so many great doctors. Thank you again for being with us, and we’ll have you back.

Dr. Michael Niccole: Thank you very much everybody and Teri. I appreciate it.

Teri Struck: Thank you.