What a consultation at Medispa Maui really looks like!

Added: 2026-05-07

[00:00:09]All right. So, when I have a new patient come in or someone that hasn't been in a while and we're doing a cosmetic consultation, I like to talk about essentially what's happening as we age and what we can do about it. To do that, I have created these concepts of what I call the fourdimensional aspects of aging and the six pillars of rejuvenation. And the four-dimensional aspect of aging is really just what's happening as we age. And then the six pillars of rejuvenation is how I categorize the various treatments that we can do to help with this darn aging process. All right, so let's jump into that and let's talk about this four-dimensional aspect of aging. So what I mean by that is that like I said, we age four-dimensionally. From a three-dimensional standpoint, we age from the bone all the way out to the skin. So someone often will come in and see me and they'll be pointing out various things that are bothering them.

[00:00:57]Mostly superficial. So they're looking at more of a two-dimensional aspect of aging, but I'm really thinking about what's going on from the bone all the way out to the skin. And then also that fourth dimension like I mentioned.

[00:01:07]Firstly, we have the bone which is aging. For instance, the openings of the eyes get bigger. The jaw angle flattens.

[00:01:15]The ramis of the jaw narrows and thins.

[00:01:18]So this is all happening as we age. The next layer out is the deep fat pads. And these also age and as we get older and what happens with them is they atrophy.

[00:01:28]They thin. So we've got the bone thinning, we've got the deep fat pads thinning. The next layer is the muscle and connective tissue layer. In certain areas that can actually thicken as we age, and that can lead to more dynamic lines and wrinkles in certain areas. And in other areas such as the midface and the submental region kind of below the chin here, those muscles can actually thin and result in sagging of the tissue. The next layer out from there is the superficial fatty layer and it too can thin as we age and that can affect the texture of the skin. And then lastly, we have the skin itself which is composed of the dermis and then lastly the epidermis and that's all going to reflect in a more aged look. So when we add all this together, you know, we're often going to see the tissue that's going to fall in, down, and forward, and that's a result of that volume loss. And then we're going to get more of those superficial changes, too. Now, that's a three-dimensional way of looking at aging, but I said we age in a four-dimensional manner. So, what is that? Why why do I say we age in a four-dimensional manner? Well, that's because we're aging on a cellular level.

[00:02:29]And the cellular level could, of course, it's in this area that we're we're mostly looking at, but it's actually the cells of our entire body. And because we're aging at a cellular level and because all the cells in our body are aging, that also means that the cells that make our hormones are aging too.

[00:02:42]And that's going to reflect in actually what's causing this aging process. So the changes in our hormones are actually what's causing that three-dimensional aspect of aging that I just discussed.

[00:02:54]So we like to consider that too. That takes me to the six pillars of rejuvenation. So let's jump into that first one. I just kind of mentioned that that we're aging on a cellular level and we're aging on a hormonal level. That's that fourth dimension of aging. And so we want to consider that and that's what I call functional medicine. Well, I don't just call it functional medicine.

[00:03:12]That's what's called functional medicine. That is approaching the body from a functional medicine standpoint.

[00:03:17]On the other end, we've got surgical interventions. So there are certain things that are going to do best with surgery. The more laxity people have, the more heavy, droopy skin, whether that be over the brows, under the brows, or down in the lower face, or a lot of laxity in the neck. So, this is an area where we might consider surgical interventions as a optimal treatment.

[00:03:36]Now, a lot of people don't want to do surgery, or maybe they're not a candidate for it. They don't want the downtime of surgery or maybe it's a bit expensive for them. So, there are other options that we consider, and that's where the four minimally invasive pillars of rejuvenation come in. They include neurom modulators. We often hear of Botox. Then we've got contouring agents like fillers. And then lastly, we have energy modalities. And then we've got optimal skin care. Can use various skin care products like antioxidants, growth factors, vitamin A, peptides, and exoomes and to help stimulate that collagen process, the elastin production. All these things can be done together to help optimize how you look and feel. These are the kind of things that I like to review with my patients when they come in and so that we can get a game plan going and then from there we create a individualized customized plan for that patient. So I hope this gives you a level playing field and an idea of what we can do to help you look and feel your very best.