Beauty: Discussing Skin-Saving Strategies with Dallas's Own Dr. Teotia...

One thing I'm learning is that "aging" starts from within us. Happiness may very well be the secret to long-lasting beauty & good looks, and stress is likely one of our greatest foes. Sadly, no amount of yoga can give us a truly stress-free existence and that big bright sun up above is determined to dash any hopes we all have of baby smooth skin forever. So... what's a beauty-loving girl to do? There are choices we can make from a young age (think: childhood & teen years) to preserve the physical beauty with which we are all born to enjoy. There are also decisions we can (and should) make as adults to put our foot down when it comes to lagging skin and a dull complexion. 

You've likely noticed I've been ramping up the sheer number of beauty posts here lately. It's definitely a passionate topic for me as I feel we are very much in control of the impact our lifestyle choices have on our appearance. Adding daily exercise, fresh greens and a clean diet will definitely give you a more radiant complexion and more energy. Drinking abundant water will keep you hydrated and balanced. Being happy will visibly show on your lovely visage. Sunscreen, while not sexy, will prevent you from prematurely aging. All of these things will help - and you should be doing every one of them. 

What we can't do, however, is stop the clock. But perhaps... perhaps we can at least slow it down a bit with the right topical products and in-office professional treatments.  

I've been holding back on kicking up my skin care regime until I felt I found the right skin guru to help me. Peels, microdermabrasion, injections... they can all seem a bit "out there" if you've merely been dipping into the day spa facial services all your life. For me, this is all about trusting the right professional to guide me to the right choices and help me choose appropriate products. And then... I met her. She completely changed my mind about upgrading my skin care and putting regular chemical peels on my calendar. Who is she? Dallas's very own Dr. Stephanie Teotia. And she's amazing. 

I sat down with the lovely Dr. Teotia to talk about face-saving strategies, advanced skin care products and a range of in-office beauty treatments. How often do I have an opportunity to ask a Board Certified Plastic and Reconstructive Surgeon how she keeps her clients looking fresh, the "Golden Mean" and why we're so obsessed with those Kylie Jenner lips? Not often enough. Thus... I jumped at the chance to tap into her wisdom on our youth-obsessed culture and how we can indeed age gracefully and appropriately. 

This, dear friends, is what I learned:   

Dr. Stephanie Teotia


Dr. Stephanie Teotia

Dr. Teotia, you began our conversation with a discussion of lifestyle choices (smoking or non etc) and skin care. How much do those factors influence the condition of the skin and one’s appearance?

Lifestyle makes a huge difference in regard to appearance. I encourage my patients to exercise, eat nutrient rich foods, and take time to reflect. We know that smoking is harmful to our bodies. Smoking accelerates aging of the face and skin. Smokers are often not candidates for large cosmetic procedures. I saw a woman this week who was a great facelift candidate; however, she is an active smoker. Operating on her would be inviting wound healing problems. I love when patients stop smoking in order to have surgery! They both look and feel better.

At the practice, we try to practice what we preach. We have an outside vegetable garden growing near our clinic front door. We recently opened our location and have discussed having weekend yoga classes in our “clinic home” backyard.

The “Holy Trinity” of topical skin care seemed to include Sunscreen, Retin A (Trentinoin), and a skin lightener. What are the benefits of each?

I love the "Holy Trinity" term! Consistent use of a sunscreen is the simplest (yet most important) part of a beauty regimen. We all love a bronzed look; however, sun damage causes loss of skin elasticity resulting in wrinkles, sun spots and skin cancers.

Retin A (Trentinoin) is one of the few scientifically proven topical creams that rolls back time at the molecular level. Retin A acts by decreasing fine lines. It creates a smoother skin texture and helps to diminish brown spots. In Texas, Retin A is a prescription product which is dispensed by a pharmacy. Retinoids are the less potent cousin to Retin A and can be sold without a prescription. Retin A can cause skin redness and flaking. A patient should work with a health professional to adjust the strength or frequency of use.

Hyroquinone is a very effective skin lightener and is also a prescription product. It acts on the cells that make pigment to give an even skin tone. Hyroquinones are frequently used in the United States and are deemed safe by the FDA. However, the safety of hydrquinone has been disputed and use is banned in some countries. There are excellent natural alternatives to hydroquinone, including arbutus (from the bearberry plant), kojic acid and licorice root.

Both Retin A and and most skin lighteners make skin “sun sensitive” which is even more reason to use a sunscreen. I offer SkinMedica products in my office. I would encourage your readers to consider prescription products sold from a physician’s office. It is unfortunate that you can easily spend $400 on a jar of beauty goop at department stores. {Editor's note: she's speaking directly to all of us - or perhaps just me - with that one, isn't she? Oh, if I could recoup all the money lost an department store beauty counters... likely enough for a trip to Bali!}

Prevention is clearly the best cure. Sunscreen being the main factor in preventing visible signs of aging. What other products do you wish young patients would use and when do you recommend we all begin a regimen of the above three active ingredients?

Great question Franki. Rather than starting a specific product, I wish some products were banned. Specifically tanning beds. I realize some people "feel better" with UV light. However, it takes too much of a toll on skin. Regarding products, Vitamin C serums are great for younger (and older) patients as long as they do not have acne issues.

Sunscreens should be started in early childhood. Speak to your child's pediatrician regarding specific products and timing. Retin A is sometimes prescribed for acne and thus started at a young age. For aesthetic purposes, I would consider Retin A and a skin lightener in your 30’s.

Let’s talk treatments beyond topical. You are known for your very subtle technique when it comes to fillers and other injectibles. Describe your aesthetic approach and your philosophy on helping each patient look his or her unique best?

I first assess whether or not a patient is a surgical candidate. This decision is mostly based on the individual patient’s goals. We all see things that bother us when we look in the mirror. My main objective is to determine how to effectively and safely address the patient's concern. Facial soft tissue fillers (which increase facial volume) and neurotoxins (such as Botox) are a great alternative to surgery in the appropriate candidate. I am a bit unusual in that I do my own facial injections rather than having my staff do these procedures. Soft tissue fillers and neurotoxins are a great way to look refreshed. Unfortunately patients can appear overfilled. My philosophy is, “Less is sometimes more.” I tell patients that I am not doing my job correctly if anyone asks her or him, "Who is your plastic surgeon?" Results should elicit a response but be subtle. Instead patients should be asked, "Did you change your hair or go on vacation?"

You are a Board Certified Plastic and Reconstructive Surgeon. Could you share with my readers why that professional distinction is an important one to them?

Absolutely. Too often physicians will take weekend courses on performing liposuction or other procedures and then claim to be a Cosmetic or Plastic Surgeon. It is no wonder that there are a lot of bad results out there! A Board Certified Plastic Surgeon has completed an accredited residency training program; the current minimum is 6 years of surgical training after medical school. In addition, once in practice,the Board Certified Plastic Surgeon must pass rigorous written and oral exams. Every physician has different talents, abilities and beside manners.

However, certification from the American Board of Plastic Surgery (ABPS) should give a patient a significant degree of comfort.

What do you wish new (or potential) patients knew about Botox®, Restylane® and other treatments? Are there common misconceptions or frequent questions you’d love to address?

Patients have often heard of Botox. However, they are not sure how it works and are concerned about safety. There are three neurotoxins on the US market at this time. These include Botox, Xeomin and Dysport. I use all three in my practice. Neurotoxins act by paralyzing the facial muscles that cause wrinkles. I only use these products in the upper third of the face (forehead, crows feet, between the eyes and to elevate the eyebrows) for aesthetic purposes. The product lasts for 4-6 months. Neurotoxins can also be used for excessive sweating of the hands or under the arms.

Facial soft tissue fillers are injected to recreate facial volume and harmony. The vast majority of the products that I inject are hyaluronic acid (HA) based. HA’s are naturally found in your body but also naturally break down in time. Thus, the fillers are temporary and last between 6 months to 2 years. It is fairly easy to inject these products. We use a numbing cream on the patients face, and injections are performed, in clinic, with the patient awake. I use different products in different areas based on the thickness and properties of the filler. Injections can fill in hollowing of the temples, cheek volume loss, tear troughs, nasolabial folds, pre-jowls — to name a few. It is pretty amazing how you can subtly change the structure of the face using these fillers. Make sure that your injector has significant experience.

Dr. Teotia, much like our prized relationships with personal hairstylists it seems that a long-term relationship with a Board Certified Plastic Surgeon would yield the best results. Building the relationship over time develops a deeper understanding of the patient as well as provides a trusted medical professional to turn to for medical needs beyond beauty treatements. Do you find this to be true? 

Absolutely. You can often create a timeline with the patient regarding future treatments or procedures. The relationship often expands to other family members as well. You repair a laceration on their child's face or perform their mom's breast cancer reconstruction. 

Botox® seems unique to me in that it can (and perhaps should) be used preventatively. Would you share with us the long-term benefits of using Botox® (and similar products) before those pesky signs of aging begin to appear? 

When you paralyze a muscle, the muscle begins to waste away (similar to not exercising). It is movement of the forehead muscles and muscles around the eyes that cause lines in the upper face. In time, these lines become etched wrinkles that are present without muscular animation. Recurrent use of a neurotoxin in the upper third of the face helps prevent these lines from forming. However, the injector must know which muscles to paralyze and which ones to avoid. Detailed knowledge of facial anatomy is needed for the best result. 

Lip treatments are popular, and celebs like Kylie Jenner are fueling our cultural desire for fuller lips. What can you tell us the treatment and patient satisfaction?

I see a number of younger patients that want full lips. Other than breast augmentation, this is probably the most popular procedure on my 20-something patient age group. Older patients just want their lips back! Part of facial aging is elongation of the upper lip with turning in of the vermillion (the red part). Time causes you to lose your upper lip.

There are several ways to augment lips. Some options include silicone implants, fat injection, and placement of an acellular matrix sheet. I pretty much stick to injections with a hyaluronic acid based filler. The fillers are soft and can give a very natural look. I tend to be conservative - especially if the patient has not had lip augmentation before.

I spent a year operating on the lips of cleft patients during my Pediatric Craniofacial Fellowship. I learned that there are natural ratios to the size and projection of the upper and lower lip. Once these ratios are unbalanced the eye knows that the lips look “fake” or often duck-like.

It seems to me that our culture is fighting the signs of aging earlier than perhaps our mothers did. What tips can you offer readers for determining if it’s time to begin considering stepping up their skin care program by visiting a medical professional like yourself?

We maintain our cars. We update our software (it seems like continually). Why should it be a big deal to work on ourselves? There is a spectrum of treatments for different ages and goals. Protect your skin when young, and seek professional advise when signs of bothersome aging appear (note the word bothersome).

Your office! Can I just way how attentive and warm your staff and the environment is? I love that you are in a freestanding building and not in a hospital. What guided your decision to locate your practice in it’s current location?

I wanted patients to feel like they were at home or at least hanging out with good friends (who also happen to be qualified medical professionals). I checked out numerous options in the Dallas area. I was put off by parking issues and confusing medical campuses. Our "clinic home" affords patients both privacy and ease. Hospitals (my hospital privileges are at Baylor facilities) serve a great purpose. I always operate on larger cases in accredited facilities.

Is there anything else you’d love to share with my readers? We are eager to glean any wisdom and professional insights you can offer!

It is important for patients to know that I am a mom, wife and caregiver. I'm the one unloading the dishes in the evening (not that I want to)! As a female plastic surgeon, I feel that I can relate to most issues or concerns that my female patients express. The best part of my job is feeling like I get to know my patients well and knowing that they feel good about how they look and feel.

Also, I recently moved my plastic surgery practice to Dallas and I have to thank many people in the medical community for being so welcoming. Specifically, prior to his recent death, Dr Byron Brown gifted me his patients, phone number and his amazing nurse. Dr Brown was the Chairman of Plastic Surgery at Baylor University Medical Center for about 30 years. I am honored to try to follow his footsteps.

Beauty really is from the inside; however, it never hurts to look good on the outside as well. Investigate your physician and proposed treatments. If something doesn't seem to be right or fit your goals, then seek a second opinion.

PROFESSIONAL SKIN-SAVERS

A few of the SkinMedia products she offers that I'll be switching to:

So much knowledge and if you noticed - her preferred weapons against signs of aging are all tools YOU have at your disposal: healthy living, exercise, a positive outlook on life and SUNBLOCK. I can't stress sun care enough as it is near and dear to me. 

As mentioned above, Dr. Teotia's office is not in a hospital. Instead, she and her amazing staff have a freestanding building with ample sunlight and a terrific vibe. I was impressed with their selection of skin care products and, frankly, every touchpoint of her practice. She's rallied a great team of attentive employees who all seem to truly enjoy what they do. It seemed fun to tap into their world as well and give you their side of the skin care experience. 


Here's what Michelle from Dr. Teotia's team had to share: 

What is a typical day at Dr. Stephanie Teotia’s office like?

Our typical day consists of a busy schedule of consults, minor office procedures and Surgeries at our various facilities: Baylor University Medical Center, Baylor Surgical, Baylor Uptown, and Valley View.  

I am not only the Patient Coordinator, I am here Marketing Manager.  I work with the website developer, Facebook, RealSelf, as well as market around the Dallas/Ft Worth Metroplex.  Being as though we are new to this area I really try and market to other Surgeons, Dermatologists, OBGYN’s to get our Name and Business out there.  Also Bridal Boutiques, Hair Salons (Mens and Womens), Jewelry Stores, and even Restaurants and Retail.  

I discovered Dr. Stephanie via RealSelf.com. They seem to be dominating Google at the moment, so I'm guessing I'm not the only one! 

We are going on month 3 of RealSelf and are seeing a large amount of inquiries from the site. We stay active on it answering questions and posting before and after photos, as well as post offers on there as well.

Dallas girls (and boys!) are very into beauty treatments! What treatments performed at the office seem to be trending right now? 

We are always trying to stay up with the “latest trends” and right now we are offering a New type of procedure called the “Weekend Augmentation”: an outpatient procedure done under local, where you inject saline solution directly into the breasts for instant volume and enhancement.  It is virtually painless and gives the patient a temporary look for a Night out, Red Carpet Event, Wedding, etc.  It lasts 24-48 hours and right now we are offering a Special - for $1500.  It is a NEW and exciting procedure and Dr Teotia is one of the only Surgeons in Dallas offering it.  

Other than that, Breast Augmentations, Body Contouring, and Facelifts are always trending. Quite possibly our most popular surgeries. We also have a lot of patients come in for Botox, Fillers, and Chemical peels.  

I was impressed by the skin care products you offered. Which lines does the doctor recommend and which products seem to be the most highly prized? 

We carry SkinMedica, a great line that helps to refine pores, smooth and diminish wrinkles, and brighten & lighten dark pigmentation in the skin.  Many of our products include growth factors that helps build healthy collagen in the skin. 

I loved everything about my visit to your sunny office! Dr. Stephanie has a way of putting you at ease right away. What do patients seem to love most about her and the results she produces?

Dr. Teotia has a large, loyal patient following from Midland (where she practiced for a over a year)…and we love to have patients visit us from all over.  Not only those patients but ALL of our patients always give us a lot of feedback regarding the practice and state things such as “it is so inviting”, “it is so homey”, “i love how it doesn’t feel like a medical office” etc.

It is very nice to hear all the positive feedback.  

Is there something offered by Dr. Stephanie that you wish more patients (current, new or potential) knew about? 

One thing we really push on our end is the fact that Dr. Teotia is a FEMALE Board Certified Plastic Surgeon. We find that a lot of our patients come in stating that they found us on the internet by searching “Female Surgeon”….It is a breath of fresh air for our patients to meet Dr. Teotia and see that 1. she’s extremely personable, 2. she is FEMALE 3. she’s a mom and can relate to other women. {Editor's note: I agree! Standing face to face with another mommy was comforting and I instantly knew she "got it" when it came to my questions and concerns.}

It has to be fun seeing smiles on faces all day. What do you love most about your job? 

The thing I LOVE most about my job is meeting patients from ALL over with different ethnicities, backgrounds, cultures, etc and help them to change their lives…..give them confidence and put a smile on their face….I love the Medical Field (especially Plastic Surgery) because it is constantly changing and NEW and modern techniques are always coming out.  I believe in empowering people (especially women) and I am so blessed to be a part of Dr Teotia’s practice.  I feel we can be one of the BEST in the Nation :)


Suffice it to say I'm convinced. I am also actively planning out my peels and upgrading to better products - pronto. Thanks to this introduction I'm also no longer afraid to ramp it up and take preventative care much more seriously. Retin A is a must and those peels are sure to help kickstart my "get fresh-faced" program. Dr. Teotia's advice on skin care and lifestyle choices really hit home for me, as they are exactly in line with my personal beliefs and way of living. If you're still sitting on the sidelines wondering if you should step it up - the answer is yes. Start wearing sunblock immediately and find a highly qualified physician like I did to talk about stepping up your face-saving game. Your future self will thank you! 

(Editor's note: for those interested, Dr. Stephanie's profile is on RealSelf and she can be found directly at her web site. As I discovered, you don't need to be seeking plastic surgery to see a physician for your skin care. And yes, I love that she's a female and "gets it" when it comes to our girly concerns! Plus, who better to trust for chemical peels and other in-office treatments than an expert? If you are in Dallas, her office has SkinMedica products for sale right at the front desk. Swing by & say hello!)