That is such a key point, because one of the ways that I've learned that we can really help people boost their self-esteem is helping them realign with the reflection that they're seeing in the mirror.

So when we do esthetic work ethically, elegantly, conservatively, and we help the patient look in the mirror and say, yes, that is me, that's me. That is the true beauty of helping people boost their self-confidence.

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Hello, hello and welcome back to Double Down with Doctor Dee. I'm Doctor Dee, triple board certified physician, a Latina in perimenopause. A big believer that authenticity is the path to freedom.

And I will invest in my self-care and my well-being forever. Ever. Today, as part of our menopause series and our talks about midlife, we are going to discuss beauty, beauty everywhere, basically beauty and esthetics.

So while esthetics always dismiss as something superficial, something that is like only people who is too much into themselves, but esthetics goes beyond that and we all have to accept that we do care about esthetics and it has a subjective meaning, esthetics.

But it's so powerful, yet so self judgmental or even we judge others about it. So today I wanted to invite someone fantastic that knows everything about esthetics and she can dive deep into why statics is at its core.

It has a lot to do with self-care. We want to welcome Doctor Murray Salazar. Maria Salazar is a physician assistant with 20 years of experience in the field of dermatology, plastic surgery, esthetics.

Now hormone replacement therapy. And she graduated from FSU, Florida Atlantic University and a master's of medical clinical science from Bari University.

Her practice is dedicated to approach the individual from the inside and find any deficiencies. Micronutrient deficiencies replace them when needed and as well to performing esthetics treatments.

She's the founder and CEO of Indie Health, a beauty practice that is dedicated make you feel confident in the way you look and to live vibrantly healthy.

Welcome Doctor Mari Salazar to double down with doctor D. I doctor D such a pleasure to be on here. I'm always happy to speak with you, Mari. Today we're deepening to this fascinating intersection of beauty, self-worth, and with some someone who truly understand, how the art and science of looking from looking beautiful inside and out.

So my first question to you really is, in this moment in midlife, we are always looking for aging gracefully, but it's always that little line on aging gracefully versus trying too hard.

So let's talk about beyond the Wrinkles. This new prospect of aging. Tell us, how do you got your patience in making a realistic decision instead of and looking natural beauty instead of looking a little artificial?

Wow. So that is a big question because a lot of that depends on the patient coming in. Right? Some patients come in for the very first time in midlife, and they want to take very conservative approaches to enhancing their beauty.

And other patients come in and they've already had quite a bit of work done. And that means that my job there is to to hold back and try to, restore a more natural look.

Right. So expectations change based on the patient. Some of us, some of us have just very unrealistic, visions of what beauty should be. And which brings me to another important point.

Picking your provider. Right. So you want to you want to. And that's why I think me and you have always gotten along so well, because we do have the same vision of beauty, right?

We have a natural, balanced, esthetic vision of beauty. And that's what I. That's what I try to give my patients. I mean, we need to we need to understand that looking youthful does not mean having no wrinkles.

You know, we've all seen that women walking on the street and we don't think, wow, she looks so young, right? We think, oh, she looks a little bit overdone.

Like she's trying too hard. And and what I try to explain to people is that looking young is an inside out process, right? So, of course, there's procedures and things that we do externally to help.

But truly looking young is a an inside out process where we are vibrantly healthy, where our cells are radiating health, where we are glowing from within.

And that makes my job a lot easier to kind of soften wrinkles and restore volume. But yeah, patient expectation is something that every practitioner has to manage very carefully and hopefully patients fall into the right hands because, you know, things can things can get out of control pretty quickly in the world of esthetics.

Yes. And you, you, you touch a very important point. Well, two important points from my perspective. One. Esthetics has a meaning, a little subjective, right?

But at one point you need someone that you can trust and with no interest can almost give you their perspective of what esthetics should look to you. And and that's important because yes, you can lose that perspective out of how the world judges you.

So that one person there for you, that relationship with that one person, I find that is essential. You just mention it. And the second part from the inside and out and you'll say, oh, is that a skin is the mirror of internal health.

So you tell us a little bit about how you start that, process of like that workup of what's going on within you so I can start fixing what is fixable and slowly arrive to the surface.

That is where you want to see in the mirror. Yes, absolutely. Skin is a manifestation of what is happening on the inside. So the healthier we are on the inside, the better our skin looks, and the more and the more youthful we look.

Because what I explain to people is that health is beauty. So after probably 15 years, I've been in practice 20 now, but after about 15 years of just injecting, just doing treatments on skin, I decided that we needed to work internally.

So we do blood work. You know, we need to look for deficiencies in midlife. We may have deficiencies in hormones and vitamins, minerals, amino acids, antioxidants, and, those are the tools, right, that our cells need in order for them to perform their job.

Each one of our cells has one job to do. And in order for it to do that job optimally, it needs its particular set of tools. So when we restore or replete those deficiencies, everything works a little bit better.

So if that cell's job was to produce hair, our hair gets better. If that cell's job was to produce muscle, our muscle gets better. If that cell's job was to produce collagen, our collagen gets better.

So once we've restored all of those deficiencies internally, you absolutely see that externally, which then makes my job of injecting and improving quality of skin so much easier.

It's a lot of fun work. I think that when patients understand that they have the, ability to restore these things, they take much more ownership and response ability over the aging process and not just a quick Botox treatment, which most likely they will not be happy with because if their skin is blotchy and they look dull, the eyes look dull and they're just not healthy and they're lacking estrogen, you know, or they're lacking progesterone.

They, you know, it's it's just it's a treatment done halfway. It's not a full treatment. Yeah, I love it. This is the way how we do a holistic approach to esthetics, which is such a thing, because that includes as well your mental wellness and and it's about how even arriving to a point that someone feel that they are looking good and they can present and show up in the world that way.

They were always dreaming or going back, and they were who they used to be. It's very empowering. So for me, these, this is this art of violence that you provide.

It's also helping the patient to navigate through their mental wellness. Absolutely. It is. That is such a key point because one of the ways that I've learned that we can really help people boost their self-esteem is helping them realign with the reflection that they're seeing in the mirror what happens to us in perimenopause and menopause and post menopause that will look in the mirror and we just don't even recognize ourselves sometimes.

And that disconnect can be very disheartening and confusing to us. So when we do esthetic work ethically, elegantly, conservatively, and we help the patient look in the mirror and say, yes, that that is me.

That's me. That is the true beauty of helping people boost their self-confidence. That realignment, that reconnection. Of. Seeing the way that you want to feel.

I love Anne Marie because I have to tell you, this is I mean, these feel in the field of medicine, right from the beginning. I'm a big advocate of trust, and, and I but I never I never imagined, like, you need to keep trust with your esthetic specialist.

Yes. You trust their hands, you trust that they know what they're doing, but not to the point of like that. That confining these very deep, precious private life.

But I see the relationship that having the relay arriving to a provider like you, starting to create a relationship. Getting that, like I trust you, I, I believe in you and what you're telling me.

I take it because you are going to be a better judge of my the way how I look more than my best friend or the mirror in the morning. And then next you tell me.

Let's just start with how your own body is going to help us to go through this process. And this is when you go inside and then whatever. We cannot replace or supplements or, or or having a response after making a decision on certain vitamins that you are request requiring, then it comes the the treatments that are available that we all are very grateful that they exist.

And but then is the whole relationship at the end and then coming to my next question, which is awesome and is who you are, your philosophy, how vibrant that you love that word.

I told you that that totally describes you. Like this is how you are right now with your beautiful, mustard yellow sweater, that Byron Marie Salazar that is on the other side, because there is always a sense of identification with the person that it is treating you.

So, once I, we create all this process and engagement between you as my provider and me as a patient then, and I relate to you then I can almost feel these that it was that is the beauty.

So tell us about your personal philosophy on that beauty and aging, which is what I'm going to relate to for the future steps. Yeah. Well, I think that we all understand that there can be many versions of ourselves, many versions, and if we are lucky enough to have the education and the disposable income and the and the energy and the want to do it, we need to strive to be the best version of ourselves.

And, you know, like as we've been talking since the beginning, that means internally and giving yourself all of the tools that your body needs to be as optimal as possible.

Like we said, when it comes to micro nutrients and hormones and then, you know, externally doing the fun little stuff that we get to do in the office, like Botox and fillers and microneedling and collagen stimulating treatments, the combination or the marry, the marrying of those two things helps us be a better version of ourselves, because it also helps, like we said, with our self-confidence, with the way that we, look at the world, with how we portray ourselves to the world.

Beauty is about energy. Beauty is about radiating, a positive energy that makes you attractive to the world and attractive to all types of energy. And that's that's my philosophy in the practice, my I focus a lot on very natural, results.

I think that, unfortunately, there is a lot in my profession of people doing things in a way that, just exaggerated features. And, and we become caricatures of ourselves.

Remember those caricatures people draw in the, in the, in the theme parks. I see so many people walking around looking like a caricature of themselves.

And, you know, they they lose their, their beautiful genuineness. There's there is beauty in some asymmetry. There is beauty in some imperfections. You know, we we don't have to strive for that perfection.

We have to strive to look rested, to, be healthy, rested is an important thing. I mean, how important is sleep, right? And and so many of us don't get good quality sleep.

That's one of my number one beauty hacks, you know, figure out your sleep. Because if you're not sleeping or not restoring or not detoxifying, you're not rejuvenating.

So sleep is number one. Beauty hack. Other things that we do that I do personally is skincare, for sure. Consistency is key when it comes to anti-aging.

So in the morning, a good antioxidant, a good sunscreen in the evening. A little bit more involved. You know, you want to really cleanse the skin, you want to massage, you want to invigorate, you want to increase blood perfusion to the surface of the skin.

Blood is what's bringing oxygen and nutrients and hormones to your skin. So I, I, I'm a big believer in just stimulating stuff, getting getting your skin pink.

And after that, you know, a good, chemical exfoliant, some kind of glycolic, some kind of alpha lipoic acid, some kind, sorry, alpha hydroxy acid, some kind of retinol.

And then massive moisture. Because as Perry than apostle women, we feel dry. Right. So it's so massive, massive moisture at night and and, you know, another beautiful thing that I've learned, which was very difficult for me, years ago as a young mother and not having a lot of time is the beauty of the ritual of self-care.

Really enjoying spending time with myself in front of the mirror and taking care of my skin. Which, by the way, has extended down to my neck and arms and chest because I've noticed aging even on my own skin, which has been completely neglected. Right.

I always neglected my arms and now my arms that are bothering me. But the beauty of of the ritual of self-care, and I really like spending time with myself now, you know, and, and, and I think that when we give energy to anything improves.

And I've noticed that when I give energy to myself and and my skin, it it improves. So I love that concept. You see holistic again. And you touch a little bit of my next question because as a board certified lifestyle magazine physician, I have to come up and say, yes, I agree with you going through the root cause.

More like the functional doctor, one that is looking for the supplements, minerals, vitamins, whatever we're missing. What about other lifestyle choices that we can add on into our ritual?

That for sure is going to show up in our phase as almost being grateful for doing it beyond our sleep? Absolutely. I agree 100%. It's any other tips from a lifestyle medicine kind of healers that you can just grab on?

Yeah. Well, I, I mean, I, I do a lot of things. I put, collagen peptides in my coffee. I make sure that my protein intake is on point, you know, so I do I count my protein throughout the day.

I want to get around 100g at least of protein a day. I take creatine for, my muscles, my brain, my skin. I take a lot of supplements. Omegas, vitamin C's are crucial to stimulate the production of collagen, methylated B vitamins.

Probiotics. I exfoliate, I exfoliate my skin. Like I said, in the morning, I will use an antioxidant always in the morning. And that changes because I'm always trying different things out.

But I will always, always use an antioxidant in the morning and sunscreen. And then in the evening I'll use some kind of exfoliant to, help sloughed off the dull dead skin.

And those, those, those are the things that I do most consistently. And then once in a while, of course, I do in-office procedures. I'll do a microneedling, I do sculpture, which I love, I'll do I do my Botox, obviously, you know, at least three times a year.

So those are the main things that I do. Well, what about the rest of the fillers? I want to know about your diet, your nutritional approach to your skin health and your the exercise that's exercise will have an impact.

Okay. Some, you know, toxic substances that we take. Absolutely. We all enjoy a glass of wine but now moderation etc.. I would like you to comment on that.

Yeah yeah yeah. So my my like I said, with my diet my main focus is trying to get my protein intake, to be at least 100g of protein a day. I hydrate a lot.

I do electrolytes with my creatine, in my first thermos of water throughout the day. Obviously, diet, exercise is key again, not just for muscle growth, which at this stage in our life, I think that, you know, strength training is the the best type of exercise.

I don't do a lot of cardio anymore except walking, and I and I, and I feel like I am doing cardio when I'm lifting weights because my heart's going to explode out of my chest. Right?

So, that's the type of exercise that I do. Well, let's see other questions. So toxic substances like the glass of wine. Because, yes, we all have our glass of wine.

I go out on the weekends, I have cocktails with my husband. I'll eat dessert with my kids. If I do feel like I am going to have a little bit more alcohol than I should be having, I take some glue to my own.

I make sure that I take my electrolytes. I drink lots and lots of water to help flush out the the toxins. But yeah, I'm not somebody who says no to those things.

I've become somebody who says yes to life. I yes, I'm not militant on anything. I think that there is value to being social and to enjoying, a glass of wine with one of your friends and that brings value to my life and that makes me happy.

And and happiness is beauty as well as health is beauty, right? So I love it because yes, that answer the questions on how we identify to you. Right. And is it a balanced holistic.

Yes. There is things that are not ideal. But if we avoid we if we're so limiting, in our day to day, then we fall into another kind of world which is a restrictive world.

Which is happy and stressful. If my if my diet is going to stress me out, or if, you know, toxic environments are going to stress me out, then that doesn't that doesn't help me at all like the other the other day.

And I don't know if you're going to want to put this in here, but the other day I was listening to somebody, you know, say, oh, everything. Now there's, you know, microplastics and this and that, and now you have to be careful with your tea bags because tea bags have microplastics.

And I'm like, oh my God, you know, I refuse to be scared of tea, that I got nothing. I don't I'm not I'm not going to live my life like that. You know, I'm going to I'm going to I'm going to be as healthy as I possibly can be.

But fear is not going to be part of my decision making process. No, but you love it and you can control. Fantastic. If you cannot, you cannot. You know when the when the strawberries are organic and I can buy them.

Fine. When I can't not grab them because they are not in the supermarket and I, or they are $16 a box because they're robotic, then I would say, okay, maybe it's okay to eat more organic.

It's I, I totally agree, that's that's the message I pass to my patients because then it becomes a life of, of fear. A life where you are walking on eggshells no matter where you going.

And scared of teabags. No, so scared of teabags is not the philosophy of Doctor Mary Salazar, that's for sure. Well, well, you've been very generous, sharing everything that you do in your rituals and not only what you do for your patients that what you do in your rituals.

Because we would love to look like you and ehm, you guys, if you are not seeing this as a video and just as an audio, you have to google Doctor Mary Salazar in the health because she looks absolutely gorgeous, fantastic and vibrant.

Because I agree is the energy that it comes out of you. It comes as youth doesn't matter what age you are. Yeah. And and it's it's it's a wholeness is not in a vial.

It's not in a vial. It's not in a is not in a machine. Those are just tools that we can have. And and I'm a big believer the self-care, it is part of our wellbeing in general, and especially now that we're going through these midlife, what we start questioning many things.

So I my idea with this Cosmo is to empower women to have me live as a, as a, an opportunity of transformation. And since we have so many experiences already, and we really believe that we already created important things in the world, not having all these, questioning that we have in our early years, teenager years or young adults, now we know a little bit more about life.

We can almost, take ownership. But on the other side, the mirror is the first thing that we take as the judge of how we are looking and feeling and even determines how we're acting on that day or in the years to come.

And that's the thing that I want to everybody to say, no, do not, do not. It's we have to embrace what is within us. And if that day you don't want to embrace the person that looks in the mirror because it's okay.

It's been happening to me. The bags, since I start using glasses, the bags under my eyes are no bothers me, but some days I can't. I'm like, what? I don't even want to look myself in the mirror and I'm going to get out of here.

Some days I'm like, no, I'm just going to put some tea bags regardless that there is some, microbiota there. And, and I'm just going to feel good and is going to show is connection is going to show.

And two things before we wrap up that it's just I'm sure everybody's curious about it. Well, first, you saved me because when we met, you knew that I was not used in writing.

All I know, everybody's like, this is impossible. It's like not using toothpaste, but, and I'm like, no, I think I'm allergic because I was very puffy, and I was.

And two things to take to take away home. Take away a message. It's one that retinol has to be. You have to be educated on how to, to put it on your face before you react, because it is supposed to create some inflammation.

Things that I thought I was allergic to, so I stop. I never used retinol for ten years and and you always said, I know who uses retinol and I know who doesn't because this is like we're almost buying a, like king collagen of our youth just using retinol.

We are like saving some of that. You want to make a comment on that because I love it. And my other question before I forget it. And then you can just, piggyback to my to the first answer, it's I want your opinion on estrogen cream and, you know, the, the recent hype and I because I do I treat women going through menopause.

I'm going to pause and and it's more of a traditional doctor. So, many of my patients use their vaginal cream on their face. And we have this conversation because there is science behind of.

It's fine. It's you're not absorbing too much that you're increasing the amount of estrogen that I've been replacing with you. But on the other side, obviously the pharmaceutical companies are trying to make money out of that, but they say, no, my same vaginal cream is going to go up there.

So, I would like you to comment on those. Those two. Hi. Yes. Wonderful. So the retinol. Yes. The difference that I see in the skin of my patients who have been using a retinol for ten, 15, 20 years and those that have never used it is dramatic.

But yes, people can be scared of retinol because it can be uncomfortable. Tips that I've learned throughout the years with retinol is one you do not need a strong one.

You can use an over-the-counter retinol. You can use a prescription tretinoin, but it does not need to be strong. You don't need to use it every day. You're going to skip days.

A good tip is that when you put a new, tretinoin or retinol on your skin, wait two days because the peeling and the irritation is going to happen at day two.

If that day two you are okay, go ahead and do it again. If that day two you're peeling, you know you're going to have to wait a few more days in between.

If waiting days in between isn't enough, we do something called the sandwich method, right? So you'll put a moisturizer first to kind of buffer the skin, then layer on top of that your tretinoin.

And then you can on top of that put another another layer of a thicker moisturizer. And that helps, alleviate some of the irritation that can happen. And then the third important tip that I give people when it comes to retinols or tretinoin is, is don't do it around the mouth so much.

The area around our mouth is an area that stretches and shrinks so much as we're animating throughout the day that the skin can crack and break and get more irritated.

So if you use your nose or retinols from your cheek, back your forehead, those areas do not get as irritated and peely and it's not as uncomfortable. And then just once in a while, do it around, around the mouth.

But, the key is that we all need a chemical exfoliant if we're interested in keeping our skin look as looking as youthful and as plump, and as thick as as possible.

So those are, those are the, the retinol slash tretinoin tricks that I have learned throughout the years. I love it. I even mix a little bit of it with my moisturizer.

Remember how I talked about my self-consciousness about my arms now? Yes. I've, I even mixed some retinol and put it on on my arms. And yeah, absolute you you notice the difference.

We need we need some kind of chemical exfoliant at night. Estrogens. I think estrogens are fantastic when needed, right? I mean, in the world of hormones, you.

It's like the Goldilocks story. You know, you can't do too much. You can't do too little. But right in the middle, that's where the sweet things happen.

I think that women, if they're going through menopause, need to get their estrogens checked and they need to replace it, whether it's through a cream, a patch, pellet, whatever delivery mechanism you want.

But having optimal levels internally of estrogens are going to save not just our skin, but our brain, our bones, our heart, our mood. You know, our the the health of our of our, vagina and vulva, all of that.

You know, it's going to save all of that. If somebody is has their estrogen levels at pretty optimal ranges, I don't think it's absolutely necessary to do an estrogen topically.

If you are going to do an estrogen topically on top of the other estrogen, I would use an S trial, not an estradiol. Right. So an S trial is going to be much more localized.

It isn't going to interfere or increase the amount of estrogen systemically. And I think that those are absolutely fine. Fine to use. And, and I'm, I'm of the belief that we need to give our, our body a chance and experiment safely with things.

But I am all for experimenting with things and and seeing how we react to it. We're all different, right? And so what works for one person just doesn't work for the other.

But as long as you're you're doing it responsibly and and safely, I'm all for trying different things out. No, I agree, this is almost so much fun to write to this age.

And we have all these things available for as a need. I even have. I'm having a lot of fun, I really am, I, I'm 47 and I, I am so happy where I am right now, you know, I mean, of course I would want a little bit less crow's feet, but I am, I, I'm, I'm as confident as I've ever been.

I've, you know, I, I feel really, really good at this place in my life and, and, and I think that since we were talking about esthetics, what I said in the beginning of the, the, the reflection in the mirror or being something that you internally align with, that's when that's when we're with that's when we feel really good.

Yes, yes, I Love You are the perfect example of going through this transformation through Meet Life. Towards I had a guess about the it, which is the Japanese concept of wisdom when you were right to a certain age that it was given to the women because they were the ones who had all these experiences.

And you will have a perfect advice for the community. And also, they were not busy anymore raising kids. They are just the back up support with all these knowledge.

That is amazing. And it is. This is who we are. We should be almost like, so honored to be in these moments. You know, we're. Absolutely I agree absolutely.

It's a it's a really fun time to live. This phase of my life has been really, really fun. And and like I said, you know, just really connecting with the ritual of self-care and loving to love myself has been something that has only happened now in this time of my life in perimenopause.

Yes, yes, we had other worries before, so we were not mindful and we were not in the present. And now we had that opportunity and Marie has been a pleasure to have you, as a, as a guest in my podcast, Double Down with doctor D just before we leave.

Is there anything else that you wanted to tell to our audience? And also, please, how could they reach out to you? How where they can find you? Well, I, I think that looking for a provider, if you feel like you need some help navigating, the way that you look and feel through menopause, looking for a provider that has your best interest in mind?

You know, there's there's a lot of, especially in esthetics. There's a lot out there that, you know, you have to be careful with. So making sure that you feel a good connection with the with the person that you pick to help you navigate through this phase of life.

And how can people connect with me? Well, I have a I have my practice in Western Florida. My practices name is Indy Health. You can look up look us up online, Indy health.com.

Indy Health on Instagram. And and yeah, we'd be we'd be happy to meet any any anybody interested in coming in us. So for my audience, thank you so much for listening.

And this continues this series of transformation through meet live. I'm telling you, I'm finding these awesome models that we all can relate to empower us as a women.

We keep our intensity, gives us steps to sustain beautiful and to reach even more beauty. And we all get educated and we all want to be very comfortable within our skin, inside and out.

See you next. Thank you for tuning in to Doctor Talks. We hope today's episode has enlightened and inspired you on your path to optimal health. Each day is a new opportunity to make choices that empower your well-being.

For more insights and strategies, subscribe to our podcast and visit our website w ww dot doctor Talksport.com. Stay connected, stay healthy and join us next time on Doctor Talks.

Real talks from real doctors on the issues that matter to you most.

The Inside-Out Glow: Hormones, Skin & Real Beauty Rituals

Paola D’Aleman Poveda, MD

Mari Salazar, PA-C

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