Nelson Novick, MD - Dermatologist in New York City

Eva Sheie (00:03):
The purpose of this podcast is simple. We want you to get to know your doctor before meeting them in person, because you're making a life-changing decision. And time is scarce. The more you can learn about who your doctor is before you meet them, the better that first meeting will be. There's no substitute for an in-person appointment, but we hope this comes close. I'm your host, Eva Sheie, and you're listening to Meet the Doctor. My guest on Meet the Doctor today is Nelson Novick. He's dermatologist in New York City. Welcome to the podcast, Dr. Novick. 

Dr. Novick (00:39):
Thank you for having me. 

Eva Sheie (00:40):
So tell us a little bit about yourself. Let's start there. 

Dr. Novick (00:44):
I'm a clinical professor of dermatology at the Mount Sinai School of Medicine in New York, and an attending physician at the Mount Sinai Medical Center. I am a fellow of the American Academy of Cosmetic Surgery, a fellow of the American Society for Dermatologic Surgery, a fellow of the American Academy of Dermatology. And I'm, uh, privileged to be double board certified in both internal medicine and dermatology. And I have a practice on the Upper East side of Manhattan in cosmetic dermatology. 

Eva Sheie (01:19):
There's a lot going on there. 

Dr. Novick (01:21):
<laugh>. 

Eva Sheie (01:22):
Let's start with training. I think it takes a very special kind of doctor to dedicate their life to training other doctors. So I'm curious, uh, how did you end up in that teaching position and what is that like every day? 

Dr. Novick (01:38):
Well, first of all, I wanted to be a doctor ever since I was eight years of age. And so that was my sole focus since I was eight years of age. And I was privileged to be able to go to the Mount Sinai School of Medicine. Then after that, I completed an internship in residency in internal medicine in its entirety. And then afterwards I did an entire residency at, uh, New York University Skin and Cancer Unit in dermatology. And then got my board certifications in both. And then I returned to Mount Sinai on the faculty and, you know, through publications, you know, numerous, numerous medical publications, being a medical editor of, of books and journals and, and articles, hundreds of articles. I worked my way up all the way from a senior lecturer all the way through a full clinical professor of dermatology at the Mount Sinai School of Medicine. In fact, for several years I was actually on the admissions committee for the Mount Sinai School of Medicine. 

Eva Sheie (02:39):
That's a big job. How much of your time today is spent teaching versus practicing then? 

Dr. Novick (02:45):
Well, I've sort of modified my time. I spend a, a couple of weeks going into the, the medical center to teach on a clinical level. I teach medical students and dermatology, uh, residents, basics of clinical dermatology to some degree the aesthetics in the clinic. But I devote the majority of my time to my clinical practice on the Upper East Side, which is, uh, as I mentioned, is devoted to dermatology, which is skin, hair, and nail conditions, as well as the, all the aesthetic aspects. But my primary interest is actually non-surgical rejuvenation of all kinds of procedures that can be accomplished for rejuvenation of the face, the neck, the chest, and the hands via non-surgical approaches. 

Eva Sheie (03:33):
So lasers, fillers, injectables, things like that. 

Dr. Novick (03:37):
Certainly fillers and neurotoxins. I was actually one of the first in the entire United States in 1991 to use Botox for aesthetic reasons. And I was, uh, probably one of the first, uh, to use the, uh, hyaluronic acid fillers back, uh, 15 or more years ago. And, uh, in the early days in the 1980s, I was actually one of the first in the greater New York area to use the original collagen fillers. But, uh, lasers I don't concentrate on simply because unfortunately, the hard science to back up lasers in aesthetics lags woefully behind the heavy duty social market, uh, skin influencing and also the media hype. And so I really rely on using procedures that have stood the test of time, of decades of time, simple, far less expensive, you know, procedures that have stood the test of time for efficacy for, you know, for effectiveness as well as safety. 

Eva Sheie (04:40):
What you're saying is resonating because I've been writing and marketing these procedures for 20 years, and so many of them have come and gone quickly. And I think you just connected a dot for me in that maybe some of them came and went quickly because they didn't really work. 

Dr. Novick (04:57):
Yes. And and in fact, there's a lot to back that up. In a recent January article by the cosmetics editor, a physician of, uh, practical dermatology, his comment was that the innovations of today, and we're specifically referring to the, you know, to the devices, the machines, the bells and whistles, the gizmos. And he was saying the devices make very little progress in innovation despite the claims. He says, and unfortunately he says, these machines run well over $300,000 these days. And he says, the same lecturers who claimed that gen one of the devices was God's gift to humanity come out with Gen two and say, oh, gen one didn't work. And so his final conclusion was, he's gonna wait till Gen six.

Eva Sheie (05:45):
Six might be too early still. 

Dr. Novick (05:48):
Well, frankly, for many of my answers, when I answer questions on RealSelf, my, my followers know that I caution them to exercise a very heavy dose of buyer beware when it comes to evaluating the claims for these various next big thing gizmos, because they're expensive and they can be very disappointing and frustrating. And many of my, the patients who come to me have already come to me after they've, they've expended a, a fortune for these prior treatments. And then they say, but I, I just spent $10,000. How can I spend a few hundred on this? I said, well, I mean, if you read my columns, you would see that I've been cautioning people for years that, you know, not to fall prey to the, you knwo to the heavy marketing for these things. 'cause the science is simply not there. 

Eva Sheie (06:41):
Your patients in, I expect that your students are lucky to have you <laugh>. 'cause the skepticism is important in it. 

Dr. Novick (06:48):
Well, I try to really instill in them a heavy skepticism, but I have to tell you, the, the marketing even to the physicians is so intense that many physicians have confided in me. Well, I said, how can you really buy this device and then basically hawk it to the patient population when you know the science well? But if I, the answer usually is, well, if I don't buy it, then they're off the social media. Dr. Google and Dr. YouTube <laugh> are going to tell me that I, you know, that I have to get this, this specific God's gift to humanity. And so I'll go to the next doctor who offers it, so therefore I have to buy it just to say that I have it. 

Eva Sheie (07:30):
That does happen. So what do you do instead? Like, let's take something like, um, rosacea where I know that there are laser treatments that are very effective for this, like the older ones, maybe V Beam or something like that. Are you able to get results for things like that without using devices at all? 

Dr. Novick (07:49):
Un unquestionably, yeah. Unquestionably, I mean, and it's very often the lack look, in my practice, I'm very, very, very proud of, we have a very unique setup. Each new patient who comes to me, their first appointment is an hour and a half, and each follow-up for regular patients is one hour, because you cannot, in the five minutes that are usually allotted in a Henry Ford factory style, you know Yeah. Operation, you cannot actually deliver the, the information that a patient needs to really handle his or her problems. So in the hour and a half, I take them back to how, whether it's rosacea, whether it's regular acne, whether it's somebody suffering from male or female pattern, hair loss, or any other kinds of, of the routine skin conditions, or who even come to me for the aesthetic for wrinkles and brown spots and, and sagging skin. 

(08:47)
Everyone gets a full explanation of how it started. Why do you have it, how did you get here? And I, I always tell them in advance, I say to, look, you are gonna sit here. I've told you, you know, my, my receptionists tell the patients that your first visit's gonna be an hour and a half, and each subsequent one is going to be an hour. So don't plan a visit 10 minutes after your time for me. And everybody runs. We have a hundred percent on time in my, in my practice. Mm-hmm. <affirmative>, if a person has a 10 o'clock appointment, if they show up at 10, they will be seen at 10 o'clock. And if I finish early with a previous patient and they show up slightly before 10, I'll see them then. But they're guaranteed the 10 o'clock spot if they book the 10 o'clock spot. 

(09:30)
Now, in the hour and a half that I have in a first consultation, I said, now listen here, I'm a professor and I like to lecture <laugh>. I said that what I'm gonna tell you right now is going to be a lecture. That is a monologue. I mean, I will ask questions, but those will be rhetorical questions and I'll answer them. But I want you to know how you got here, because I know you've been to other doctors and I'm convinced in advance knowing that you didn't hear this story, and that's why you're sitting in front of me right now. Now, very often, their story is the following. I got to the doctor's office, I opened the door, and as soon as I opened the door, it was, they were come on for the free consultation. You know, the consultation was, they, they got what they paid for in the five minutes that it was when the person opens the door and the doctor says immediately before they've even planted their dairy air in the seat, oh, you need such and such a machine, basically, that, that was just purchased by them. 

(10:33)
And please go out and see my cosmetics coordinator. You'll sign up for the following treatments and you know, X number of treatments for X, you know, thousand or $4,000 worth of so many treatments, and that's the substance of the entire visit. So I said, you can't get better with that kind of approach. I said, you might at the end, look in the mirror, you know, after four treatments and plunking down several thousand dollars, you may look in the mirror while the technician who's given you the treatment is standing by you saying, don't you see the improvement? And then what happens is the patient says, oh yeah, I think, oh yeah, there is a little bit of improvement <laugh>. So I said, well, you know what that's called. That's called buyer's remorse. Because if you say that I don't see any improvement, then what's gonna happen is you have to live with the reality that you have just down the drain X number of dollars and you're no better. 

Dr. Novick (11:31):
So you walk out saying, yeah, I think I'm a little bit better. So I said, so now that you're sitting in front of me, we're really gonna discuss this condition and what really can be done about it. And nine times, almost 10 times out of 10, what happens is the patient has never really treated himself or herself properly for the condition, for the length of time that it's required. So once I explain to them, they'll say, oh, I did use that medication that you just prescribing. I I used it for a week. Well, hey, you know, if you have rosacea or if you have regular acne or if you have other conditions, most medications for these conditions do not begin to work, be they oral or topical. They don't begin to work for eight to 16 weeks. 

(12:25)
So that's right, that's to begin to work then, after I see the incredulity on your face right now. Now, so the thing is that the audience can't see it, but I saw it. So the thing is that after the eight to 16 weeks when the medication has begun to work, then you have to be on it for about four to six months. Mm-hmm. <affirmative>, I said, and that applies regardless of whether you are given, you know, elephant guns like, uh, Accutane for, for acne, which is seldom ever really needed. And you, you don't need the medications that can be toxic oral antibiotics for certain things. If you are really diligent about using and you know what to expect. All that is part of an hour and a half visit in my office, or the hour follow ups in my office so that a person can then say, well, what happens during the month if I can, I'm continuing to break out. Well, that's why we have to schedule appointment to see me, because there are in office procedures that can be done that will compliment the at-home regimen that you have until you're finally finished with me after about three or four visits, and you can go on and live your life and your pocketbook and your wallet have not been lightened furiously, and you're not so frustrated that you run to the, you run from doctor to doctor to doctor and get no satisfaction. 

Eva Sheie (13:51):
I can hear a pattern here, and I, I think you're wanting to get to the cause maybe because of your internal medicine background. Is that fair statement? 

Dr. Novick (14:01):
I think it's a contributory statement, but I, I honestly think the most important element is the amount of time that a knowledgeable physician spends with, with his or her patient to be able to make them understand what their condition is, why they have it, what to expect in the treatment course. And you can't do this in a five minute visit. If the doctor doesn't spend his or her time appropriately with the patient, the loser is the patient. 

Eva Sheie (14:32):
I think there's two other things going on here. Just as a, as an observer of trends and patterns among patients, we want instant gratification. And sometimes the best treatment is not something that will give you instant gratification. So over time we gravitate towards things that will be able to fix us right now. 

Dr. Novick (14:51):
However, there really are, sometimes there are treatments that can give people instant gratification. 

Eva Sheie (14:58):
Sure. 

Dr. Novick (14:58):
And that, and that's where it gets the doctor instant gratification. For example, the non-surgical approaches to facial neck and chest and hand rejuvenation via fillers. Those in experienced hands can give, I mean, I developed, for example, the non-surgical filler neck lift. It takes about 20 minutes to be able to take care of a neck that has the bands down the neck and has the crinkling and the horizontal necklace lines around the neck that can all be dealt with. And then the person gets off built into my mirrors in my office, other, the words giant. "Wow". Because I know that I can wow the patient in the same visit. Now I always tell the patient, you know, when they're skeptical, of course when I said, you know, you are in, in the next 15 or 20 minutes, you are going to look like these, uh, befores and afters I'm showing you. And of course they're very, uh, skeptical. But what happens is, I'm holding up a mirror to you and I'm saying that you are gonna say, wow, in the next 15 or 20 minutes, my reputation is on the line. And if I can't make good that I wouldn't have the reputation I have. 

Eva Sheie (16:10):
Indeed. So what filler are you using for this non-surgical neck lift and how long is it lasting? 

Dr. Novick (16:17):
Okay, so it's not one filler each, each company now make 

Eva Sheie (16:22):
About a hundred. Yeah. 

Dr. Novick (16:24):
Well, they <laugh> without exaggeration, they make about six, or each individual company makes about six or eight different fillers that are to be used for different purposes. We have such a great number of these products for each one designated for a different purpose that it really is that I have to examine a person up close and personal to be able to say, well, over here I'm going to use this particular product in order to get a lift to the sides of your neck, I'm going to use a separate product from a different company that has different properties that that's going to take care of the crepiness that you have in your neck. So it depends upon, 'cause people have lines, they have crepiness, they have crinkles, they have bands, they have sagging, they have jowls in along the jaw. Each thing requires its own particular product to use as well as its own technique. 

(17:22)
This is an art as much as a science. And the doctor has to be an experienced injector to be able to know which particular filler or fillers will get the job done. 'cause there, there are different purposes for fillers, there's volumizing fillers, there are contouring fillers, there are fillers for quality of the skin. It's, it's tone, it's brightness, it's hydration. There are fillers that are lifting fillers. So each set of fillers has its own particular purpose. And the doctor has to be experienced with each of them to know how to, how to mix and match in order to get the results. And it's very juvenile and it's very amateur actually, in, in my opinion, and I have several decades of experience in doing this to offer a patient, you know, uh, buy it by the syringe. That's not the way to do it. A person that comes to my office, I tell them what the job costs, the fee in advance. Well, let's put it this way, would you go to a surgeon, let's say to have your gallbladder out? And and the surgeon says, okay, I'll charge you for the cut here. I'll charge you for how many pieces of gauze that I'm, I'm going to use. How many packages of suture material, or would you expect as an experienced surgeon to say, your operation is $10,000 start to finish. And if the surgeon finds out he uses 10 million pieces of gauze, you wouldn't expect that surgeon to charge the patient anymore than they quoted. So when 

Eva Sheie (18:56):
You knew the insurance company would, but not the surgeon.

Dr. Novick (18:57):
But not the surgeon. So when a patient comes to me and says, what will it cost to rejuvenate my neck? Or what will it cost to recontour my face or to take care of the jowls along the jawline to give me a feminine brow, to give me higher cheekbones, to give me a more masculine jaw or a masculine chin, I can tell them, this is what it will cost you. And if it turns out that I have to use 50 times the amount of material that I had anticipated too bad on me, this is what I quoted to the patient, but I'm not gonna do it in this sort of quasi juvenile way of, you know, oh, I'll charge you by syringe. 

Eva Sheie (19:40):
I bet you're not wrong very often. 

Dr. Novick (19:42):
No, I'm not <laugh> I've been, I've been doing it long enough. 

Eva Sheie (19:45):
<laugh> You've been injecting, um, probably longer than most doctors in the United States at this point. 

Dr. Novick (19:51):
Yes, I think so. I, I started injecting in about 1982. I gave up injecting silicone. Okay. Because once the natural collagen fillers came on the scene, I could no longer justify using a permanent filler. And to this very day, I don't use permanent fillers anymore because permanent fillers can translate into permanent or very long lasting adverse reactions. Whereas with the fillers like hyaluronic acid, you can simply dissolve them away. 

Eva Sheie (20:23):
Do you have a, a passion for research and is there something that you study or have studied over the years? 

Dr. Novick (20:28):
Well, I actually was a developer of the 10 minute eye lift. I was the developer of what's called field subcision for the treatment of cellulite. 

(20:38)
Yeah. Well, you can use it for cellulite, but it's primarily used field subcision is primarily used, you know, in my, in my for acne related atrophy of, of large areas of the skin. 

Eva Sheie (20:51):
Oh, this makes sense. 

Dr. Novick (20:52):
Like of the cheeks. Yeah. Or of the temples or around the jawline. That's the primary reason for using a field sub precision where you can take, because what happens is acne, because of the damage in the atrophy, the loss of tissue, loss of collagen that it creates prematurely ages people's faces. So I explained to them how a field sub precision can reverse that, and it's usually a one-off procedure. But I have also been using individual subs for elevating and smoothing individual acne scars since, and I've developed quite a national reputation for treating acne scars as a matter of fact. And I've been doing that since 1995, and I've done tens of thousands as an understatement of, of subs. 

(21:39)
You, if one can imagine that a person can have, you know, 10, 15 or 20 individual box car scars or rolling scars on the face. And that's what sub is ideally for. If I'm seeing several dozen patients in, in the course of a week and each one has 15 or 20 different spots, it doesn't take long with the number of weeks in the year and the number of years that I've been doing this to calculate that, we're talking more into the hundreds of thousands rather than just tens of thousands. So I have quite a bit of experience and, and I'm very proud of the reputation that I've built nationwide. My practice attracts people not just from all over the United States, but from Europe, from Canada, which is on fire these days, and even from the far east, that I have a tremendous diversity of patients in my practice. Not just the people of European descent, but a very, very substantive, uh, population of, of African Americans, Latinx people, and a very large, uh, proportion of, of Asian patients because they, they seem to suffer particularly from acne scarring. 

Eva Sheie (22:47):
Is there anything else that you're known for, like, along those same lines? 

Dr. Novick (22:52):
Well, I also treat very actively hair loss in both men and women of the various kinds of hair loss, not just male and pattern of hair loss, but I've written on stress induced hair loss, like the kind that one gets after serious infections or surgeries or, or birth post-delivery. Uh, so I've developed quite a reputation in that and I'm very proud of my reputation in treating acne vulgaris the, uh, what we used to be called teenage acne. But we now know that about 14% of of people in their twenties, thirties, forties, and even 5% of women ages, uh, 50 to 55 have what we used to call teenage acne. So we don't insult anybody these days by calling it teenage acne. We simply call it acne vulgaris vulgar meaning commonplace, common run of the mill. And so I have quite a reputation. I'm very proud of that. 

(23:42)
It's again, the same kind of thing if you sit down and explain how a person gets acne in detail in that hour and a half that I spend with the patients, if you actually explain it in detail and you explain to them how they got it and what to expect, then with topical medication, I have treated successfully, even the most severe cases of acne without having to use the elephant gun. I have tons of patients who've come in who have either were about to start it or have unfortunately taken it. And I explained to them, look, you know, in five minutes, it's very easy to prescribe an elephant gun to kill a mosquito. The trick is killing a mosquito with a fly swatter. I said, and acne, even severe acne can be maintained with the fly swatter. You don't need to make the person suffer for the sins of their face, the whole body to suffer for the sins of just their face, because that's what you're doing when you give them Accutane or when you give them systemic antibiotics or hormones. You know, uh, even if a person doesn't need birth control pills for birth control, I'm not a very big fan of giving it for acne because it, it's not necessary. And again, you're playing with somebody's hormones and their systemic effects when it's very unlikely they're going to need it. They just need somebody to teach them how to use the fly swatter and not make their whole body suffer for the sins of their face. 

Eva Sheie (25:12):
You just brought me all the way back around. So I, I mentioned that we want instant gratification, but I also think there's a problem with people not understanding the root cause of what is happening to them. And that medicine has a part to play in that too, because they don't necessarily wanna figure out the root cause. And I see this more and more where you, you go in and you say, this is what's happening, and they just start writing prescriptions and say, go away. And I've had it happen with my kids and I, I've had it happen myself, and I'm very frustrated with this. And I know I'm not the only one. You are of a different generation, and I hear you saying you wanna get to the root cause for everybody that, that you're seeing. 

Dr. Novick (25:55):
I do. And I also don't wanna spend my entire visit with my face in my computer. I wanna look at the patient the way I'm looking at you right now, which is how I do it. I mean, there is none of this, my face in the computer, unfortunately. I have to deal with people's misconceptions that they've, they've picked up from doctors Google and, and YouTube and Instagram and TikTok. And so people come in thinking that they know the solutions to, you know, to their own problems. And so you have to, part of the major problem these days is having to deal with people's misconceptions. Misapprehensions,  

Eva Sheie (26:32):
You're gonna end up with two hour appointments at some point, <laugh> 

Dr. Novick (26:35):
Well, some, frankly, sometimes it does overextend the hour and a half. But as I said, I try to keep to a, you know, a schedule where everybody is seen. Exactly. And I, it's pretty much a hundred percent in, in that regards. And it's very hard these days. It's actually harder than in times past prior to the internet, I'm sure. Because you first have to knock down the misconceptions. And I have to remind people, you know, first of all, there's no regulation on what's said on the internet. There is no fact checker to fact check. And a lot of what you see is either, is either, uh, misrepresentation bias advertising in, in the guise of public service, many non-professionals giving opinions, and also a lot of under the table things, especially when it comes to products and manufacturers, that the skin influencers, you know, are privy to under the table when they get in front of the camera and they say, I am going for my treatment and I'm going to tell you in two weeks what I am going to look like and I'll be back in two weeks. And then two weeks later they come back and they say, I see a little bit of improvement, but I'll let you know in another two weeks <laugh>. But meanwhile, they are influencing people, and I have to, my job is to try to really set them right with real facts and real medicine. 

Eva Sheie (28:02):
Mm-hmm <affirmative>, That's very important. There is data recently that compared information sources and the trust level among patients with everything except for the actual doctor was much, much lower. So I'm not gonna get too depressed about what you're saying, but I do agree with you and I, and part of what I try to do is bring the trusted information sources to the forefront so that people can access the real doctor, you know, much more often than they're able to right now. They wanna know you. They wanna know what you think, what you say. That's why we're here, which is so much fun. 

Dr. Novick (28:37):
Well, I'm glad to be able to help, and as I said, my interests are non-surgical. See, everybody comes in, actually that's a, that's another point. They come in and they say to me, I need a facelift. And they pull on their skin. So I usually give them the example. I said, look, I said, this is not the way we have learned. You know, about 15, 17 years ago, people started to do the anatomy of aging. Prior to that, when they did anatomic dissections and things, they were looking for diseases. But then the bright idea came about 15, 17 years ago. You know, we haven't really examined what happens to people when they, we age. We're beginning to know what happens when they get disease states, but what about aging? So the thing is that they started to look and suddenly they found out that aging, that what we thought was just sagging of the skin and everything was largely dependent on volume loss. 

(29:30)
In the volume. Underneath that, we have a bunch of fat pads deep underneath the skin, in the cheeks, in the forehead, and various other places which contribute to how young we look. Now, above that, you have a separate fat layer, which acts as a mask, like a Venetian mask over and above those. So that, that's why we have people who suddenly lose a great many pounds. And everybody says, oh my God, that weight loss of 25 or 40 pounds, they've aged overnight. No, they haven't aged overnight. They've been aging gradually since age 21 and, and 31 and 41, just as anybody else is. It's just the Venetian mask of that overlaying fat layer, which is responsive to weight gain. And weight loss was there and now was removed. And suddenly after they've lost the 25 or 40 pounds, what was underneath and going on, gradually every single day becomes apparent. 

(30:28)
So once we learned, it's those fat pads underneath which contributes so much to the volume. You see, if you take, for example, the fat pad in the cheek, there's a sort of a triangular fat pad, which acts as a support for the under eyes and also pulls up on the area below it, you know, of the smile line and pulls up from the area of the jowl along the jawline. Now, when that fat pad shrinks and shrivels with age, now gravity has a chance to grab a hold of it and pulls it downward and inward. So if you can picture that fat pad, which was once up, sitting up below the eyes and along the outer cheek, is now pressing on the inner area towards the nose, giving you the smile line. It presses a little further down to give you the marionette line, the sad lines on the, on the angles of the mouth straight down. 

(31:18)
It causes the jowl along the jawline. So what you need to do, and what looks like magic to the patient is restore the volume underneath. You take, you take an injectable hyaluronic acid, volumizing filler, you inject it in properly and poof, five minutes aside, and suddenly the person looks in the mirror and said, my God. 

Eva Sheie (31:41):
Wow, <laugh>. 

Dr. Novick (31:41):
Wow. Exactly. And that's how it works. Now, for each individual area, there are different fat pads and different, different changes. And if you address those changes properly, you can get the wow reaction on the spot after the treatment. Now think about this in comparison to the, the way of surgically doing a surgical facelift rather than the non-surgical that I've just referred to the, the, the non-surgical filler lift. This is what a surgery can do. First of all, it's very expensive. Secondly, it has a very prolonged downtime. 

(32:15)
After the surgery, there's the risk of scarring and everything, which many people complain about that they need treated after you see the questions on RealSelf, but even from the standpoint of the procedure, why is it that so often when you walk, if a person walks down the street, you can say, oh, she's been done or he's been done. Why do you think that is? The reason is because what happens is the surgeon has taken the skin, which is not the primary problem, and pulled it tight over the underlying bones and cut off the excess skin and sewn it back together so that you end up with what's called a sist face. A face that looks like a skeleton. Now, if it's difficult to picture, I'm gonna give you another scenario. Imagine you have a beautiful dining room table and you have the guests coming and you put have all three pieces you know of that you put in to extend the table. 

(33:15)
And then you get a beautiful matching tablecloth to go over it, which hangs just so around the table, halfway down, and it looks gorgeous. Now the guests come, they love your table and tablecloth and everything, and now they go and you now remove the, the three pieces. And suddenly, and you put the table together. Suddenly the beautiful tablecloth that hung so beautifully around the table is now dragging on the floor. What do you do? Go around with a scissor and cut it all the way around to make, to make 

Eva Sheie (33:46):
No.

Dr. Novick (33:46):
No. 

Eva Sheie (33:46):
You just put the leaves back in. 

Dr. Novick (33:47):
You put the leaves back exactly into the table. So by re volumizing your face, we're putting the leaves back into the table rather than cutting the tablecloth around by trimming the edges of your skin when it's pulled tight so that the person looks like a skeleton. 

Eva Sheie (34:04):
It makes very good sense. I think you're onto something. 

Dr. Novick (34:08):
Well, it's not new. This non-surgical approach really drastically affected the number of, of surgical procedures that have, have been done. It's, it's understandable why, who wants to be cut up when you can achieve something without any real significant downtime in the course of one visit. And you know, you can, you can get an effect that, that's dramatic. It's a no brainer. Actually. 

Eva Sheie (34:32):
<laugh>, I think there are some surgeons who do think the way you do, and they would argue that they prolong the need for the facelift as long as possible by doing these other things. 

Dr. Novick (34:43):
Well that, that has been shown. The earlier one intervenes, that's called pre rejuvenation. I mean, it's, uh, people always ask, should I be doing it? Or questions on RealSelf? Should I be doing this? Uh, you know, I'm only 20 some. I started with some of my daughters-in-law when they were 19 years of age, because the science shows that the earlier one intervenes, the longer one will be able to go before something dramatic and drastic has to be done. 

Eva Sheie (35:10):
You said, you said daughters-in-law and you reminded me that you have some sons. How many sons do you have? 

Dr. Novick (35:16):
I have, I have seven sons. 

Eva Sheie (35:17):
Seven. And your other name is,

Dr. Novick (35:18):
We, we, we have seven sons. 

Eva Sheie (35:20):
Your name is Abraham <laugh>. Do you know that song <laugh>? 

Dr. Novick (35:24):
No. 

Eva Sheie (35:24):
Father Abraham. We only did only like little Lutheran kids sing this song? It's this cute Sunday school song. Father Abraham had seven sons. Seven sons. <laugh>. That's what I thought when you said you had seven sons. He was like, 

Dr. Novick (35:38):
Oh, my wife told me she wanted, when we first were engaged, she said that she wanted a minimum of six kids. So minimum of kids achiever kids is is seven <laugh>. 

Eva Sheie (35:47):
Uh, you did it. That's so, so wonderful. 

Dr. Novick (35:50):
But, they're all only sons, seven sons. 

Eva Sheie (35:55):
And so how many daughters-in-law? Seven. 

Dr. Novick (35:57):
No, we, we have three daughters-in-law. 

Eva Sheie (36:00):
So far. 

Dr. Novick (36:00):
So far. 

Eva Sheie (36:01):
That's so fantastic. <laugh>. So before we wrap it up, what do you like to do outside of the office? 

Dr. Novick (36:08):
I love to travel. I've traveled all around the world. I've been to all seven continents. 

Eva Sheie (36:13):
Antarctica. 

Dr. Novick (36:14):
Yes. Yes. And I've traveled to all those and been to countries many times in, into countries that people haven't frequently in Latvia and Lithuania. And we're always looking for something new to explore Bulgaria less. We've done the road less traveled as well as the, the road most traveled. Um, I love that.  

Eva Sheie (36:36):
So give us the country you would never go back to and the one you would go back to right now if you could. 

Dr. Novick (36:43):
Well, the country that I, that I had difficulty with was, believe it or not, Thailand, because the temperatures are so high and the humidity so high and the smells from the, the meat markets hanging with the meat, just hanging unrefrigerated was a little bit difficult on my <laugh> on my sensory system.

Eva Sheie (37:03):
And you're a New Yorker, so that is saying a lot. 

Dr. Novick (37:04):
Yes, it was a, it was a, one of my sons also said that's not a place he would go back to either. 

Eva Sheie (37:10):
I just said this about New York yesterday. It's too smelly. And you're telling me I'm never going to Thailand now <laugh>. Okay. 

Dr. Novick (37:17):
And as far as going back to cities, of course the, the main cities that you know, that I would go back to are Paris and I, I did enjoy London and I certainly enjoyed Rome, but one place that I would love to go back to but is, is sort of FairBot and right now, and that's Moscow. 

Eva Sheie (37:34):
Oh, I've heard it's beautiful. 

Dr. Novick (37:35):
It it is, it, it is. Moss, Moscow and St. Petersburg are absolutely must, must visits for people who have not visited them. But I've been to many, many beautiful places and I really don't want to, you know, besmirch the reputation of Thailand. There are many people who are more tolerable to, to heat and humidity than I and are less bothered by it. But that was on my list of not going back to, that's <laugh>. That, that is the top <laugh>. 

Eva Sheie (38:04):
Good advice. Okay. So last question is, if we're interested in finding out more about you, we're listening today, where should we find you online? 

Dr. Novick (38:13):
Well, you can find me at my website, younger looking without surgery.com, that there's no dots in between. It's younger looking without surgery.com or dr Novick.com. That's D O C T O R Novick no dots in between N O V I C K.com. 

Eva Sheie (38:33):
Thank you so much for sharing so much of yourself with us today. 

Dr. Novick (38:37):
Thank you so much for having me. 

Eva Sheie (38:38):
It's been a privilege. Thank you.

Dr. Novick (38:39):
It's been my pleasure. 

Eva Sheie (38:45):
If you are considering making an appointment or are on your way to meet this doctor, be sure to let them know you heard them on the Meet the Doctor podcast. Check the show notes for links including the doctor's website and Instagram to learn more. Are you a doctor or do you know a doctor who'd like to be on the Meet the Doctor podcast? Book your free recording session at Meet the Doctor podcast.com. Meet the Doctor is Made with Love in Austin, Texas and is a production of The Axis, T H E A X I S io.