The Entrepreneurial Life Chose Me

I was trained  to be an Ear, Nose, and Throat physician, but the life of an entrepreneur chose me.
 
My employee mindset changed as a result of an interview during residency. The interview was with a private practice physician, who I had known during my training. He had first-hand knowledge of my assets as a physician: surgical skill, sound judgment, physician-patient rapport and superb communication skills. Despite my positive attributes, his job offer for my annual salary was significantly less than the price of the Porsche 911 he was driving and much less than the MGMA (Medical Group Management Association) standard for physician compensation. MGMA is the resource leader for healthcare salary compensation.
 
This experience left me baffled and humiliated but I realized something very important… I didn’t have the employee mindset that most physicians do.  I wanted the freedom  to create and design my own practice and there was no reason I couldn’t do that. I thrived on risk to experience a greater reward. I despise rules, structure and predictability. I wanted to change the world, not just have a job. Failures in my mind were setbacks and an opportunity to learn. Despite all the challenges I have faced over the years, starting my own practice was the best decision of my life. I was able to build a team and office culture of stellar employees.  I was able to tailor my practice to the aspects of ENT that I enjoyed most – minimally invasive procedures to treat chronic sinusitis and improve nasal obstruction. My patients are so thankful to be offered minimally invasive solutions to avoid the downtime, healing, and expense of more aggressive surgical alternatives.
 
Once my ENT practice was successful, my next venture was adding a Medical Spa to my practice. So many patients would not consider cosmetic rejuvenation procedures because of artificial and unnatural looking results. My goal was to achieve a well- rested youthful appearance without the obvious tell-tale signs that a procedure was performed. This difference in approach allowed me to attract patients that were looking for intervention that appeared natural, not artificial.
 
Things were going so well for me until I was diagnosed and treated for Thyroid cancer at the age of 34.  I had surgery to remove my entire thyroid gland and I had radioactive iodine treatment. Because the exact cause of thyroid cancer is unknown, I suspected that my diet and choice of personal care products I used could be a contributing factor.  I decided to detox my life by eating better quality food and avoiding pesticides. I reviewed my personal care products that I was using; like shampoos, lotions, deodorants; and eliminated chemicals as much as possible.
 
I reviewed the ingredients in the skin care products I was recommending to my Medical Spa clients and I was appalled that some products didn’t clearly list their ingredients and all of them contained chemicals that I didn’t approve of.  I was appalled when I found out that there is no federal regulation of ingredients to protect the consumer from dangerous chemicals.
 
From my frustration with the cosmetic industry, my next entrepreneurial venture was born.
 
I set out to create a skincare line that addressed common anti-aging issues such as dark spots, loss of elasticity, blemishes and more. The ingredients would be plant and mineral based, contain no harsh ingredients or chemical preservatives. The ingredients needed to work synergistically to provide superior results. KalVera Skincare was created to provide consumers with healthy skin care and to support my mission to educate consumers about hazardous ingredients found in personal care products and empower them to make safer choices.
 
My journey as an Entrepreneur has been euphoric but it is not the lifestyle for everyone. Entrepreneurship is often a lonely, risky, anxiety-provoking and ever humbling expedition. It can also be addictive. Although KalVera Skincare is my most recent creation, I doubt it will be my last entrepreneurial endeavor.
 
*Cheers*
-Dr. D
 

How Does Air Pollution Affect Your Skin?

Most of us think of air pollution only being an issue for our respiratory health. But did you know that pollution in the air can affect your skin?  
The worst pollutants for skin
Air pollutants can include polycyclic aromatic hydrocarbons (PAHs), volatile organic compounds (VOCs), particulate matter (PM), ozone (O3), cigarette smoke and oxides.  These pollutants contribute to skin aging, including dryness, wrinkling, and dark spots. Additionally, air pollution has been associated with skin cancer, atopic dermatitis, psoriasis and acne.
Pollution creates damage to our skin by creating free radicals which are unpaired atoms with an odd number of electrons. Free radicals are formed when oxygen interacts with certain molecules creating a chain reaction of damage to important cellular structures.
How to combat pollution
Luckily, antioxidants can interact with free radicals to stop cellular damage. The most common antioxidants utilized in skin care products to protect the impact of pollution to our skin are Vitamin E and Vitamin C. Vitamins E and C are most commonly ingested, but they can also be used topically to provide skin protection since they are two of the primary antioxidants found in the skin and are easily absorbed.
Since everyone is susceptible to skin damage from air pollution, we must all be mindful of protecting our skin. Creating a physical barrier with sunscreen and moisturizer is effective before you head out to start your day.  At the end of the day, I recommend cleansing your face with a sulfate-free cleanser to wash away the toxins we are exposed to daily.
Need a sulfate-free cleanser? Check out Clearly Luminous Cleanser!

Which Skin Care Products Are Right For You?

The mirror can be your best friend, but it can also be your worst enemy. The mirror won’t lie. It reveals uneven skin tone and texture, dark spots, fine lines, and wrinkles. It haunts you with the harsh reality of aging. Once you see these imperfections, they glare at you every time you see your reflection. You know it’s time to do something, but there are so many lies in marketing. How can you figure out what skin care products are right for you?
Here are some tips to help you decide:
Over the counter brands
These are big names such as L’Oréal, Revlon, etc. These products are loaded with chemicals and are endorsed by celebrities who make spectacular claims for a product that is relatively inexpensive. According to Business Insider, L’Oréal spent 2.2 billion dollars for marketing in 2015, whereas Revlon spent a “meager” 210 million in 2014.
Apparently, celebrity spokesmodels and television commercials aren’t cheap. With products priced ranging from $8 to $20 dollars, it is obvious that the majority of the product cost likely goes into advertising, not the actual product.

  • Pros- inexpensive and easily available
  • Cons- contains small amounts of active ingredients and contains many chemicals that can be harmful, such as parabens, sulfates and harsh preservatives

High-end department store brands
These products can contain great ingredients that are usually profiled at the front of the ingredient deck. Toward the end of the list, you will often find fragrance, artificial colors, and preservatives. Moisturizers like La Mer will cost $465 for a 3.4 oz. product!  With that price tag, you are better off investing in Botox or filler.

  • Pros- effective ingredients
  • Cons- expensive and often contains chemicals, fragrance, artificial colors

Medical grade skin care
This category includes Obagi, SkinCeuticals, and Rodan + Fields. These products are effective but contain numerous chemicals. Some of the labels even contain warnings about serious allergic reactions and pregnancy warnings. Many of the brands do not list all the ingredients found in the product; they only list the active ingredients.  

  • Pros- effective ingredients
  • Cons- expensive and contains numerous chemicals, fragrances, artificial colors, and harsh preservatives

Natural skin care
This type of product seems like a DIY skin care regimen in a nice package. Lush is a very popular brand in this realm which contains natural ingredients such as shea butter, papaya juice, and various other food products and plants. Amongst the safe synthetics listed in the ingredient deck are parabens and methylparabens – which are not safe enough in my opinion.  

  • Pros- contains natural ingredients
  • Cons- the ingredients are natural but are not effective enough for mature skin. The labels need to be read carefully because there is no guarantee that the ingredients are natural or safe. Depending on the choice of preservatives, the product may not stay fresh very long.

Decisions, decisions!
With all these options available, how can you make a decision? This was the exact problem that I faced. I wanted a product that utilized effective ingredients to reverse signs of aging in mature skin, but I wanted them to be chemical-free and safe, especially after I was diagnosed and treated for thyroid cancer in my early thirties. I realized that labels that stated “natural” were misleading once I reviewed the ingredient deck.
That was why I created Avanti Rx using effective plant and mineral ingredients which are combined to create powerful results. The products are formulated to exfoliate and reduce blemishes, redness, dark spots, and wrinkles.
We are proud to be chemical free, cruelty free, non-GMO, and Vegan friendly. I wanted the product to be a reflection of my strict ingredients standards so that my clients didn’t have to worry about deciphering confusing labels.  Healthy skin care doesn’t have to be a luxury; it should be a necessity.  And you don’t have to be a celebrity to afford it.
Ready to check out what Avanti Rx has to offer? View our current products here.

Six Makeup Tips to Improve Your Skin Health

Most makeup fanatics love spending time at the MAC counter, and they love watching makeup tutorials on YouTube to create the best cat eyes, ombre lips, and perfecting contouring techniques.  However, makeup fanatics don’t usually like to spend as much time on the less exciting chores of makeup removal.
Here are some six of the most common questions I get asked and some of my personal tips:
Should I always remove my makeup? 
I can’t even believe that I get asked this question, but yes makeup should always be removed. It should be removed before bed, before the gym and even before cleansing.
What type of makeup remover should I use?
Most makeup removers consist of alcohol or oil.  Alcohol can over dry skin and oil can clog pores, which exacerbate breakouts for acne prone skin. If you opt for a makeup wipe, choose one that does not contain alcohol and is biodegradable. I use Micellar water since it does not contain alcohol, oil, or fragrance. It will remove makeup (except waterproof makeup) and prep your skin to be cleansed.
How should I remove makeup?  
Saturate a cotton face pad and wipe away your makeup.  For eye makeup let the product soak on your eye lid for a few seconds first and then wipe.  Do not harshly scrub your skin, especially in the delicate eye area.
What kind of cleanser should I use?  
Although a Sulfate-free cleanser will not excessively foam, it is better for your skin since as it won’t remove the skin’s natural moisture barrier. I personally like to cleanse my face with my Clarisonic device and Clearly Luminous Cleanser.   
Do I need to clean my makeup brushes?  
Absolutely! Makeup brushes harbor bacteria and could be the cause of your breakouts. Brushes should be cleaned weekly with a brush cleaner and Micellar water. I partially submerge my brushes in a cup with a mixture of dish soap and a few drops of alcohol to serve as a disinfectant. I soak for five minutes and leave them on a paper towel to dry overnight.
Can I keep my makeup forever?
Makeup, like most everything else, has an expiration date. Check the expiration date on your cosmetics and discard when it’s time. I check my makeup every six months to ensure that I am not putting applying expired product on my face.
Follow these tips to help maintain radiant, blemish-free skin. 
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What You Should Know Before Getting Botox or Filler at a Day Spa

Day spas are a perfect retreat for the busy woman who needs a chance to rest, relax, and rejuvenate. It’s a one-stop shop for massages, manicures, pedicures, facials, and body treatments. As you enjoy the serene ambiance sipping champagne, one of the estheticians informs you that the spa is now offering Botox and other filler services. Your inner voice says, “This would be amazing since I am too busy to make another appointment with my doctor!”
Before you fully succumb to that multi-tasking inner voice, here are a few questions you need to ask of your day spa.

  1. Who is the doctor performing the procedure? It is important to know what kind of physician is performing the procedure. My recommendation is to make sure it is either a Board Certified Plastic Surgeon or ENT Physician who focuses on cosmetic procedures. Surgeons typically have a better understanding of the facial anatomy and facial balance.  
  2. Where is the physician’s practice located? Many day spas have physicians who come from out of town to perform the procedures one or two times a month. Excellent physicians are often plenty busy in their own practices. So, they do not have the time or desire to travel long distances to work.
  3. Will a follow up appointment be scheduled? As a consumer, you must understand how post-procedure questions, concerns, or dissatisfaction with results will be handled.  
  4. Are the procedures performed in a medical environment with medically trained professionals? Make sure the injectables are purchased directly from the manufacturer and not a knock -off website. The staff would should be trained on occupational safety standards from OSHA, and sharps should be disposed of appropriately.  

The last thing to consider is that a physician who travels to perform your procedure may not be as invested in your outcome as a physician that you see regularly. The relationship and communication between physician and patient is of great importance, especially when it comes to your face!
Are you in the St. Augustine area? Come visit me at Avanti Med Spa

Reviving Aging Skin: Focusing on The Outside

Previously, we talked about fighting aging from the inside.  But once you have followed the hydration and nutritional tips, what else can you do to keep your skin looking youthful and flawless?

  1. Microdermabrasions are a great way to resurface the skin using crystals or a diamond tip.  Microdermabrasions can improve the texture and the skin tone. I recommend using Clearly Luminous Cleanser as part of your home regimen to keep your skin exfoliated and blemish-free.
  2. Facials are effective in smoothing and brightening skin. During a HydraFacial procedure, serums and peels can be part of the signature treatment tailored for your specific skincare needs.  
  3. Brown spots, also called sun or age spots, are a tell-tale sign of age. To help fade them, use Age Spot Remedy, an alternative to Hydroquinone, a chemical with some harmful side effects, for lightening the appearance of age spots. This product cant be used but  one to two times daily.
  4. Sun exposure is a huge factor in aging. Make sure you use an SPF 30-50 and reapply every two to three hours. If you are in the sun during the hottest part of the day, make sure you are wearing a wide-brimmed hat to further block harmful ultraviolet rays.
  5. When more conservative approaches fail, a Fraxel laser treatment can be considered to greatly diminish wrinkles and brown spots in an office procedure with little minimal to no downtime. The settings of the laser can be customized based on your skin coloring and the desired effect.  The physician is capable of providing a more aggressive treatment or a lighter treatment based on the desires of the patient.

 
http:/https://youtu.be/EZmtPWFdhL4
Turning back the clock used to require aggressive surgery.  Luckily, we have many noninvasive options for facial rejuvenation that don’t require going under the knife.

Revive Aging Skin from the Inside Out

Aging is a fact of life, but beauty and well-being is a choice.  As we age, our hormone levels can shift resulting in decreased estrogen levels. The result on the skin is thinning, sagging, dryness, and wrinkling.
Here are some suggestions to keep your skin looking radiant and youthful during the aging process:

  1. Hydrate inside and out: The older you get, the thirstier your skin gets. The skin’s oil glands aren’t as active as they were in your younger years.  In order to keep your skin hydrated, drink  at least 2 to 3 liters of water per day.  
  2. Eat up: Nutrition plays a major role in the condition of your skin. Among the most beneficial food elements for aging skin are antioxidants, which can help combat the effects of the loss of skin-plumping collagen. Antioxidants are found primarily in brightly colored fruits and vegetables.  An antioxidant supplement should also be considered, such as Vinali, which contains grape seed extract, Vitamin C and Acerola Cherry to protect against free radical damage, or Beauty Boost, which contains Dermaval, a proprietary blend of extracts from nine superfoods.
  3. Stay active: Exercise tones more than your muscles. It boosts circulation of oxygen-rich blood needed to help your skin look brighter and healthier.
  4. Bust stress: Stress is a proven primary factor in aging. It can dry out your skin, making it more sensitive and prone to wrinkling. Regular exercise is a great stress-buster, as are meditation;, adequate sleep (aim for eight hours of uninterrupted sleep nightly), and – believe it or not – laughter. A great laugh boosts heart rate, stimulates blood circulation, and aids muscle reaction.http://https://youtu.be/eggJndE6S38

Reviving aging skin requires a multi-factorial approach and a commitment to health and well-being.  It is a commitment you won’t regret as the golden years approach.

Why Do Celebrities Look So Strange?

Celebrities set the standard of beauty in magazines, television, and on the runway. The general public expects celebrities to set this standard.
But what happens when we see celebrities look like caricatures of themselves with excessively plumped cheeks and lips. Celebrities can afford the best, but is this what all that money buys you?
My suspicion is that this overdone, unnatural look is created by the mindset of the client and the physician performing the procedure.
The client wants perfection and doesn’t understand that our imperfections are what make our faces unique and interesting. The physician does not want to disappoint the client and does exactly what the client asks for, instead of suggesting that injecting too much filler will actually make them appear less attractive. Unfortunately, this confuses the general public into thinking that all cosmetic procedures look unnatural.

In my medical spa, I take a different approach with my clients. First and foremost, my patients choose me to perform their procedures because they want to look refreshed and rejuvenated.  They do not want to look as if they had a procedure done.
When filler is injected properly, keeping the client’s unique facial balance in mind, no one can tell  a procedure was performed.  Friends and family will assume that you look younger because you went on vacation, or that you did something different with your hair or makeup. You look younger and more vibrant, but they just can’t pinpoint why.
On the contrary, when filler is overdone, it changes your face by changing the unique facial characteristics that make you special.  It looks “fake” or “overdone”.  This phenomenon can be easily avoided by speaking with the Physician, Physician Assistant, or Nurse Practitioner performing the procedure.
Make sure their ideas about your final result are congruent with yours.  Also, conduct a thorough visual survey of the person injecting you. Do they appear to practice self care? Do they look older or younger than they are? How well do they take care of their skin? Do they look natural or overdone?
These two things will likely tell you everything you need to know about how your final result will look.

What Does Beige Say About You?

We live in a world of conformity. No one wants to stand out or be different. Fitting in feels like hanging out in your favorite pajamas. Beige is neutral so we wear it, paint our walls with it, cover our floors in it, and even drive in it. No other color makes a more unoriginal statement than beige.
What if we all had beige personalities? Beige means dependable, conservative, and flexible, as well as neutral, calm, and relaxing. But beige is boring as h#$*.
 
Here is what goes through my mind when I see someone who is beige:
 

  1. They are afraid to be unique. Being beige is the perfect way to fit in and not get noticed. This works especially well if you are uncomfortable in your own skin and don’t have a sense of who you are.
  2. They are safe and conservative. Beige people will not take risks. If you can’t take a small risk with your wardrobe, how can you possibly be interesting?  This is not the person you want to invite to a party, unless you need furniture for the corner.  
  3. They have no sense of style. If you have a burning desire to wear beige, please coordinate it with a bright accessory or a bright wardrobe piece that has a significant spark of color. Don’t wear beige because it matches everything, and it allows you to be lazy.  
  4. Their house is beige so they can sell it easily.  The walls are varying shades of beige, and so are the carpets and floors. Most likely the residents are wearing beige, so they can adequately morph into their surroundings.

 
My advice to anyone who just can’t break their beige habit is to move out of their comfort zone and get uncomfortable.   Embrace color with your own individuality so that the world can benefit from your unique contribution.  Remember, beige is boring…are you?

Who needs skin care when you can just get Botox?

The advent of Botox leaves many thinking they no longer have to worry about their everyday skin care.
Nothing could be farther from the truth.
In my practice, we start every Botox consult with a Visia skin analysis. This simple analysis uses cross polarized and UV light to give us an analysis of sun damage, texture, brown spots, and wrinkles in the form of a score in each category. The score is obtained by comparing you to peers in your age group. Just like a test, higher numbers are better. It is important to know this information since these are factors in skin aging.
Botox is a neuromodulator that is effective in reducing the appearance of forehead wrinkles, crow’s feet, and those pesky scowl lines between your eyebrows. It can also help turn your frown upside down by elevating the corners of your mouth. So, with all these amazing things that Botox can do, who needs skin care?

Importance of Skin Care
Botox only improves lines and wrinkles, but wrinkles are not the only reason that people look older. Youthful skin has smooth texture and an even skin tone without fine lines or wrinkles. Botox does nothing for the radiance, texture, and brown spots. Nourishing skin care will improve skin elasticity and texture while reducing brown spots. Exfoliating your skin and adding a retinol to your skin care regimen will help increase cell turnover, which greatly decreases as we age. Moisturizing your skin will improve its elasticity and enhance your Botox procedure.
Save Money with Proper Skin Care
Skin care can actually save you money! Botox can cost on average $300 or more every three months, depending on which areas you address and how deep your wrinkles are. In my practice, the patients that are diligent with skin care and sun protection typically spend less on Botox treatments when compared to clients who neglect their skin. Remember that all skin care is not created equal. Look for brands without harsh chemicals that contain plant-based active ingredients. Also, be careful not to base your decision solely on marketing and packaging!