Tune In: The Skin Care Advice A Holistic Plastic Surgeon Gives His A-List Clients

On today's episode of Clean Beauty School, I'm talking to aesthetics pioneer and board-certified plastic surgeon Julius Few, M.D. He's been at the forefront of many innovations, from researching nonsurgical interventions such as lasers and various injectables to practicing holistic plastic surgery. 

"As a plastic surgeon, it would be very easy for me to say, 'Oh you have a wrinkle, so let me do something about that.' But my view is so much more broad spectrum. It's the idea of why do you have a wrinkle? Are you healthy and do you have a healthy lifestyle? Is there some other mitigating reason that feeds into this skin concern that maybe doing just an outward treatment would not necessarily be the best solution?" he says about his all-encompassing approach to his practice. 

"Beauty is not static but is instead a continuum of time," he says. As he explains in the episode, Few does not view his work as an isolated experience—one that can be evaluated by a simple before-and-after photo. 

According to Few, there are several dimensions to view aesthetic work: Two dimensional is the face as viewed as a picture. Think the aforementioned before-and-after photos, selfies, and Instagram posts. Three-dimensional beauty is how a face looks in front of you. 

But four-dimensional beauty goes one step further: It's viewing the face in motion and across time. "If I took a 30-second video of an individual and then took segments to make them into still images, you'd see huge swings in volume when measuring with a validated scale," he says. "You could literally be viewing the same person within a 30-second window and have a two- or three-point swing in what their volume reading would be." 

However, movement is often not considered in aesthetic work: "It's really important not to over-treat people. For example, if you add a ton of volume to somebody's face, it won't move naturally. If it doesn't move naturally, that interferes with their fourth dimension of activity," he says. "This happens a lot: You meet somebody, who in a picture or a social media post looks freaking amazing, but in real life, it's like 'What happened to this person?' That's because whatever they've done has erased their ability to annotate in a natural way." 

And because four-dimensional beauty is influenced by time (meaning how the face changes with movement and age), his work is dependent on and influenced by several full-body cofactors, such as nutrition, sleep, mental health, and more. These, he notes, can play a huge role in how his work evolves. 

The advice I hear most often on the podcast is "less is more." When guests say it, it's usually about their approach to skin care or what active ingredients they recommend. But never is that advice more pertinent than when you're talking about aesthetic intervention. 

"We have a saying in plastic surgery, "The person who has the least experience is the one who tends to do the most,'" Few says. "For anybody who's thinking about doing something cosmetic, do not try to alter anything more than 85% of what you think is ideal. If you abide by that, you will stay out of trouble."

In aesthetics, there's a phenomenon known as "perception drift." This happens when folks cannot accurately see changes and progress happening in the mirror—leaving people feeling like the work is never quite "done." When left unchecked, perception drift can lead to overuse of filler, neuromodulators, and dramatic surgical interventions. 

Not only is the skin constantly fighting off environmental pollutants—things like particulate matter that can trigger free radical damage in the skin—but there are also skin care pollutants to be mindful of, says Few. 

"It's important to stay away from things that behave as pollutants in skin care. A lot of folks don't think about this, but when you buy products that aren't thoughtfully manufactured, they often contain a lot of different things that may or may not be nice to your skin," he says, noting that the skin often views these ingredients as they would an external stressor or pollutant. "You don't want to introduce something into your system that is going to aggravate it and make it sick." 

These pollutants are ingredients that are known to cause irritation or inflammation in the skin, such as sulfates, phthalates, and parabens. Avoiding common pollutants is a core pillar of his new skin care line, Dr. Few Skin Care, which currently boasts a Gentle Exfoliating Cleanser, Clean Retinol, and a Tinted Mineral Sunscreen. 

However, he's quick to note it's not about being absolutist in your routine—but to just be mindful of what you're exposing your skin to on a regular basis.