Conversations in Aesthetics

Dermsquared
  • 5.0 (1)
  • MEDICINE

Conversations in Aesthetics invites you into the real work of aesthetic medicine: the judgment, the dialogue, and the small decisions that shape outcomes. Hosted by Gary Goldenberg, MD, each episode features a leading clinician who shares their approach and the thinking behind it. Designed for dermatology professionals, it’s practical, grounded insight you can feel and use. 

Episodes

  1. The Art of Skin Quality

    JAN 20

    The Art of Skin Quality

    In this episode of Conversations in Aesthetics, host Gary Goldenberg, MD, welcomes longtime colleague Dee Anna Glaser, MD, for a thoughtful discussion on what defines success in aesthetic dermatology and why subtlety, communication, and judgment matter as much as technique.  Dr Glaser begins by defining a successful cosmetic procedure as one that delivers meaningful improvement while preserving confidence and natural appearance. She describes an approach rooted in individuality, where genetics, lifestyle, age, and patient goals shape every decision. Central to that approach is the willingness to redirect—or even refer—patients when requested treatments fall outside her aesthetic philosophy, a decision she describes as one of the most challenging but necessary parts of practice.  The conversation returns repeatedly to the consultation, not as a single moment, but as an ongoing dialogue. Dr Glaser explains how she structures patient conversations over time by setting expectations, revisiting outcomes, and adjusting plans at each visit. She shares a simple but revealing exercise she uses in consults: asking patients to name two things they like about themselves. The responses, she notes, often reveal how self-critical patients can be, and how reframing around strengths can build trust and momentum.  From there, they turn to procedural strategy, with a focus on skin quality as a foundation for aesthetic results. Dr Glaser outlines why toxin and resurfacing remain core tools in her practice, and how she helps patients weigh results against downtime across options such as chemical peels, microneedling, and more aggressive resurfacing. Together, she and Dr Goldenberg discuss shifting patient preferences toward greater downtime in exchange for better outcomes.  A video demonstration anchors the episode’s procedural component, with Dr Glaser walking through her microneedling technique for the face and neck. She discusses depth selection, regional variation, priming the skin, and the use of adjunctive therapies such as PRP and exosomes, emphasizing safety, customization, and realistic healing timelines. They also explore how microneedling compares to energy-based devices, particularly in pigment-prone skin and sensitive areas like the neck.  In the latter part of the conversation, Dr Glaser reflects on her transition from academic medicine to private practice, offering candid insight into autonomy, trade-offs, and long-term professional satisfaction. The episode closes with a forward-looking discussion on where aesthetic dermatology is headed: earlier patient engagement, increasing demand for skin tightening and body treatments, challenges posed by social media trends, and the growing need for safe, effective options across diverse skin types.

    42 min
  2. Health, Happiness, and the Full-Face Approach

    12/09/2025

    Health, Happiness, and the Full-Face Approach

    In the second episode of Conversations in Aesthetics, host Gary Goldenberg, MD, sits down with longtime colleague and friend Mark Nestor, MD, PhD, dermatologist, researcher, clinical innovator, and educator whose career spans more than three decades. Their conversation opens with what Dr Nestor considers the central focus of modern dermatology: a holistic view of patient care grounded in health, happiness, and well-being. They begin where every aesthetic journey starts—the consultation. Dr Nestor walks through how he listens for a patient’s real motivations, distinguishes wants from needs, and maintains the freedom to say no when expectations are not aligned. He emphasizes a minimalist, science-based approach to facial rejuvenation, grounded in realism, restraint, and the belief that aesthetic work should enhance a patient’s natural appearance, not overwrite it. Together, he and Dr Goldenberg explore the importance of educating patients on aging as a continuous process, why “less is more” remains a guiding principle, and how downtime often correlates with deeper, more lasting results, especially when choosing between nonablative and ablative resurfacing. The conversation then widens to procedures and patterns they both see in practice today: the rising demand for hair-loss treatments, especially among women; the evolving understanding of autoimmune and inflammatory contributions since the pandemic; and the role of regenerative medicine, from PRP and exosomes to emerging medical foods, in supporting both clinical and aesthetic outcomes. From there, Dr Nestor introduces a concept he has studied extensively: emotional anatomy. He explains how targeted botulinum toxin injections, particularly in the glabellar complex, have demonstrated effects on mood beyond cosmetic benefit. They discuss facial mimicry, the biological underpinnings of “the real smile” versus a constrained one, and why thoughtful injection technique—depth, distribution, units, and anatomy—separates consistent, natural results from occasional ones. A video demonstration illustrates his approach to injecting the corrugators, procerus, and lateral orbicularis to lift the brows and support a more open, positive expression. As they look ahead, Dr Nestor highlights what excites him about the next decade: hybrid toxins, a renewed appreciation for ablative resurfacing, continued growth in regenerative therapeutics, and urgently needed innovation in UVA-protective sunscreens as skin-cancer patterns shift. He returns to a theme woven throughout the episode—patients seeking solutions that feel natural, are rooted in science, and support whole-person wellness. This conversation offers a thoughtful, wide-ranging tour through the art and science of aesthetics today, reminding viewers that beauty, health, and happiness are deeply interconnected and that skill, judgment, and intention matter at every step.

    45 min
  3. Conversations in Aesthetics – Episode 1 - Aesthetics Begins with the Art of the Consult

    11/11/2025

    Conversations in Aesthetics – Episode 1 - Aesthetics Begins with the Art of the Consult

    In the first episode of Conversations in Aesthetics, host Gary Goldenberg, MD, sits down with Mathew Avram, MD, JD, Director of the Laser and Cosmetic Center at Massachusetts General Hospital, for a grounded, candid conversation about the core of aesthetic practice—understanding the patient in front of you. Dr Avram emphasizes that elective procedures are a different kind of medicine. Patients arrive with hopes, vulnerabilities, and expectations shaped by personal experiences, social media, and cultural trends. The work, he notes, begins long before any syringe or device is in hand. It’s in the consultation; how to listen carefully, assess whether expectations are realistic, and sometimes, when to choose not to treat. Together, they discuss how aesthetic dermatology has shifted over the past two decades, from patient demographics to the influence of selfies and video calls, and how psychology plays an undeniable role in patient satisfaction. They explore Dr Avram’s approach to expectation-setting, which includes how he frames outcomes for skin tightening or fractional resurfacing in ways patients can genuinely understand. The conversation then turns to today’s procedural landscape: the rise of botulinum toxin as a first-line aesthetic entry point, vascular and fractional lasers as foundational tools in Dr Avram’s practice, the evolving role of acne lasers as alternatives to systemic therapy for select patients, and emerging energy-based and micro-coring technologies, including where they fit and where caution is needed. Throughout, Dr Avram and Dr Goldenberg return to a core idea; aesthetic dermatology is not just about looking better. It can also support skin health and regeneration, and reflects a growing overlap between aesthetics and wellness. This episode offers a thoughtful lens on practicing aesthetics with clarity, restraint, and intention. Reminding us that the most meaningful part of the work often happens in the conversation, not the procedure.

    58 min
  • 3 Episodes

About

Conversations in Aesthetics invites you into the real work of aesthetic medicine: the judgment, the dialogue, and the small decisions that shape outcomes. Hosted by Gary Goldenberg, MD, each episode features a leading clinician who shares their approach and the thinking behind it. Designed for dermatology professionals, it’s practical, grounded insight you can feel and use. 

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