My Warm Table ... with Sonia

Botox, skin needling and anti-ageing aesthetics with Nurse Practitioner Shiree Walker

June 14, 2022 Sonia Nolan Season 1 Episode 7
My Warm Table ... with Sonia
Botox, skin needling and anti-ageing aesthetics with Nurse Practitioner Shiree Walker
My Warm Table ... with Sonia +
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Show Notes Transcript

Shiree Walker gives you the low down on laugh lines and wrinkle relaxers and shares a behind the scenes look at the ever-growing cosmetics and injectable industry. 

This is the first of a three-part special on ‘Women’s Wellness’. You’ll find out what a Nurse Practitioner can do, what the ‘gateway drug’ into cosmetics is, and why there are different skin aesthetic techniques for people of colour. 

As a Nurse Practitioner, Shiree’s expertise stretches across 21 years of emergency care nursing and specialist skills in urinary, gynaecology and further post graduate training to become an advanced cosmetic injector. 

“When someone asks us ‘what is the number one anti-aging skin care product?’ We always say that it is by far, SPF.” – Shiree Walker, Nurse Practitioner.

You’ll hear:

  • What is a Nurse Practitioner? (1:30)
  • Cosmetics and injectable treatments (7:30)
  • Skin needling (10:10)
  • Wrinkle relaxers (12:20)
  • Sun damage (16:00)
  • Dermal fillers (22:00)
  • Laugh lines (26:00)
  • Mechanical thread lifts (28:00)
  • Aesthetics for people of colour (32:20)
  • Fitzpatrick skin scale (33:20)

Duration: 37 minutes.

 Mentioned in this episode:

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  • Sincere thanks to Jay (Justin) Hill for his expert sound mastering and patience! Jay, together with the incr
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My Warm Table, translated into Italian is Tavola Calda. These were the words my Papa used to describe a table of good friends, good food and good conversation. I always aim to create a tavola calda in my life and I hope this podcast encourages you to do so too!

Shiree Walker:

Cosmetics is Yeah, it's a big business and it's just evolving and evolving. And this time that we spent at home. You know, during COVID people have gone two ways of amplifying what they what they think or they're like going right had all the time I couldn't spend my money on, because I couldn't go out they're like, this is what's important.

Sonia Nolan:

That's Shiree Walker, a nurse practitioner who's joining me on My Warm Table for a three part special, where we'll be talking about everything from pelvic floors and menopause, to cosmetic wrinkle relaxants, and adrenal fatigue. Shiree popped over after leading a community yoga class where all the proceeds went to her favourite charity. Over chicken sandwiches and cups of tea with lots of sugar, we talked for hours recording these bytes of wisdom, especially for women, busy women, tired women, menopausal women, ageing women, do any of those sound like you? I can tell you, they certainly sound like me. Shiree has amazing knowledge, experience and qualifications to support a growing need and demand to tackle these issues head on. I learned a lot. And I laughed a lot with Shiree that afternoon and I hope that you will too. Shiree, thanks so much for joining me today. It's just such a pleasure to meet you. And I'm so excited about hearing the work that you do, because I have to admit, I hadn't heard of a nurse practitioner as a as a job title as a role until really recently. So could you please tell me a bit about what a nurse practitioner is, and and maybe even your road to get there?

Shiree Walker:

Yeah, for sure. And thank you for having me. So a nurse practitioner, so we all start off as registered nurses. So we've done an undergraduate programme through a university, and then we have gone on to get more experience in a clinical area. So we are senior registered nurses, then we move on to doing a Master's Degree. So just depending on which university you go to, depending on what it's called. So I did a Masters of Nursing Nurse Practitioner Degree. And then from there, the next step from there is then being endorsed by APRA, which is the governing body for health professionals, to then have endorsement as a nurse practitioner to be able to then work in whatever field public or private field as a nurse practitioner,

Sonia Nolan:

and then what do you do as a nurse practitioner.

Shiree Walker:

So depending on what field you're in, but the general goal or role of a nurse practitioner is, we are able to do or should be able to do head to toe assessments. We can order and interpret pathology and radiology. We can prescribe medications. And we can diagnose clients.

Sonia Nolan:

There's quite a few GP clinics now I think, who also have nurse practitioners working there alongside the GP. So in very similar roles, is that fair to say?

Shiree Walker:

Yes, yep. So they either will do similar primary health care, or they might have an area of specialty while they're working in a GP practice. So it might be women's health, children's health, you know, there are some nurses who are jewel midwives and nurses. So then they go into the nurse practitioners so they can do maternal health and children's health. Yeah, lots of different areas and I do know of a colleague who, you know, diabetes nurse practitioner, so that also really lends to working within the GP practice. Also mental health nurse practitioners. So there can be a wide variety, but I guess, treating clients who have more that chronic disease element, so that really works well in the primary health care setting.

Sonia Nolan:

Yeah, brilliant. I want to touch a bit more on your experience. But I want to jump straight into some of the really interesting things that you're doing, Shiree, because we've just actually enjoyed lunch around my warm table. And and of course, we've had the most amazing conversation, which I said, No, no, stop we need to we need to record this now. Because you what you're doing is so interesting. And I want you to share the work that you're doing in cosmetics, because it's a growing industry. But it's also something that is, you know, we've really got to do it with caution.

Shiree Walker:

Yes, definitely. So I was working in the emergency department. At the same time, one of the doctors that I worked with her plan was to go further her training as a GP and get into cosmetics as well. So put my hand up out of interest and said if you're ever doing this, let me know. I'm keen. But yeah, she rotated went to another hospital. We stayed in contact and then when she was ready, she was like Shiree I'm going to be doing this. So we trained together, trained up together. I did extra studies in that area. And then

Sonia Nolan:

so you're already a nurse practitioner at this Yeah, sure,

Shiree Walker:

Yes. So I had when I met her I was doing my point. nurse practitioner studies and then by the time she was ready to do that I was a nurse practitioner. So we did training. She then moved down south to finish her GP training and didn't come back up to Perth. But we stayed very much and we are very much in contact. She's my collaborative doctor that I work even though we're separate, we bounce ideas off each other. So I then got it. So work in the emergency department yeah. And then I got a bit more into it, I always had done my further studies in cosmetics and started just slowly doing a couple of clinics around around Perth, and then got involved in local clinic to myself and had an amazing nurse there who was a very experienced Cosmetic Nurse, take me on board, train, train me up a bit more got into more the skin side of things. And then that's kind of evolved. So I still stayed in ED for about eight years after that. Cosmetics was kind of like my side gig. had my foot in there. And I could see that it was beginning to grow. And a lot of nurses and doctors were trying to get into the field. And I did have this point where I was like, maybe I should just like, step away from it. And I actually had people go Shiree like, do not because it actually for nurses, it is quite hard to get into the field.

Sonia Nolan:

I think something that I've certainly found in my experience of anything medical is that nurses explain, take the time to explain things in really great detail and in normal words, which is always helpful when you don't have a medical background. And I wonder whether that plays a part in you as a medical practitioner?

Shiree Walker:

I think so I'm a very visual learner. Like, I like pictures and diagrams, till the cows come home. And we'll use it a lot in my consults and explaining. And I think, because then clients get it, and then they know exactly what they're in for and why you're choosing one treatment over the other. Or if you give them several treatment options. And they can go away and think about it. So I think that my probably came about from my previous background doing like wound care and continence because it's a very internal visual thing. My one example is when you explain to someone pelvic floor, people like, what how do I engage it? Where is

Sonia Nolan:

where is the where is it? How do I find it?

Shiree Walker:

Yeah. So you know, we really had to get the diagrams and that sensation of getting people right, well, it's connected here, here and here, do this do this. So I think it's evolved from that. But I realised that people needed that visual and an understanding and to break it down in a language that they can definitely understand.

Sonia Nolan:

So Shiree I just want to find out about what it is that is cosmetics. For someone like yourself as a nurse practitioner, what do you do in that field?

Shiree Walker:

So I do a variety of things. Mainly injectable, so that includes Wrinkle Relaxers, dermal fillers, then I do a treatment called PRP, which is platelet rich plasma.

Sonia Nolan:

Oh, I want to know about that. That sounds interesting.

Shiree Walker:

So that is a procedure where we take the client's blood sample, we put it in a specific tube, we spin it in a central centrifuge, then their plasma rises to the top of that tube, which has all these great growth factors, we're able to draw that plasma out and then able to re inject it back into their skin.

Sonia Nolan:

Oh, okay, and why would people want to do that?

Shiree Walker:

So one option is they're potentially not ready for dermal fillers. So PRP is a more quote unquote natural way because they're using their own body product,

Sonia Nolan:

Oh okay.

Shiree Walker:

But it does help with collagen stimulation and elastin simulation, so you can inject it into fine lines, it helps to tighten the skin. It can be used in areas that are tricky to treat like under eye tear trough areas, fillers on that area can be quite problematic for some clients. So PRP is a good alternative. You can also use it for hair growth and stimulation as long as there are hair follicles present.

Sonia Nolan:

So you have men and women going back into that?

Shiree Walker:

I have a few men and women who are having that treatment. So it can be used as a quite a wide variety of areas. There are some other treatments available, which I will tell you about you do have to be specifically trained by a doctor he owns the trademarks on these specific procedures. So you can't use these names without having done his trading and I think you potentially pay him a fee for that trademark. So one is called the Vampire Facial

Sonia Nolan:

and where did that come from? Because I know there's a story behind that.

Shiree Walker:

It got quite well known if you Google Kim Kardashian and Vampire Facial you will see a picture of her looking very happy, covered with blood. She went and had this treatment and it got a lot

Sonia Nolan:

Oh my gosh. of traction after of course that went viral. So it sparked a lot of interest. So that was using platelet rich plasma and then skin needling into the skin and getting a lot of blood. Under this doctor you can also train Sorry, I'm so new to this the thought of any sort of fillers on my face or anything, just it hasn't got there yet. But yes, I'm sort of the other side where I'm just sort of thinking I don't want to put anything in my body because I'm actually trying to get rid of a lot of stuff. So, so all of this is just so fascinating for me. So I don't understand why you'd be needling your skin. and making it bleed. And, yeah. Can you just walk me through all of that?

Shiree Walker:

So, skin cell turnover in the body is 30 days. And also, if I explained to clients if you were to injure yourself, so you got to cut by that, you know, there's this whole process your body goes through to stop the wound from bleeding, remodel the skin, heal it, get your pigmentation back to normal. That can be a 30 day cycle. So with doing things like skin needling is a controlled injury of the skin. So we're using a special machine like, so this is another treatment, something called a skin needling device, or people might know it is collagen induction therapy. So it's a specific machine that's used that kind of it vibrates, it has a sterile head on it, and you dial that head up to a certain amount. So it goes from 0.5 to 2.5, depending on how much penetration you want, and also your endpoint. So there used to be this thing where having that blood was like, Oh, that's a good endpoint. But now there's more research saying you don't actually need that gory blood look, you can just get this nice redness in the skin. And what that controlled penetration of the skin is doing is increasing that skin cell turnover. So it's treating things like pigmentation so it's kind of making the pigmentation in the slightly deeper layers of the skin breakup, rise to the surface and then slough off essentiall. It helps with like acne scarring, surgical scarring, because it's recreating that collagen stimulation which you know, with with acne scarring can be very different types of scarring like really deep scarring, pitted scars, tethered scars, so it helps in that process as well. And then it helps with fine lines and wrinkles. So it's a bit of a all rounder, and same again, it's just using your own body's natural doing the skin remodelling. So can do like normally you can do your face your neck and decolletage. You can do the back. So you can actually do really anywhere on the body. You can do like sometimes on tummies, like for stretch marks as well. So it's one of those ones where skin needling can be used for a wide range of areas as well.

Sonia Nolan:

What is the thing you get asked for the most?

Shiree Walker:

I think call it the gateway drug.

Sonia Nolan:

gateway drug. I love it. Tell me what is it?

Shiree Walker:

I would say Wrinkle Relaxers

Sonia Nolan:

wrinkle relaxer?

Shiree Walker:

Yes. So we have three drugs available in Australia as Wrinkle Relaxers. So one's called Botox. One's called Dysport. One's called Zeeman. So they're the Therapeutic Goods Administration and TGA approved drugs in Australia at the moment but we call them Wrinkle Relaxers from an advertising point of view on our social media APRA guidelines. We can't mention the name so I'll just, but on podcasts I can mention them. Yes, we'll talk we'll call the Wrinkle Relaxers from here on in

Sonia Nolan:

now I've got a lovely friend of mine who talks about preventative Botox. She talks about preventative Botox and and I've always found that really fascinating that that whole term about preventative so I'd love you to explore that with me as well.

Shiree Walker:

So Wrinkle Relaxers effectively temporarily stopped the muscles from moving, they stop that muscle pump. So it's something that it's not permanent. If you don't like the way it looks or feels it wears off and your muscles go back to normal. So there is that thought process of if I don't have a lot of wrinkles right now, if I just do a bit of a baby sprinkle, is that gonna stop the ageing process and it's also about the amount of product that's used. So we have in each area we inject in the face for Wrinkle Relaxers, there's a certain amount that is safe to do. So we have a minimum and maximum dose which is safe to do in one sitting. Then we would review you normally the wrinkle relaxers take about five to 10 days to kick in and then I'd normally review clients at about the two week mark and then we can add on safely from there. If you go too heavy handed is when you can get potential complications like droopy eyelids and things like that which then people are then stuck with for until the wrinkle relaxer starts wearing off. So it's a lot easier to just start at a lower dose and that's when the clients are beginning to like be like hear about their friends having baby Botox or you know, the sprinkle as I call it and then kind of seeing how they go go from there. And you know, sometimes they want to meet you first have a chat. See what you have to say before they think about it. Or they'll be like they get to know you and be like yeah, let's just go let's do it. I trust you. I mean, you sound like you know what you're talking about. So off you go. So it's a bit of that yeah, having a bit of wrinkle relaxer to stop the ageing process in that you're stopping fine lines and wrinkles from progressing.

Sonia Nolan:

But do you have to keep doing that though. So so say you start the baby Botox or the sprinkle in your 30s, - oh to be in my 30s again - that are you actually stopping it? Or are you just sort of pausing it for that moment and then it just accelerates again,

Shiree Walker:

I think it's two things one might be that you are going to have to potentially pause it if you have children. So we don't do any type of injectables during pregnancy and breastfeeding. So you will have that gap where you aren't able to have it done. And then also, if you're having said that the lifespan of Wrinkle Relaxers is usually about three to four months. And that's when you would come back for another treatment. But depending on, I guess how your muscles are moving and your muscle mass, you might need it, you might have a longer wear time than someone else, we just say the average is three to four months. So if you're starting, when you don't have a lot of wrinkles, you might not need as much product, which means because your wrinkles aren't progressing, so you're not actually having it as often. So you kind of are stopping the ageing process to a degree, but then you've got your other factors of health and lifestyle, sun damage ... So it's not a necessarily given that just doing this is gonna stop the ageing process. So there are the factors that we need to let our

Sonia Nolan:

You've just raised a really interesting point because I want to talk about sun damage. And I'm sure you see the results of sun damage. And look, that's something that I have constant conversations within this house, about you know, please put on a hat, please put on a shirt, please use some sunscreen, I would love you to help us understand what can sun damage do and what does it look like? And you know where you might be able to help down the track but preventative is always a good start.

Shiree Walker:

So we always say when people ask us, what is the number one anti ageing skincare product? SPF. Yes, that is by far, no matter what skin type skin tone, ethnicity you are. SPF, daily SPF is what is required?

Sonia Nolan:

And at what stage or what age should you start using SPF? It's significant.

Shiree Walker:

I would think early 20s Even as teens really, Yeah, I can see anyone at the beginning of their but um, whether you gonna get compliance, so that but yeah, early 20s. And then moving on from there. And then I guess what I see is the pigmentation changes. Specific sun, where sunspots or sun has hit pigmentation potentially also can be hormonal changes, especially in women through you know, like pregnancies, menopause periods, and then the fine lines and wrinkles. So there's there's a couple of good journey or at a preventative level in their journey. So something I have a lot of mothers and daughters that actually come in, or the daughters who are like mum did articles that are out there. And there's some famous pictures this, this and this and I don't want to look like that. Or I can see I'm beginning to look like that. So the skin pigmentation probably is the big issue that people find is ageing for them. that go around where they've got a picture of it. He's an So sometimes it can just be like, freckles, sunspots. I quite like freckles. But, you know, for whatever reason. So American Truck driver, quite an elderly man. And you see the with myself being of an Indian background, I know with my mum and sister we get these darker spots, which is our equivalent of a freckle, but not as easy to reverse in a darker skin tone side of his face that was exposed to the sun on the versus someone in a lighter like a fair hair, redhead, paler skin, like more Celtic background, where they've got driver's side compared to the left the other side, completely freckles. You could do IPL treatments on them to potentially remove those that pigmentation so it really just depends on where they are. And then I guess the pigmentation, sun damaged. Wrinkles sagging. Or there's another one of twins, we're looking at what products we would be using to help get rid of the pigmentation, whether it's just skincare products, or then going into those more in not invasive procedures. But the one who has smoked and had sun damage. And then one who hasn't. next step like the skin needling, which we discussed earlier, so there's lots of different potential avenues then going all the way up to IPL laser on the spectrum. I don't use laser in my clinic not yet because I feel there's a plenty And the just the ageing process between the two identical twins. of other places who are experts in that. So I'm always happy to refer on if it's something that's what someone needs

Sonia Nolan:

SPF. Number one preventative ageing. Yeah, that's the easy thing we can all do. But then there are some tricks up your sleeve should we get to a point where we've got some some spots and some sun damage, there are there is work that can be done to help the skin at that level.

Shiree Walker:

Yes, definitely. So you can look at just specific skincare products. So these are more the products you would probably need to go to a clinic to get they're not necessarily things you would buy over the counter because you probably want a good skin assessment before you would go into these products because they might not necessarily be the best thing for you depending on your skin type and what's happening. So there are products who will I guess kind of lighten and brighten the skin. There are some products who which will actually suppress pigmentation and then we go all the way to certain products which will increase skin cell turnover, which then kind of helps to lift the pigment From the deeper layers of the skin, bring it up and then you kind of get rid of it. But that all takes time.

Sonia Nolan:

Yes, yeah.

Shiree Walker:

And then we got all the way into prescriptive medication for light, lightening and brightening skin, but it's helping to lift that pigmentation. And there's different formulations. So there's the ones that you can get, you know, a lot of GPs will prescribe and then you go into compounded formulations, which would prescribe similar prescription but getting it made up at a compounding pharmacy that can put different types of medications together that will help that process.

Sonia Nolan:

So that's an interesting part of you know, what we were saying earlier about a nurse practitioner is that you can actually prescribe medications,

Shiree Walker:

things are also very much ever evolving. I was speaking with a nurse practitioner yesterday. And there are things like anti ageing, like actually compounding hormones into skincare medication, as an anti ageing, so putting oestrogen and progesterone into creams, CBD oil into creams, you know, there's a lot of research, more research, we need to go down the pathway. But there's these different formulations and combinations which work for some people, not necessarily for everyone. But there's different things that we can try. And this is where it is if people aren't wanting to go down injectables, we've got that whole what are we doing with the paint job on the face to help that anti ageing process? And if that's as far as I want to get, that's completely fine as well.

Sonia Nolan:

And that opportunity to compound just means that you can be a lot more flexible with what it is that you're it's not an off the shelf fix?

Shiree Walker:

Yeah, yeah. So it's very prescriptive for that for that person. What works for one person might not work for the other. But it might work you and your girlfriend or your friend, it might it might work for both of you. So it just, it just depends. And that's why we might start something just on the skincare products first, just to see how they're gonna make sure they don't have sensitive skin. See what works for them. Because you I guess you don't also want to go to prescription if you don't have to. But if we need to take that next step, we've got the option there.

Sonia Nolan:

Yeah, great. So okay, so we talked about the gateway drug, which is wrinkle relaxer, love that love that theory. And then then what what might be something people are looking to achieve with their look?

Shiree Walker:

then I guess the next step, people then begin to play around with the idea or might ask questions about dermal filler. So dermal filler is made of something called hyaluronic acid, which is a natural, naturally occurring substance within the body, they've just been able to recreate that in a lab, so we can then re inject it into the body. So it helps with essentially volumization of the skin. Depending on who you speak with the basic they call it like the jelly it is when you inject it out, it's like it's like a jelly that comes out. So one syringe is essentially one mil which is actually not a lot of product people kind of go I don't want to look like this alien, when when with one mill one mill is the equivalent of one blueberry.

Sonia Nolan:

Oh, okay,

Shiree Walker:

so it's actually not a lot of product potentially might be decent product in lip because the lip is a smaller area smaller compartment. But if we're putting it in cheeks, jaw lines, all these other areas, it's actually you normally need like several mils to get a result. But also, it depends on what a client wants and their budget as well. So you would probably just start off with a small, small amount, whatever's within their budget and go from there. And so fillers depending on which brand they are this there, they're all hyaluronic, while the brand that I use, it's all hyaluronic acid, their structure is slightly different. So the best way I describe it is you if in the lips, you want something nice soft and natural, but in the cheeks or the jaw line, you probably want something with a bit more structure and a bit more lift. So that's how they kind of how I kind of describe it so we're not going to necessarily because people go oh, if I did I don't want all of my lips can you like put it here?

Sonia Nolan:

Syringe all over the way Yeah,

Shiree Walker:

so I kind of go we can but you're not gonna get the result that you want because it's just not gonna have that the correct structure for that area we want to inject it into

Sonia Nolan:

Do you think the lip is a bit of a trend at the moment?

Shiree Walker:

I think it has been for a while thanks to Kylie Jenner and the Kardashians

Sonia Nolan:

they're so influential.

Shiree Walker:

But it's also flipped this trend of people saying that's not what I want to look like. So it's this two part effect you do have certain demographic who want that look and others who are like I don't want that look, I think it's probably the most popular in regards to fill it I feel depending on the age range. But it also it can have a really pleasing effect but also not just the lip but the whole peri aural area can age someone so it's not necessarily about putting the filler just on the lips if you do the structural work around the mouth can actually decrease age and the look of the age of the client as well.

Sonia Nolan:

Yeah, this is gonna be really silly question, but I'm going to ask it anyway, Shiree, with the advent of masks are people wanting less filler on their lips because you can't see them anyway?

Shiree Walker:

I actually think it's wanting more because they can have the downtime without people knowing

Sonia Nolan:

I never thought about that. Okay, so I've got sunglasses, mask, had my whole face done, but no one no one knows yet.

Shiree Walker:

Yeah, or I'm working from home on Zoom and people can't really see what's going on. So it's that it's a mix of

Sonia Nolan:

who knew that there you go - everyone's secret? What's going on under the mask?

Shiree Walker:

And then the increase in like Zoom calls is actually I think that's also maybe in part where Cosmetics is taking off, because people are like, is that what I look like?

Sonia Nolan:

It's so invasive, isn't it? Every little flaw is magnified.

Shiree Walker:

Yep. So it is that Cosmetics is yes, it's a big business. And it's just evolving and evolving. And this time that we spent at home, you know, during COVID, people have, they've gone two ways where they're, they're either not wanting or shouldn't say not wanting, or that it's amplifying what they what they think, or they're like, going right ahead all the time. I couldn't spend my money on. I couldn't go out there - this is what's important. So when we talk about wrinkle relaxers people, when we assess their face, they have two different types of lines. So the lines are, they have their dynamic lines that come with expression. And then they can have static lines that come when they're not moving,

Sonia Nolan:

resting bitchface

Shiree Walker:

or they say my dad has that exact thing and I've got it.

Sonia Nolan:

So is it the elevens is that what it's called?

Shiree Walker:

or forehead or crow's feet, or just different areas

Sonia Nolan:

Laugh lines. That's what I'm calling them. I'm going for the positive.

Shiree Walker:

So Wrinkle Relaxers can, depending on how etched those lines are, like I tell people that's come on over like 10-15 years, we're not necessarily going to be able to get rid of that maybe potentially altogether, we might need to do other things. That's where the PRP might come in and potentially the fillers. Now, fillers in certain areas of the face can be quite high risk. So into the elevens. And the nose is quite high risk for complications as in vascular occlusions and potential blindness.

Sonia Nolan:

That's very serious,

Shiree Walker:

it's very serious. So even though Cosmetics is like all people think it's fun there is this side of it actually that is quite serious when things go bad,

Sonia Nolan:

which is why you need to have somebody qualified, experienced and an absolute medical practitioner who's who's doing that treatment for you.

Shiree Walker:

yeah, exactly. And so and I don't treat that area, I'm more than happy to I will actually refer to plastic surgeons that I know, I have no problems in that to whatever people are comfortable with doing. I'm not comfortable with doing that. And I'm minimising risk. So that might be where I might look at doing the PRP in those lines there because that will also help with fine lines and wrinkles. There's a few different things on the market. And I'm not sure if you've seen there are things called mechanical thread lifts, mono threads and then collagen stimulator. So your mechanical threads and your mono threads, essentially are very similar to the suture material that we use, in hospitals. The ones that are left inside. And then the mechanical lifting threads are long threads that are put in at certain vector points in the face. They're not equivalent to a facelift, but they might give you a little bit of time for if that's the way that you're going to want to go down. So they will slightly elevate some parts of the face, the threads are left in and then over like the three month period, the threads will begin to break down in the body and while they're breaking down, they're stimulating collagen and then holding the skin back. Then there are mono threads which are also of a similar material. They're very small, thin needles that go in that very small filaments of the similar type of material. So you can do a lot more structural scaffolding work throughout the face neck, decolletage tummy. Lots of different parts of the body as well. Same again, lots of little needles go in leave these little threads of the material behind them and same they will break down and also over that three to six month period and the collagen production increases so they get that skin tightening. It has a bit of a skin brightening effect because you're collagen stimulating. And then you have collagen bio simulators which is in a liquid form. So collagen bio simulator, it comes in a powder form, we dilute it, we put some a little bit of local anaesthetic in it. And then we actually inject it into essentially the face you can do in other parts of the body. You might have heard like something about the Brazilian butt lift where they they put collagen bio stimulator in there. So we can use it in like the face and the jaw line, the neck and decolletage. The one good thing about that is actually it's stimulating your own collagen as well. So yes, it is I guess a form of substance we're putting in but it's actually stimulating your own collagen in your body which gives you a very, it's a slow progression. So I always tell people it's not it's not a quick fix. Dermal filler is more of a bit of a quick fix because you see an immediate result. Collagen, bio simulators take about three to six months to see a result. But it's your own collagen that's being stimulated, which means you get a much longer effect, because it actually is helping with that process. And there is some research and there's a doctor that I follow in, in Beverly Hills, who is also done a little, her little snippets that she talks about the collagen bio simulator actually can help remodel bone as well. So that's part of the ageing process is our bone reabsorbs. And so then our structural process, so our muscles, fat pads on my face, skin begin to move and droop, which is part of the ageing.

Sonia Nolan:

Interesting I see. That's why that happens.

Shiree Walker:

That's another thing, it's been around for a very long time, it's kind of getting, making a bit of a comeback as well, because people are wanting, I guess, quote unquote, a bit more natural because it's in your own collagen stimulation that happening in that process.

Sonia Nolan:

And that's something you said a couple of times as we've been chatting over the afternoon, Shiree is that these things have been around for a long time. And and I guess that gives a little bit of comfort, if you like that they've been tried, they've been tested, they, they they've been used for lots of different medical purposes. And now they're sort of finding a rebirth in cosmetic surgery. And like you've said, through reusing what the body's already doing, or, and even understanding how the body's processes work, so that you can stimulate it in the right way for that sort of anti ageing approach.

Shiree Walker:

Yeah, for sure. So a lot of these procedures or treatments have been around for a very long time, like the mechanical threads, I think have been around for like 40 years, I should say the mechanical thread material had been around for like 40 years, but in the last five years have made this really big comeback. So I think it kind of goes in these circles as to what what's used, what's in favour. And then also the longevity of what the actual treatment outcomes are like. So I I'm a bit of a cautious one, I will watch and observe and see what the results are like and even I'll have clients ask are you doing this? are you're doing that? And like, yeah, I can do that. And I have trained to do that. But I think this is a better outcome and where your money is spent in longevity. So not necessarily hopping on trends, but making sure it's gonna give my client the best results.

Sonia Nolan:

Now an area of real interest for you, Shiree is these aesthetics for women of colour, or people of colour, not not just women, people of colour. So tell me about your findings in that and why that's such a passion for you.

Shiree Walker:

So I guess I have another colleague who I think on her social, she calls it melanin rich skin rich. So I guess it's just as I kind of got more into the skin side of things, you know, and coming from a nursing background, we don't know I like I have a wound care background. So I know about chronic wounds and the healing process, but then past a skin healing, whatever, like you're on your own. So as you're getting to this cosmetic and dermatology field, skin of colour can be a lot harder to treat than lighter skin tones, which I thought was the other way around. So I kinda was like going right well, what's happening and a lot of it was is that darker skin tones, there's potential for more adverse outcomes depending on the treatment. And also if they're not the skin is not prepared properly. And that is often to do with the melanin in the skin and what are we talking about adverse outcomes. So there is something called the I just got one set back so called the Fitzpatrick skin scale. So that is your skin phototype based on your heritage, so it goes from one I think it's up to about six or seven and one would be like you're really pale skin red hair, freckles green eyes, then it goes all the way you know very much up to indigenous African very darker skin tone. So depending on your Fitzpatrick skin type depends on what is safe for your skin type. So for for myself being Indian heritage depending on where you are from, I guess in India or Southeast Asia, your skin type could really vary from Fitzpatrick three all the way up to six depending on how much melanin you have have your skin how much sun exposure. So things for me if I was wanting to have something a bit more invasive, like skin needling, I would really need to prepare my skin because I have a risk of what we call rebound hyperpigmentation where the controlled injury of the skin if my skin wasn't prepared, I could actually end up with more pigmentation and that is very much a healing process. So we can go from hyperpigmentation where you know, with darker skin types you'll have blotches of white skin like or hyper hypo so pale bits hyper where it's darker, and that not just in my ethnicity, but we're talking about with yourself being Italian background, but you know, your skin type probably changes as the seasons change. So if I was to meet you in summer, you might be a lot more olive

Sonia Nolan:

a little bit a little bit. Yeah, that's right.

Shiree Walker:

But it's important to ask a client what their heritage is, which, you know, it comes back to the practitioner's level of understanding and educate patients what what they ask? And some people be like, Oh, I've never been asked that before but yeah, you need to you need to know that mix to know what to say because just because you don't I might treat someone in winter with a paler skin type but they're like as olive as me in summer, they might still have that adverse outcome.

Sonia Nolan:

That's all that's all just so interesting, Shiree. Yeah, honestly, I've learned so much today because I'm such a novice when it comes to skincare products look, I'll use my you know, use my skincare products most days and like I said, I think I've had one IPL treatment and my whole my whole life it was some pumpkin, some pumpkin peel. I thought you know how bad can a pumpkin be? I couldn't go out in the sun for a week.

Shiree Walker:

Yep that enzyme enzymatic

Sonia Nolan:

And I just wasn't prepared. I just I'm sure she explained that to me, but I just you know, I just thought oh, that's really inconvenient. I've done this pumpkin thing and now I can't go out in the sun for a week. So yeah, so I'm uh you know now full bottle on wrinkle relaxants and gateway drugs. And I'm just so thankful for your time today. It looks I think it's been really really interesting. I know you've got an amazing Instagram page where you do Tik Tok, and you're really cool and happening and that people will be able to find you on that. The name of your business is

Shiree Walker:

Glow Aesthetics Perth,

Sonia Nolan:

Glow Aesthetics Perth, and I'm just, I'm going to be checking out what what it is that you do offer. I don't think I'm there yet. But you know, look, never say never, never say never my elevens are growing and you never know. Thanks so much for your time today.

Shiree Walker:

No worries. Thank you.

Sonia Nolan:

You've been listening to My Warm Table with Sonia Nolan in Italian a tavola calda is a warm and welcoming table where you can share big ideas, friendship, laughter and life. So much happens around the kitchen table and I wanted to amplify it here in this podcast. My aim is to feed your mind and soul through smart conversations with heart. No topic is off limits for good table manners rule. I hope you'll join us each week as we set the table for my extraordinary guests who will let you feast on their deep knowledge, life experiences and wise insights. Let's keep the conversation flowing. Please subscribe to the My Warm Table podcast and share it with your friends and networks. Perhaps if they are new to podcasting, take a moment to show them how to download and subscribe so they don't miss an episode either. I'd also love you to join our community on Facebook. You'll find the group at My Warm Table Podcast. Your support is very much appreciated.