What happens before the needle, laser, or device may matter just as much as the treatment itself. In this episode of Conversations in Aesthetics, host Gary Goldenberg, MD, sits down with dermatologist Glynis Ablon, MD, to talk through the way she approaches an aesthetic patient from the first conversation forward: listening closely, setting realistic expectations, assessing the face from skin to bone, and knowing when the right answer is no.

From there, the conversation opens into everything that shapes how patients age, heal, and respond to treatment. Dr Ablon shares how she thinks about skincare as the foundation, why she keeps routines simple, and where nutrition, menopause, collagen loss, and overall health fit into the aesthetic picture. She and Dr Goldenberg also dig into the growing impact of GLP-1 medications, including why those conversations may need to start earlier and how aesthetic planning can evolve alongside significant weight loss. 
 
Then, they move into the treatment room for a closer look at resurfacing, tightening, post-procedure topicals, and the practical decisions that shape Dr Ablon’s approach to devices and combination treatment. And in keeping with her broader philosophy, the goal is never simply to do more. It is to understand the person in front of you, make a thoughtful plan together, and preserve what still looks and feels like them.

The episode closes with a quicker round on the treatments and tools she returns to most often, along with a bigger question about where aesthetics may be headed next. Her answer brings the conversation back to where they began—less about chasing youth, and more about helping patients look well, feel well, and age with intention.

In this episode of Conversations in Aesthetics, Gary Goldenberg, MD, sits down with Susan Weinkle, MD, for a wide-ranging conversation on how aesthetic dermatology has evolved, from the earliest collagen fillers to today’s broader understanding of facial aging, biostimulation, devices, and treatment planning. 

Dr Weinkle reflects on the shift from simply filling individual lines to thinking more globally about proportion, movement, skin quality, and the way the face changes over time. Much of the discussion focuses on the cosmetic consultation itself: starting with what the patient sees in the mirror, identifying where treatment can make the greatest impact, setting expectations early, and building a gradual plan rather than trying to correct everything at once. 

The conversation also explores changing attitudes toward filler, including concerns about overfilling and growing interest in biostimulatory approaches. Drs Goldenberg and Weinkle discuss how they counsel patients on response, longevity, and the importance of matching the treatment to the individual rather than relying on a single formula. 

From there, the focus moves below the jawline to what Dr Weinkle calls the “neglected neck.” She walks through her approach to platysmal bands, horizontal neck lines, hyperdilute biostimulators, and the anatomy and technique that shape her treatment decisions, while emphasizing that meaningful improvement often requires a combination of modalities and more than one session. 

Throughout, the episode is grounded in the kind of practical judgment that comes with experience—know what your patient is asking for, know what your tools can realistically deliver, and have the confidence to say no when the treatment is not right. 

In this episode of Conversations in Aesthetics, Gary Goldenberg, MD, sits down with dermatologist Nicholas Brownstone, MD, for a conversation about building an aesthetic practice, developing confidence with procedures, and recognizing when the right decision is not to treat.

Dr Brownstone reflects on his path from plastic surgery training to dermatology and the experience of establishing an aesthetic patient base early in practice. The discussion kicks off with practical ways to grow that work organically, including introducing aesthetic options to existing medical dermatology patients, learning from treatment follow-up, and becoming fully comfortable with the physics, terminology, and clinical endpoints behind laser procedures.

The conversation then turns to the aesthetic consultation itself. Drs Goldenberg and Brownstone discuss beginning with the patient’s concerns, recommending treatments within the clinician’s skill set, and being candid when surgery or another procedure may offer a more meaningful result. Throughout, they emphasize education over selling, realistic expectations, and the importance of knowing both the capabilities and limitations of the treatments being offered.

A substantial portion of the episode examines body dysmorphic disorder and the challenges it can present in aesthetic medicine. Dr Brownstone reviews behaviors that may raise concern, questions clinicians can use to assess whether a patient is an appropriate candidate, and the role of the entire office team in recognizing warning signs. He also discusses how clinicians can respond with empathy and validation while avoiding procedures that are unlikely to resolve, and may worsen, the patient’s distress.

The episode closes with a rapid-fire look at Dr Brownstone’s preferred injectables, lasers, and aesthetic procedures, including his particular interest in vascular and pigmentary concerns. Across both the clinical and practical discussion, the message remains consistent: build trust, understand what the patient is truly asking for, and remain willing to draw a line when treatment is not in their best interest.

In this episode of Conversations in Aesthetics, Gary Goldenberg, MD, sits down with dermatologist Emmy Graber, MD, for a conversation shaped by acne, rosacea, lasers, cosmetics, and the operational decisions behind a focused clinical niche. 

Dr Graber traces how an early interest in acne led her to laser training in Boston, and eventually to a practice built around the patients and conditions she most wanted to treat. The discussion moves into what it means to build that kind of practice with intention, from knowing the local patient population to resisting the pressure to buy every new device that enters the market. 

Much of the conversation centers on acne as a procedural condition. Drs Goldenberg and Graber discuss where lasers may fit alongside topicals, oral medications, spironolactone, and isotretinoin, especially for patients who cannot take isotretinoin, will not take it, or want to exhaust other options first. Just as important is the way those options are presented—plainly, honestly, and without pretending any one treatment works for everyone. 

The episode also widens into practice management, including virtual front desk support, virtual scribes, AI-assisted HPI capture, online scheduling, and the small efficiencies that help with climbing reimbursement, labor, rent, and device costs. 

Throughout, the throughline is practical: choose the patients you want to serve, tools that make sense for them, and build a practice that can actually support both. 

In this episode of Conversations in Aesthetics, Gary Goldenberg, MD, sits down with dermatologist and Mohs surgeon Joel L Cohen, MD, Director of AboutSkin Dermatology, Denver, Colorado, for a detailed conversation that starts where many consults do: a patient asking for “a little Botox” and pointing to a single area. 

From there, Dr Cohen walks through how he approaches the person in front of him. Not all lines are the same, and not all treatments are interchangeable. Early dynamic changes may respond to neuromodulators. Deeper, etched lines may call for filler, if the tissue allows for it. And when the surface has shifted entirely and the skin takes on that “peau d’orange” texture, the conversation moves to resurfacing. 

What follows is a broader look at how those decisions come together in practice. In Denver, where sun exposure is constant and cumulative, photodamage is frequently the primary driver. That reality shapes both the consult and the plan. How aggressively to treat, how much downtime is realistic, and how to sequence interventions, from volume replacement to fractional or full-field resurfacing. 

The discussion also moves into technique, including the timing of neuromodulators around resurfacing, what energy-based devices may or may not affect filler longevity, and how to think through anesthesia and recovery for more intensive treatments. 

Throughout, the pair returns to a simple principle: match the tool to the problem. The goal is to do what actually works for the skin in front of you, based on its structure, degree of damage, and what the patient can realistically tolerate. 

Disclaimer: This podcast is not intended to provide diagnosis, treatment, or medical advice. Content provided in this podcast is for educational purposes only. Please consult with a physician regarding any health-related diagnosis or treatment.

In this episode of Conversations in Aesthetics, Gary Goldenberg, MD, speaks with dermatologist and professor of dermatology at Howard University, Cheri Frey, MD, about how aesthetic dermatology actually plays out in practice, from the consult through device selection, technique, and outcomes. 

Dr Frey frames aesthetics through a clinical lens. Even when the chief complaint is cosmetic, the drivers are often clinical—post-inflammatory erythema, hyperpigmentation, scarring, hair loss. The work sits in that overlap, where aesthetic goals are shaped by underlying disease and biology. 

The consult is central. She emphasizes defining endpoints early by discussing “improvement” in practical terms and what it will take to get there. Reduction in erythema, lightening of pigment, softening of scar depth. Many of these patients require multiple sessions, combination approaches, and ongoing maintenance. As she notes, “results may vary,” and setting that expectation upfront matters. 

Risk assessment goes beyond what’s visible. Ancestry, treatment history, and timing all factor in, especially with energy-based devices. While hyperpigmentation is common, hypopigmentation is the complication she’s most cautious about, given how difficult it is to reverse. 

They move through treatment strategies with that framework in mind. Microneedling remains a foundation, typically paired with PRP or exosomes. Depth is adjusted by anatomic site, with the aim of reaching the dermis without unnecessary injury. 

In melasma, she moves past pigment alone. The target includes ectatic vessels, senescent fibroblasts, and dermal changes consistent with solar elastosis. Using pulsed radiofrequency microneedling, she works to address these layers while limiting thermal buildup that can exacerbate pigment. 

The conversation ends where the field is heading, on prevention. Less correction, less volume for the sake of volume. More attention to maintaining collagen, elastin, and skin quality over time—so patients look like themselves, just held in place a little longer. 

Disclaimer: This podcast is not intended to provide diagnosis, treatment, or medical advice. Content provided in this podcast is for educational purposes only. Please consult with a physician regarding any health-related diagnosis or treatment.

In this special live episode of Conversations in Aesthetics, recorded at Winter Clinical Miami, our host, Gary Goldenberg, MD, sits down with friend and dermatologist Todd Schlesinger, MD, for a wide-ranging conversation about the evolution of aesthetic dermatology and the philosophy that guides modern practice. 

Dr Schlesinger reflects on more than two decades in dermatology, from the early days of collagen fillers and the arrival of neuromodulators to today’s rapidly expanding landscape of injectables, lasers, and regenerative treatments. For him, aesthetics ultimately comes down to a simple idea, creating results patients can both see and feel while keeping treatments thoughtful and proportional. 

The discussion moves through consultation strategy, the growing influence of GLP-associated weight loss on facial volume and hair changes, and how social media and AI imagery are reshaping patient expectations. Dr Schlesinger and Dr Goldenberg also walk through their practical approaches to lip filler, emphasizing anatomy, conservative technique, and natural contour rather than exaggerated results. 

Throughout the conversation, one theme stands out: aesthetic medicine works best when expectations are realistic, treatment plans are individualized, and the focus remains on helping patients look like the best version of themselves. 

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. 

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.

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.