Moderator: Welcome to today’s episode of True to Form with your host, President and Co-founder of Crystal Clear, highly regarded speaker and two time Inc. 500 Entrepreneur, Tim Sawyer. True to Form is a podcast that highlights leaders making headway in the Aesthetic, Anti-Aging, and Elective Medical industries. Learn from the experts to discover the secrets to success and the pitfalls to avoid, when it comes to growing your aesthetic revenue with the authentic, the transparent, Tim Sawyer.

Tim Sawyer: Hello and welcome to True to Form podcast that connects you to the people, technology and hot topics that shape the elective medical community; brought to you by Crystal Clear Digital Marketing. I am your host Tim Sawyer. And to our returning guest, welcome back and for our first time listeners, we appreciate you joining us and encourage you to become a subscriber. Last week we spoke with Dr. Michael Bedecs, a leader in the Anti-Aging who provided an amazing No-BS Blueprint for integrating hormone therapy and wellness into your existing practice. If you have missed it, you got to check it out.

With all that said and just when you thought it couldn’t get any better, we are taking it to another level today. As promised we bring you the Movers and the Shakers in Elective Medicine. And today we head north and it is my pleasure to introduce Dr. Jennifer Pearlman and Dr. Pearlman is an internationally recognized Women’s Health, Hormone and Beauty Expert. She is a Medical Director and owner of PearlMD Rejuvenation in Toronto, Canada and has spent over a decade helping to run the largest menopause clinic in the country. Dr. Pearlman is a certified menopause practitioner, faculty and fellow of Anti-Aging and Regenerative Medicine, triple-board certified, not double-board certified, triple-board certified in Anti-Aging Medicine and a recognized expert in Women’s Health and Mental Health. She has built a cosmetic practice over the past two decades having been involved with cosmetic Botox and fillers, since their first commercial use and development. She is a leader in the industry in her cosmetic practice Dr. Pearlman combines her aesthetic expertise with clinical excellence in the most advanced technology and techniques. She has developed her own line of medical grade skincare and curated a high potency food grade line of health supplements, to meet the varying needs of her patients. She is a nationally contributing health expert to the Globe, Mail and Huffington Post and has appeared on numerous, popular TV publications. So without further ado I would like to introduce Dr. Jen Pearlman. And Dr. Pearlman what I would like to start with, is you have got a very unique practice and you really treat the whole person inside and out. So talk to us a little bit about the practice of how you got started in your philosophy.

Jennifer Pearlman: So Tim, thank you so much for the invitation to join you here today. It’s such a pleasure to be here with you. I appreciate the generous introduction and yeah as you said, I do have a unique philosophy in my practice and really focusing on each and every one of my patient on their individual needs, but on the whole of them from the inside-out. And the business really grew from I would say simultaneous interest of mine, you know I can talk in a moment about sort of way back my up growth bringing as a dancer, my you know personal experiences with things like fitness and nutrition, having had very little formal training to my traditional medical career in Canada or you know I would say even to this day as it would exist across North America our Conventional Medical training curriculum. But really came to practice personally understanding the importance of lifestyle and having had a very early interest in beauty and facial beauty, I had some opportunity to dabble you know little bit of modeling as the young person and always very interested in facial beauty. Literally drawing faces from a young age and happened to be a medical student working with a principle investigators of cosmetic Botox as you may or may not know, as a group of Canadian docs that actually first developed the cosmetic use of Botox.

And as this new non-surgical, injectable aesthetic field emerged, I guess I was right there in its infancy and I knew this was for me. So my career trajectory evolves in holistic or Functional Medicine in Women’s Health and in this new emerging field of non-surgical cosmetic medicine which really enabled a dynamic relationship with the patients. You know you are have an awake, engaged patient to perhaps over a series of visits and now in practice you know over many, many years put together a program of needle-based, chemical-based, technological-based treatments to help them eat their very best. And so that’s really how my practice evolved, I run two simultaneous practices that for many patients will be cohesively presented to them as an inner/outer approach to aging while, but I certainly have patients who only see me for precision, functional kind of gene-based medicine, I believe it’s within –.

Tim Sawyer: And I want to talk about that, but hold on because I want to make sure I got this straight, okay. So as a young person you were a dancer, you were a model, you drew faces, you were fascinated some could say obsessed with beauty. So was there ever a part in your medical training or I guess at what point in your medical training did you say, you know what, that’s the type of doctor I want to be, was there one ‘aha’ moment or?

Jennifer Pearlman: You know what, there is a piece I didn’t go through and you know I guess the brain complex, we talk about the right and the left brain and art and beauty and particularly like as I said it was always facial beauty, I have been drawing faces since I was young girl but then the other side of me Math, Science I always knew I wanted to be a doctor. And a lot of that actually came from my dad, who sadly when he was younger than I am now, he was in his mid-30s, had a really serious heart attack. And as a young girl I knew I wanted to fix my dad and that really was propelling me forward in medicine but really cardiology. So here I am, you know yes I love beauty and the art. I always was engaged in you know some creative discipline dance, art etc. but knew I wanted to pursue medicine, cardiology was my first passion. I actually did a lot of research and have a few publications in the role of hormones and women’s heart health.

But let me take you back because long time ago, and this is when, for instance plastic surgery which is, I think which is where you were kind of going with me Tim like you know did you consider plastic surgery. Well plastic surgery for me as a medical student or early trainee was like gunshot wounds, trauma, burn unit in the hospital, there was not the field but there was today. And again I had this other really strong set of interest and passion and just personal connection. So my role is really evolving through women’s health, hormone, role of preventative role of hormone. While you know the as I alluded to in my later stages of training, the non-surgical role of aesthetic medicines started exploding with you know at first it was laser hair removal and injectable and cosmetic Botox.

And I should add one other layer although I know, you would probably want to get into you know relevant topics for today, but one other layer just to shut in my background which is let me take you back, this is the late 90s and 2000, it’s the biotech bubble and you know sort of aesthetic world was really also first starting to appear in Wall Street. And you know at that time Allergan was in eye-witness and I happened to have an opportunity as I am finishing my residency to take a job with an investment firm here on B Street which is like Wall Street. So I am actually concurrently doing a medical residency while working as a healthcare analyst, traveling around, meeting CEOs of leading healthcare company, mostly in the U.S. but across the world and happened to meet the CEO of Allergan as I had begun financial analysis of the company and led my firm into being one of the early stage investors in this company. And so I am kind of riding the wave in different ways as the trainee, early in my own professional, kind of evolution but also as a financial analyst working for an investment firm to take some early investment positions in this emerging field of aesthetic medicines.

But let me tell you, I knew that this was going to be a huge field, you know a huge industry in the future and really reshaped what we know of as you know at that time cosmetic or plastic surgery. And so I just fast-forward a little bit from the approval of cosmetic Botox that was 2001 to 2003 when the huge trials get unblended and published in major media outlet showing that hormones caused breast cancer. And though this wasn’t actually what [inaudible] [00:10:36] I am referring to the Women’s Health Initiative trials or largest two-day trial of hormone therapy done throughout over 100 centers that suggested that hormone therapy use and of course this was what in America was a common forms of hormone, so estrogen from pregnant course of urine and synthetic, what we knew to be even at that time talks that progesterone when taken together caused increased risk of breast cancer and stroke in women involved in the study who frankly were not reflective of the actual women we treat they were on an average 50 years old.

Tim Sawyer: Let me in — when do you think, if you had to put it through finger on a period of time where, you have been doing this for a long time, right and there is obviously a lot of clinicians, providers that are trying to come into this field but it’s fairly complicated as you can tell. At what point did hormone replacement become kind of, if it is somewhat mainstream, was it, this –?

Jennifer Pearlman: Well, let me, I want to take you to this time because I think so few people realize how pivotal this event was. So 2003 the study comes out and basically what happened is, to then it was a write a passage of women to get their script for Prempro, it was called the, let’s just call them the toxic hormone combo involved in the study and all of a sudden the studies are published, mass-media around the world pick up the news, you know headlines are you know scaring women’s from continuing their scripts, they throw them in the garbage, they go to their doctors, their doctors have only antidepressants to give them. And it results in the loss of faith of women and their conventional allopathic doctors. And at that moment in time you will see the explosion of the alternative medicine world, is where women are going to help resort to alternative providers whether it’s naturopath, homeopath, you know all these really pseudoscience based fields that are giving them concoction maybe botanicals, herbal or this kind of new terminology of bioidentical hormone possibly cream espoused by Suzanne Somers and her book and such really begins the explosion of functional medicine.

And for me, again I am thinking you know simultaneously through the journey, the explosion of non-surgical aesthetic medicine and the, you know real evolution of bioidentical hormones and functional medicine. This is where I looked at my patient and you know I spoke earlier just a little bit about, I for long time because of what I did, I knew about the interplay of hormones, nutrition and fitness, I knew about the importance of lifestyle like it was just part of who I was. So the interest in a more holistic approach to health like I am there with my patient, I didn’t give them the antidepressant, I started learning. I started really learning to be the expert, I didn’t want them seeing the [inaudible] [00:13:40] work in the health and food store for health you know guidance. And I began my journey first as a student and now as international faculty in Functional Medicine, to be the expert in all these fields integrated into one practice and rooted in science. And that I know is a long story but that really explains the evolution of my practice. And you know when you come to know me and as my patients do, it’s like very intimate practice, not, although we do so much here in the practice from genomics, to brain health, to fitness, to beauty, skin, body shaping you know all of these services, it all make sense when you kind of hear the trajectory along functional medicine, hormone and cosmetic medicine. So that sort of brings us, I guess to like where we are today.

Tim Sawyer: And that is, I mean obviously you have put a lot of time, energy and effort research into this. And the fact you can tell that you are a business person right, so let me ask you this, because this is kind of personal to me, so and I am happy to share with everybody, I am 51 years old, you know married 26 years, my wife just turned 50. And how would you so that the conversation and my wife knows I talk about this all the time, it goes back and forth, how do you take something that is relatively I won’t to say complicated but can be somewhat complicated or intimidating for a women who is going through that period in her life where hormone therapy, would absolutely help, but she is somewhat intimidated, doesn’t know where to start. How to you approach that person and like a simple explanation of, “Hey listen, this is how it’s going to –.

Jennifer Pearlman: Well, first let me unpack this a little bit, I mean kudos to you more than half of your life married to the same woman and here she is, you know she is reaching you know aging along the average timeline. She would be right in the throes of what we call the menopause transition. And just before I answer your question which is how do you walk a woman through you know sort of what to expect to the transition perhaps you know physiologically what’s happening in her body and also the rationale and risk of hormone therapy. So before I go there, let me just backup to say that this requires such a high level of expertise, it is so complex that my goal has always been like sort of talked about the journey but my goal has always been to be like the bridge. The bridge that take the holistic, functional medical approach which may involve nature based therapies, herbals, botanical and hormone therapy. But provide it in a way that is science based on top of the standard of care. You know at the highest level of women’s health that would include screening and everything within the scope of what you know and as viewed expert may provide her within as mentioned in my bio for over a decade, I have been involved and really building and helping to run the largest menopause clinic in the country. And I am so proud to say because to me this is one of the greatest achievements is I have had my you know this medicine, my primary research, my own research actually presented and published in the experts medical societies, meeting and publications called the North American Menopause Society.

So I really am, I feel very engaged as the forefront of both world, the holistic world and the expert’s conventional world. And so I always want my women to know that whatever I am recommending, whether it’s the lifestyle intervention, a herbal product or a hormone this is going to be science based. And I am thinking in all dimensions. So now to what I would say to what say your lovely wife who has put up with you Tim for 26 years, what I would say is, first of all I want to be meeting her perhaps about 5 to 6 years ago and again assuming that she is aging along the average timeline. So what I mean there is that, 51 is the average age a woman hits menopause. Menopause is just a useless definition, it’s 12 months after women’s last period. So you know useless because it’s too late. Her journey started about 7 years prior and when I say journey, what I am referring to is reproductive aging. Reproductive aging is a biologic phenomenon that has nothing to do with the chronologic age, but usually it’s going to start in the mid-40s, okay. And as I said average age of a menopause woman would be 51.

Men have a reproductive aging too, but like many things men dwindle and women have a clip, okay. So what’s happening and ideally and truly the bulk of my practice are women in perimenopause. So these are the early transition years and that’s because there is absolutely nothing your conventional doctor is going to give you, as a women who is starting to see symptoms or see physical changes that likely have to do with hormonal aging, hormonal changes, all the conventional doc has is the birth control pills which is the last thing you want. So perimenopause is going to be 5 to 7 years prior to the last period. It’s going to start with early hormonal changes often it a woman who is still ovulating, having a regular cycle, but that cycle may be a little wonky, it might be shorter, it might involve some early hormonal imbalance with lower progesterone level to up higher estrogen, breast swelling, tenderness, some changes in mood, notably before her period, difficulty with sleep and changes in her body shape and possibly her weight as well. As you get closer to the time of menopause we may be starting to see the more hallmarks symptoms. So perhaps getting some mental fog, some word finding difficulty, perhaps we are finding that we are getting –.

Tim Sawyer: You have met my wife, it feels like you are describing her.

Jennifer Pearlman: Yeah, so but the funny thing is she has probably seen some of these things going on for a long-time even in let’s say her early 40s when the period is regular and she would have had no idea that it was her, you know emerging menopause or the menopause transition. And let me just take you back because it’s in our kind of perimenopause especially the high estrogen phase with inadequate or very little balancing progesterone that we might also be facing changes in our tissue, changes in our breast and the [inaudible] [00:20:32] the uterus that can put us at risk for cancer. So what I want to be doing with women is speaking with her, examining her, again why you need to see a qualified expert is because no saliva test, saliva testing is bogus. No saliva test, no blood test is going to tell me tissue hormone level, nothing other than a proper vaginal exam, the only biomarker of tissue estrogen is the vaginal tissue. And again how many of these hormone docs are really qualified expert to do breast exam and vaginal exam. So you know back to why you really need to see an expert. And then –.

Tim Sawyer: Hold on for a minute, it brings up a good point because most women like I said, my wife is the perfect example, they don’t even know the questions to ask, right. And so I think you are an expert so they go to the doctor and the doctor, you know if you would see a traditional doctor, it’s like the women seem like they wouldn’t know what to ask, men too, by the way, men too, myself would know what do I do to –.

Jennifer Pearlman: Yeah, we unpack it all, we unpack it all but you know you want to know something Tim.

Tim Sawyer: Yes.

Jennifer Pearlman: It takes a long time, like from 3 to 4 hours as I onboard a patients and that onboarding I alluded to, is the story, I am looking at them. So you know back to the detective work facial, I want to come back to some cool things about biomarkers with aging, I mean just the skin the face, I can look at a woman’s face and have a good ideas about her estrogen level. You know in terms of her facial aging, so we can talk a little more about that. But you know physical exam, clinical story, all these things that you know all the deep dark corners that perhaps they are so busy with their life to think about it. Think about your wife you know in her late 40s and you know early 50s it’s the pinnacle of her career, it’s sandwich between aging parent, you know teenage kids and all of the difficulties that may –; you know partners perhaps like you that are you know needing from them as well. So women are really at a time in their life where everything is haywire and they biologically are just you know in terms of their health status, they are experiencing changes that maybe just too busy, distracted to really hone in on.

So definitely the whole idea of I talk a lot about this in the practice mind, body, medicine and self-awareness, I will draw the patient role, we will work with a women to really help them identify their goals. And I just want to pinch with that actually because this was kind of your question, like you know how do you kind of debunk all of the mystery around this. So one would say to you, I want to work early, it’s the whole transition, it’s not an event, it’s going to be a decade, it’s literally from typically mid-40s to the early years after menopause, so early 50s. It is the decade during which women age twice as fast as any other decade, okay. So two to three times more aging in our decades surrounding menopause than any other decade and that’s because of hormones and reproductive aging. And what I want them to understand is the goals here are one to help them feel good, so their goals are usually like fix my need, fix my sleep, fix my flashes, fix my vaginal dryness or my falling libido, so I call that quality of life or symptom based care, so goal one of course is that.

But deeper down is goal two, which is early targeted prevention. We want to identify and correct a risk factors before it actually takes hold and increases risk of disease. And thirdly, this more kind of far reaching goal of helping my women age well. And so by aging well what I mean, and I really like to think of this sort of mathematically is, optimizing both lifespan and health span so lifespan and health span speak to the quantity the years of life, but to lighten those years as well.

And I think as I start talking about aging well and feeling well and vitality, we come to the other side of the practice which is beauty because for men too, but for women particularly and again being a women like I know it, I feel it day in and day out, I mean we feel good when we look good and we look good when we feel good. And you know I just see the beauty practice as the other side of the coin. In my practice if you or listeners would have come visit me here in Toronto you would see like I have got the whole clinic setup so it is quite separate. So I take patients down to journey that for a single patient may be all in one visit or you know we have very you know different types of patients that we are engaging with in the two different arenas. But aging well to me is an inner/outer goal. And just a little funny joke, so I kind of took you back, Tim remember 2001, 2003, when for me the journey really got born with my personal experiences with the birth of cosmetic Botox and then the WHI catapulting me into functional medicine. So let me take you back, you know I am aging myself, I know but this is like more than 15 years ago. And I start my business and I say, okay I am you know I am going to build a business that will allow me to do all of this, right brain, left brain, inner-outer, help women age well. So I call it PearlMD Rejuvenation. And under this umbrella PearlMD Rejuvenation I got health and PD, right. And my tagline, I got to think of you know again business background so I fully read it, tagline you know that you come visit, you don’t see but I need a tagline, right, Tim because every good business needs a tagline. By the way what’s your as a Crystal Clear, what’s yours?

Tim Sawyer: It’s Find, Sell, Keep, our tag –.

Jennifer Pearlman: See at the tip of your tongue.

Tim Sawyer: Find, Sell –.

Jennifer Pearlman: And your staff know this, right –.

Tim Sawyer: All of them.

Jennifer Pearlman: Right, like you live and die by your tagline, yeah, alright. So my tagline, do you want to know.

Tim Sawyer: Yeah I would love to hear it.

Jennifer Pearlman: Do you want to know, alright.

Tim Sawyer: I will wait to hear it.

Jennifer Pearlman: So my tagline is “Ageless Vitality” and I wanted to come up with a tagline that it encapsulated everything we do, right. It captures the patients who seems me for hormones or brain health or fitness or genomics and also for skincare, [inaudible] [0:27:03], acne, shovel, you know the rubber tire on the waistline, the saggy arm bags you know whatever it is, I can summarize goals and the deliverable of our care under these ideas Ageless Vitality. And my description of this is, regardless of your age, its knowing the ultimate of health and wellbeing for the ages.

And so Ageless Vitality I came up with this again like you know we are talking about 15 years ago. And my husband, who is still my husband, we are not 26 years yet but he is still my husband. And he said to me, “Jen, no one knows what the word vitality means, you need a better word.” And I you know stubborn as I can be, when I especially when I you know think something makes sound sense to me, I stuck with it, it’s on my building, it’s on my card, it’s on my website. And now fast-forward 15 years ago and like how many businesses that you work with him that use the word rejuvenation and vitality, right. It’s like common, now common, common, yeah. So it’s just so funny how so long ago, that was just a really obscured word. So things have changed in the medicine that for me really it was a natural trajectory, it was not the norm when I got started. I think there is a lot of new entrance, I think there is a lot of providers that dabble in parts of what I do, but you know I travel a lot, I speak a lot and I haven’t really met too many docs that do everything I do. And probably I do too much in terms of like the breadth of the practice where you know if you only looked at my Instagram feed, you would have no idea that I spend you know a good chunk of my week or my day you know kneed deep in genomics, consultation with high-risk complex patient. But to me, I mean I do gene-based skincare, gene-based beauty. So it’s all part of the same theme again Ageless Vitality.

Tim Sawyer: You know if, when I hear you say, Ageless Vitality, you also said something very profound and I hope people caught it and it bears, it’s worth repeating, is the idea of you have, you want to increase the timeline of your life, in other words the longevity, but then you also want to increase the quality, the helpfulness of the years that you have, right. And so I once read this quote it was from the Dalai Lama and I am going to paraphrase, and he said, “It’s interesting of the human condition how people, men and women will spend the vast majority of their life in their careers chasing wealth or money. And then once they get that money would then give it all back to retain their youth and vitality that they miss because they were hyper focused on gaining access and they will give it all back, right.” And you know what’s funny is, I am, I feel like at some level I am that guy, right. So I have got and I am so grateful to be in the industry because I have some great friends like you who are now starting to open my eyes to, “Hey it’s not just about living long and building little stacks, it’s living well.” And I think that’s what you are saying is, there is a way to live well and use obviously, spend your entire life committed to helping people. And I want to ask you one thing because I think this is relevant too. So you have got the aesthetic piece, you have got the vitality piece. Now so let’s drop down from my 50 year old wife to my 21 year old daughter, proud of her, she is graduating from college, she has already got a job in New York City. She is going to be an auditor for KPMG, little shoutout to her. Yeah, she is hardworking kid. But she is stressed and works hard and there has got to be encouragement for her, like I wish, you know I wish you were in New York City, right –.

Jennifer Pearlman: Okay, you know what, well you know right I am not far, I have a lot of New York patients, of course like a 30% headwind on the currency, but let me just, I want to hit on something that you are asking about, (1) we see quite a few young women, young women are a new breed, so I call it My Young Vitality Program, and maybe if I just step back, like your wife would be you know the avatar my practice women, 40, let’s say you know 40s to early 60s, seeing some changes, feeling some changes, wanting to invest in health, body, beauty to help them solve age well or you know with that, this is what we will come to, invest in themselves obviously, you know, that would be the bulk of practice. But my eldest is 80 actually she is 88 and that’s my eldest health patient, my eldest cosmetic patient is now 91 who flies in from the other side of the country to see me, it is a he, I see men for beauty. A pretty profound, very successful CEO, Holocaust survivor who just wants to look great and he is like, just a pretty extraordinary man.

So back to the young gals, I do have this emerging practice, start as daughters as my patient but now we see a large group of young women. So for me that’s over 15 and under 25 which fit into my young gals program, we deal with them on a different way, it’s hormones, its mental health, it’s self-confidence, self-care. All of the, you know we talked about stress and perhaps things related to that, like confidence and anxiety and you know and this new age of the selfie and social media, so many new aspects, right. The fast sector of suicide is young women and it is just mind-blowing, jaw dropping to see how every other group, the numbers have been feeble over the past two decades but young women are the fastest age group. So you know this is something I think a lot about. And you know if I just think about women and how you know sort of the idea of not wasting the life in pursuit only too late in the games, think oh look at the, you know kind of work I have got to do to now reclaim youth, reclaim confidence, reclaim vitality.

I firstly hate the word balance, so I am a mom, I have got two young boys, both athletes, you know both like really busy schedules in themselves. So my role is like beyond 24×7. And I still just like you know all of my thoughts around gender the traditional gender rules, I still have the lot of those traditional rules at home. I think it will be probably a generation or two before there is different division of duties you know in terms of just running the household if I am not the one cooking or you know actually cleaning, I do have help but — yeah but you still, you still are you know different kind of hold on mom.

And so what I would say is I talk about flow. And I constantly think you know that there is a positive flow, balance is very structural so whether it’s your young daughter or your wife there is a probably balancing a lot of things in you know in her own right as she has perhaps taking some health issues just the idea of low self-awareness, always checking in on yourself and knowing what your outlets are. So for me and by the way it’s really cool, we look at this in our genomic profiling. Those that really get the brain benefits of exercise, like for me, fitness and exercise is my panacea, like I told you I was a dance growing up, sadly I don’t really have the time or I don’t dance anymore, I would love to find a way to get that back in my life, but I run, I am super active. I know, we have been together at meetings and you probably, if you were there early in the morning, you would know that you know I am not even when I travel early in the morning, get to workout and I just keep thriving and of course nutrition and things like that. So for me that’s what you know really helps me with my energy and my you know positivity.

And just I am such passion of what I do, like it’s yes, the desire to really help people but I absolutely love what I do, from aesthetic medicines, to functional medicine. You know I am lucky enough that I get to teach both sides just return from Paris where I was able to lecture at the preeminent cosmetic medicine meetings on some of my my own proprietary techniques and that I can share and travel and learn continuously is a joy of joy for me. So if you have passion of what you do, I work super hard, like I said, 24×7 I put it all into what I do, for my patients, for my employees, for my practice, for my family. But it’s all gift to me because I love what I do and so for me that’s the joy. And I think of the flow and I would say, there were lots of times in my life where there was got worst if you know step one for your daughter is you know like a stepping stone and there will be, I could imagine auditing for KPMG will have it highlights and perhaps low lights that you know every field has that. And if your eyes on the asking, and the deliverable and you know you are kind of structural as I call them, then –.

And I guess the other piece I should say and I have been very deliberate in my, in curating the power team. I have here at PearlMD which is a team of women providers, nurses, medical aesthetician, nutritionist, coaches, just fabulous women who I like to be with, who help me perform better, who just you know with all of us performing as a team are able to deliver a standard of care with the quality of experience, I call it the Four Seasons of Medicine, that’s our aim, that’s our mission statement. Those are highest caliber of care with the highest level of service. It takes a team right so surrounding yourself with great people –.

Tim Sawyer: But I will say, 9 times out of 10 and I do a lot of work in the space with a lot of practices, a good team is a direct function of a great leader and someone who is committed to the cause consistent as passion and principles. And you embody all of that, but I want to ask because I would be remiss if before we hung up if I didn’t ask you, what are some of the cool technologies; obviously with the proliferation of non-invasive technology, there is no shortage of devices out there. Now what are some of the exciting things that you are using in the practice whether it’s laser any or non-invasive technology?

Jennifer Pearlman: So I will take you to both, the medical side and then let me leave you with my three most exciting beauty technology, beauty and body technology. I mean I already alluded to this idea of genomic-based care and although it’s just a first chapter in a long book of life, it really embodies this emerging roles of care of medicine including aesthetic medicine of what I call precision medicine. So being able to look at your genomic footprints, as well as other things like nutrition hormones and put a patient on a program that is a precise match for them and evolve with them although the genes don’t change, all of the other dynamic markers may. And there is now a whole direct link of some of our genomic markers and not only some of the fitness recommendations or you know the care on the plan that we would put together for the patient, but also skincare and aging and some really neat ties. So gene-based beauty, gene-based skincare is –; a lot more, you hear about this idea of [inaudible] [00:39:40] beauty and I am not a big fan of that word, I think it kind of demofies it a bit too much, I like precision medicine much better. But I think that’s linked in both my health and my beauty practice.

And then if you look at my office and again invite you Tim, can’t wait to get you, it’s spring here now, so now your daughter is in New York, you have to come visit us. If you are in Toronto you will see that every single one of my room is packed with technology. And some of the things I am most excited about that I have been fortunate enough to be the North American lead with, will include new technology that delivers 3D total rejuvenation of the skin and contouring of the body. So it’s a deep dermal treating of the tissue with now cell-based evidence tissue based research showing, regenerative changes in all three dimension, so collagen, elastin, fiberglass totally different than non-invasive skin tightening procedures, you know there is a whole slew of different technologies there. And because of its deep dermal heating and the ability to again a very high level of expertise required to use this technology but you can modify the layer of treatment, you could now go into fat and thermally destroy fat permanently. So it’s a one-time treatment, I can rebuild the mummy-tummy, literally rebuild the mummy-tummy, I can target the saggy we call them bat wings but the saggy arms which no surgery, no technology would effectively do. I can deal with the lower face and the neck, all these things that were you know those request or needs of uninjectable based practice because again I am a non-surgeon so scalpels here, so that’s going to game change.

And likewise and this is supercool, first in North America with an Italian made technology that uses and so again there is nothing yet approved, this is not Health CAN approved, this is not FDA approved let me say, but I have been able to work with it in a clinical research setting and have already treated thousands of patients.

Tim Sawyer: Yeah.

Jennifer Pearlman: It is a new technology called Plasmapheresis, okay big word I know. So what that means is, a very delicate technology. So again these are things that I personally am delivering to patients. I am literally providing minute ablation, vaporization of tissue for a surgical result so a brow lift, a lid lift, I can deal with all the sort of little areas of laxity that needs elimination that till now has only been possible through surgery. So literally now a non-surgical lid lip has been a game changer for me. And I am so excited about the future of this technology. Lots of other neat ways that this emerging technology can be used including for skin health, spraying plasmapheresis all over the skin for health reason, for aging reasons, for beauty reasons, but that will be the future medicine or the future of cosmetic medicine is this technology really taking great. From Europe it’s been approved in some European countries and now the South Koreans are all over it. If you haven’t heard, South Korea really is the mecca of beauty and emerging cosmetic technology. And again we have work kind of like lightening, it’s kind of like lightening, it’s transferring energy, I don’t even touch the patient but transferring energy and I am able to deliver a surgical grade results with virtually no downtime. And treatments that involves no blood, so there is no sterilization, there is no infection risk. I mean can you just imagine what a game changer this is, right, isn’t it cool.

Tim Sawyer: It’s all amazing. I have to ask you one more question then we are going to wind out. So I was at the A4M show and there was a girl giving a talk about and she was an anti-aging specialist, self-described. And she was talking about using this 23andMe gene testing platforms to treat people, are you, you know do you subscribe to that, in other words, someone going and getting that, all that gene information and then bringing it into you, what’s the protocol for you on that?

Jennifer Pearlman: So I mean just the general idea of getting a handle of some of what I call, your genetic risk and your genetic gift, right so we are not talking about the big bad disease genes like BRCA, the Breast Cancer gene that Angelina Jolie you know brought a lot of attention to. We are talking about weaker genetic susceptibilities or strength. And 23andMe is a commercial; it’s the direct-to-consumer platform widely available. I think it has there is two different ways you can test ancestry or health and it has some basic information that when you put it through an algorithm, there are separate apps you can use or ideally bring it to a medical experts who can walk you through it. It could have some applications, we use next-gen sequencing and what I called genomic profiling. So the difference is I am looking at the whole genome, okay it’s more expensive, it’s going to be something that you are not doing online, you know it’s a whole different thing. But it’s more reproducible, it’s next-gen it’s more advanced testing platforms. But just to elaborate on what genomic sequencing offers, beyond just looking at errors in the code, like 23andMe would do, is that some of our genes, it’s not a single mutation error that would determine the susceptibility of risk, it’s actually like I am missing the gene type of error which we call CNV or Copy Number of Variant. And so CNV errors are completely missed in 23andMe, like you might have a normal gene sequence but you are missing a copy of the gene, right.

So because we look at the newer, this is a more recently discovered type of genomic risk or error, we are looking at both and some very important genes especially to like health and estrogen are susceptible to different kinds of errors that might be missed in 23andMe. But what we do specifically if you have done any prior testing, I am going to look at what you have done already before you spend your money on you know additional testing. And together we will make those decisions. So I would just reiterate whether it’s a hormone test, a nutrition test, a gut health test or a genetic test, the test is only worth its weight in the expert guidance, interpretation and care that’s delivered a long side it. And so you know really the message is that there is no magic bullet, there is no magic test we offer, but a range now of biomarkers that are available to us, both in my health practice and the beauty practice, I have introduced some really exciting, again I couldn’t speak to all of the technology markers of your facial aging, of your skin health that you know really expand my ability as an expert in working with you, to show you what a precision skincare plan or you know a precisely match plan or perhaps injectables and technology can do for you in helping you age your back.

Tim Sawyer: I would tell you what, I have to ask one promise from you and that is that you will join us again sometime soon. Your perspective on this stuff is fascinating, you have dedicated your life to it and I give you a lot of credit, someone who is you know financially savvy, someone who is incredible mom, wife, clinician you are in great shape, I think you are great role model, anybody that’s listening to this, I hope, apart from the incredible clinical information, is that’s the big takeaway right is that you can, as you have described it, if you can tap into and create flow in your life, then you can actually and not just sustain all those components of your life but also you can thrive while doing it and that –.

Jennifer Pearlman: You can thrive.

Tim Sawyer: You have inspired me, I will tell you what, I get to get a couple of that to do, Toronto, my wife and I need to come get some Dr. Pearlman time and put some of the stuff into place. But while we wind down here, so where are you headed next, where are you speaking, where can people see you speak, and where can they find you for people that are looking for more information?

Jennifer Pearlman: So every month I probably do a few you know peer-to-peer so scientific meetings and lectures, upcoming I have got some training sessions. I am leaving some of the setting technology that I just mentioned which is always a well treat, I am actually going to be demonstrating some treatments. I am also very involved in our local community, I do a lot of work and have speaking engagement with businesses, with chair leads and then our fashion industry to actually just at the left field, I spoke last night at you know large gathering of HR leaders from the country on candidates of all things, another really hot topic, fodder for another podcast, sure. And probably the next major forum that I think even I might reach out, that would be the aesthetic show in Vegas. That one coming up over this summer and I believe I have five podium appearance, five podium appearances to be fair on a whole range of exciting topics.

Tim Sawyer: Got it, it sounds to me like you need a podcast. One more thing in your life.

Jennifer Pearlman: Well let’s do it, Tim.

Tim Sawyer: I would love to do it. Listen, Dr. Pearlman, I could literally talk to you all day and what a pleasure it was today and an honor, we are really grateful for you joining the podcast and it’s www.pearlmd.com is that correct, it’s Pearl, P-E-A-R-L.

Jennifer Pearlman: www.pearlmdrejuvenation.com.

Tim Sawyer: Got it.

Jennifer Pearlman: www.pearlmdrejuvenation.com, Instagram, PearlMDRejuvenation and Facebook, Twitter, Dr. J Pearlman. So Tim, again thank you so much for having me, it was so much fun. It’s always nice to start your day with a very engaged, somewhat personal conversation. So thank you to your listeners and again very honored to be here with you.

Tim Sawyer: We really appreciate, have an awesome day, Dr. Pearlman, thank you for sharing we will catch up soon, okay.

Jennifer Pearlman: Take care, bye-bye.

Tim Sawyer: Bye-bye.

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