Gema García Marcos

Updated Saturday, February 10, 2024-13:53

A specialist in aesthetic medicine and hair regeneration, José María Ricart has become one of the dermatologists with the longest waiting list in Madrid, where he has just opened his new clinic on Paseo de la Castellana.

Although the skin is the largest organ in the human body, traditionally, it has not been given the importance it deserves. Perhaps because it was considered something 'superficial'. How important is healthy skin to our general health? Should we go to the dermatologist for an annual check-up just like we go to the dentist, gynecologist or ophthalmologist? The skin is the largest organ of all we have and has the ability to show us the things that happen inside our body, such as diseases that we have hidden, such as cancers, nutritional deficiencies, hormonal alterations and a long etcetera. That is why the skin has gained and is gaining, every day, more prominence in the global vision of human health. And even more so, with the changes that have been taking place in the last decade in which life expectancy, for both men and women, has been gradually lengthening to 85-87 years. All of this has caused a great cultural and social change. Today, we not only want to live longer and better, but we aspire to live with a better physical appearance. This change has greatly affected the new generations, people between 20, 30 and 40 years old, who, thanks to social networks, are very aware of the importance of skin care, about the creams they should or should not be applied. In short, to feel better and younger. The really interesting thing about all this is that now it is the youngest people who tell their elders that they have to apply sun protection factor, that they should look at those spots on their face that age them so much or that they should go to the dermatologist to have them checked. Analyze the condition of your skin. So we find ourselves facing the flowering of a new dermatology. A dermatology that no longer only has the curative or diagnostic vision of inflammatory and infectious diseases that has characterized it for the last 40 years, but has also opened its field of action towards trichology, hair diseases or beauty. As was the case before with other specialists, patients go to the dermatologist annually to check the health of their skin. Above all, those people who have had moles for years and which may have become malignant. In this sense, it is worth remembering that

early diagnosis can save many lives.

What does the skin say about our state of health, in general? Its level of hydration, its color...The skin gives us clear information about many of the problems that we may have in our body. For example, we know that vitamin deficiencies can cause hair loss or that hormonal alterations can cause acne or hair loss. Likewise, thyroid disorders can cause duller, duller, dehydrated skin that ages more quickly. Changes in the nails can even give us signs of alterations in the lungs, problems with heart attacks or thrombosis. Regarding cancer, I will tell a story that I remember with special fondness. Some time ago, a 28-year-old patient came to my office whose hair was falling out. I remember that, when I saw him, I was struck by the appearance of his skin and his eyes; He also had atypical hair loss. His history - he also told me that he had been feeling very tired for some time - together with the color of his sclera and his eyes gave signs of organic failure. I told him: "The first thing you have to do is go to the emergency room to have an analysis done." There,

he was diagnosed with very serious kidney failure that would have ended his life in two or three days.

I could tell more anecdotes like these, of successful cancer diagnoses that I have been able to cure. Also, some not so successful that I carry in my heart, because I did not manage to save their lives. What experience has shown me is that the skin is the mirror of what we carry inside and that we have to look at it to see what is happening inside. Dermatology has become one of the most in-demand specialties among the new batches of doctors. How do you interpret it? I interpret it to mean that patients with dermatological pathologies are lucky because they will have the best resumes at their feet to solve their dermatological problem. Although I don't think this is something recent either, because, when I applied to the MIR 25 years ago, dermatology was already one of the most chosen specialties. Because? Well, in my opinion, because it is an exciting specialty with a wide range of possibilities and opportunities to super-specialize and be happy in your daily work. Research, trichology, aesthetic dermatology, laser, internal medicine and skin-related diseases, tumors, infections, surgery... It is so broad that you can never get bored with it. I think that is one of the reasons why it is so attractive and makes everyone want to study it. How important is the boom in aesthetic medicine in this field? How have you experienced this evolution and what are, in your opinion, the changes that have made it possible for this specialty to go from being seen as something 'designed' for a minority (and from being viewed with some suspicion, too) to being viewed naturally and without tapujos? Aesthetic medicine has greatly expanded the field of work of dermatology. The dermatologist can cure your acne, but he can also eliminate all the aesthetic consequences of it: scars, marks, blemishes... I started with aesthetic medicine 20 years ago and the evolution of products, procedures and technology has been continuous; I have not stopped studying and learning for a single moment. The objective of these advances is, of course, greater effectiveness, but also to make treatments more 'friendly' for the patient, faster, painless, less invasive. Without a doubt, this has made aesthetic medicine increasingly popular and seen in a much more natural way. The change in the concept of aesthetic medicine for the general public has also been very relevant and I believe that this is due, in large part, to the trust that we doctors have been able to transmit. Aesthetic medicine based on naturalness and harmony is, in my opinion, what has made us lose the fear of medical-aesthetic treatments. Before, people were somewhat embarrassed to say that they had undergone some aesthetic treatment. This is no longer the case, is it? Yes, there has been a change in trend. Now, it has become more normalized for people to say that they have used botulinum toxin or hyaluronic acid.But let's not generalize. There are still patients who prefer to keep the secret to themselves. What happens now is that, with social networks, people have become accustomed to telling their experiences. They tell about their hair transplant process, their mammoplasty... And many times they do it because there is an economic interest behind it. Obviously, this has contributed to making it much more normalized. How important is it to looking good for our general well-being? One of the most important aspects for human beings is to feel good about themselves. Not only with weight, silhouette or facial features, but also with your strength and daily mood. In fact, it has been seen that there is a direct relationship between how we feel and how we perceive our organism and our body. Therefore, people who feel good about themselves, when they see themselves in the mirror, have a greater ability to face the challenges of everyday life. What do we need to know before 'letting ourselves touch our faces'? Here are three fundamental points:

what products they are going to use with us, what residue those products are going to leave behind and what type of results we are looking for

. There are so many brands these days that it's overwhelming. There are some that have more serious scientific studies and that have been used for years and others that are more innovative. For my patients, I try to avoid all types of treatments that are very new, because, sometimes, until some time has passed, side effects do not begin to be seen and you have to be very careful with that. Another thing that must be taken into account is whether we want the product to be permanent or temporary (resorbable). In this sense, I must say that, despite what has been stated in the last 20 years,

hyaluronic acid does leave a residue on the skin, between 10% and 15%

. Therefore, there is a lot of that product that will remain permanently on our face every time we prick ourselves, potentially creating deformities. On the other hand, there are other types of products, such as polynucleotides, which are now very popular, which do not leave any type of aesthetic mark. It is a substance that is progressively reabsorbed and what it really does is activate the different cells of the body, such as fibroblasts, so that they start working and improve the quality of the skin. Finally, it is essential to choose well the doctor who is going to perform the treatment. Look for professionals with a lot of experience, who know the products well and, above all, who are highly trained in resolving complications, so that, if any adverse effect occurs in the treatment, they will take care of us in an agile and effective way. Selecting and choosing your aesthetic dermatologist is a very serious decision that must be made conscientiously. What is, in your opinion, the greatest achievement of aesthetic medicine in recent years? The star treatment? What is yet to come? The greatest achievement of aesthetic medicine and what has made it change radically have been two things:

systematization and the quality of the products

. We have been able to put aside what is called art and put a systematic approach before each patient, as is done in other medical disciplines. This has allowed us to codify the proportions, facial harmony, the different units of aging - expression lines, spots, sagging... -, and from there to know how we should solve each of the different problems.

Aesthetic medicine has transformed from art to science,

making it quantifiable and systematizable. Now we know what response we are going to get with each patient based on the number of vials, the application of those vials and where we are going to apply those vials and, for me, that has been fundamental. The other great secret has been finding products of the highest quality that allow for very safe treatments with a very small percentage of side effects, as long as they are used with the appropriate technique and by an experienced professional. What is most used is botulinum toxin. Now, if aesthetic medicine has a secret, it is the combination. From lasers, radio frequencies, high intensity ultrasound, toxin, polynucleotides, growth factors... When we combine different techniques, we achieve truly impressive results. As for the future of aesthetic medicine, it is increasingly moving away from surgery because patients are fleeing the postoperative period. For this reason, there has been a relentless search for eight or nine years to

find systems that rejuvenate us as much as possible in a natural way and without a recovery period

. I believe that what is coming are new drugs, probably guided by

exoxomes

.

Substances that we will be able to introduce into our body and that will send messages to our cells to tell them how they should rejuvenate.

Let's not forget that our cells have an engine inside that allows them to transform into a lung cell, a liver cell, a kidney cell... depending on what you read in their genetic code. I think that, more and more, we are going to be able to send messages to our cells to tell them what we want them to do, in this case, rejuvenate. Nowadays, is it possible to undergo rejuvenating treatments without anyone noticing that you have done them? done and just wondering why you have such a good face?


Of course. Nowadays we are even able to do a treatment in the afternoon and have absolutely nothing noticeable that same night. What's more, that's what everyone wants, to look younger without anyone noticing what they've done. I'm amazed by the advances in hair regeneration... Is it really possible to make hair grow back? What we have achieved with hair has no name. It is one of the most important points of body regeneration right now. Hair treatments have left transplantation aside. 85% of patients who come for a transplant ultimately do not have it done, because. With this type of treatment, we are able to regenerate hair follicles and give the patient their hair again.

Not only do we get the hair to grow back, but it makes it stronger, thicker, shinier, even darker

. It's really a regeneration. Hopefully we can do the same with the rest of the body. What 'tweaks' or what treatments would you do because you know they are the most effective, natural, least invasive, etc.? And which ones would you never submit to?



It is not easy to answer this, but, probably, I would trust those minimally invasive treatments that do not leave any type of aesthetic mark and I would be wary of those that have a high risk of complications. High eyebrows, marked cheekbones, small and upturned noses, lips fleshy... Aren't we walking towards a clonal and exclusive beauty that, by the way, is quite lazy? At this point is where social networks are very dangerous, because it is true that patients increasingly ask for stereotypes, to look like a certain person, therefore, instead of rejuvenating what we are doing is changing faces. Therefore, the doctor must have the sensitivity to

evaluate very well when the patient begins to lose his beauty proportions

and begins to be another person. Men are not free from this 'pressure' to be 'perfect' either... No?


At the educational level, men are very different from women.

Women are very hard and critical of themselves and this makes them go more in search of perfection

. Men, on the other hand, generally have higher self-esteem. Don't you think that the fight against the passage of time is a losing battle? Don't you think that we are going to end up a little 'crazy' in this fight not to age? A battle is not lost until one surrenders. Meanwhile, there is battle. I think

leaps and bounds are being made in the pursuit of a longer life and a better life.

That's why I don't think it's a fight for crazy people, but for sensible people. In reality, the most important thing we have is our life. For this reason, every day people realize more that what is most valuable is time, not money. Therefore, the idea of ​​eternal youth should not be something crazy when generations and generations, for thousands of years, have been searching for it. In this scenario, how is the balance maintained between taking care of oneself and aging 'with dignity'? ?


In this scenario, what we should look for is

healthy longevity

and there is much research on how to live longer and better. What has been seen is that

people who are able to follow exercise routines, nutrition and studies for early diagnosis of diseases are the ones who will achieve healthy longevity.

. Now we see that people who turn 85-86 years old, in most cases, when they reach 75, begin with chronic pathologies that cause them to have sad lives in the last years of life, because they cannot do the things they they did previously. What this new concept of longevity seeks is for

us to be able to live 85-90 years, but with good quality

. That we are young, even though we are old, and that, when the light goes out, we have lived a full life during all those years. What ages us the most: the sun, stress, food, pollution, sleeping poorly...?Smoking, excessive drinking and the sun age you. But there are also things that rejuvenate, for example, I didn't know that one hour of sport a day gives us 7 hours of life. Although if we refer to the skin, specifically,

the sun and tobacco are what age it the most.

Is there any point in spending a fortune on treatments and creams if we then lead a disastrous lifestyle?


In this life we ​​must have a certain internal coherence and, normally, people who treat their faces and spend money on aesthetic medicine are coherent and also tend to take care of their bodies. Obviously, the benefits of the treatments can be harmed if the person smokes or has a disastrous diet. In fact, today, surgeons do not operate on patients who smoke because of the possible complications that may occur. Just like us, aesthetic dermatologists, when we do radiofrequency treatments with microneedles or high-intensity ultrasound on patients who smoke, we know that the response of the tissues to this treatment will be very poor or even non-existent. Therefore, there must be coherence and

people must take care of themselves globally.

What is the nicest thing a patient has ever said to you?


"Doctor, the groove was perfect. After God, you are in the creation of beauty," a patient wrote to me a few days ago. However, the greatest satisfaction you can have is saving a patient's life. Because life is our most precious treasure and that is the essence of our profession. Speaking of satisfaction, how did the idea of ​​creating the 'Erase Your Scars Foundation' arise and what is its mission? After 20 years specializing in the treatment of scars, we created the 'Erase Your Scars Foundation', a non-profit entity whose main objective is to promote social health programs to help people with traumatic scars who cannot access quality treatment. Our values ​​couldn't be clearer. Starting with our

commitment,

because we want to give back to society a part of what we receive, repairing a need not covered by public health, the problems generated by scars. We are committed to

scientific research

, concentrating our efforts on making research advance faster than public resources allow and creating new lines. The dermatologists and plastic surgeons who are part of the 'Cicatrices Foundation' carry out our activity with the

latest technology

, offering our best resources to the people who need them most. And we provide

training

to dermatologists and doctors throughout Spain on advances, techniques and treatments that improve the appearance of scars, since when and how to treat them is key when it comes to obtaining the most aesthetic result possible.