A little bit of a history of the most famous and most popular cosmetic dermatology product on the market which is Botox cosmetic. It is one of five brands now that are what we consider neurotoxins. So when I talk about injectables and topicals, we’re going to break them down into categories.

Anthony Accardo
Bucks County Triathlon Club Founder/Director
(listen to the show or read the full transcript below)

Anti-Aging Unraveled: Which Non-Invasive Cosmetic Procedure Is Right For You?

Lori Gerber D.O. (00:04):
Hey everyone. And good evening. Um, I seem to have picked a cold one for a spring night in
Philadelphia, but, um, nevertheless, I am waiting for a guest come halfway through our show that, uh,
will hopefully give us some ways to warm up with, uh, triathlon series, um, in bucks County. Um, so
that’s coming up later in the show about, about halfway through. Um, I do have a glass of wine in his
honor, so I will bring that out later. Um, he is a Somalia, so, um, we’ll be happy to welcome Anthony
Accardo when he comes on. Um, but I did do a poll, um, this weekend about what we ever wanted to
hear this weekend. And, you know, the consensus was, people wanted to know about cosmetic
dermatology and the different types of injectables and really what they were used for and how we can
kind of use them in the face and other places.
Lori Gerber D.O. (00:53):
So, um, I thought I would start with giving a little bit of a history of the most famous and most popular,
um, cosmetic dermatology product on the market, um, which is Botox cosmetic. Um, it is one of, I guess,
five brands now that are what we consider neurotoxins. So when I talk about these, um, injectables and
topicals, we’re going to break them down into categories. I’m going to try to make this really simple.
Um, I did have a bunch of questions that came in right before the show on Facebook when I kind of
announced what we were doing today. So I’m going to try to work them into the show tonight. So, um,
bear with me. If you do have any questions you can reach out on, um, info at mydrlori.com, that’s M Y D
R L O R i.com or on my name, Lorigerberdo on Facebook or Instagram.
Lori Gerber D.O. (01:46):
Um, with some questions I will try to pull them up as we go moving forward. And of course, allergies are
getting me tonight. So, uh, just bear with me, my, my voice is struggling a little bit, but I’m going to try to
get through this for you guys. So first things first is let’s kind of bring him to Botox and Botox is
something that stops movement. All right. So it works by stopping the actual muscle from contracting
and it sounds a little bit scary. Um, we all think of botulism, so I thought let’s get into a little bit of the
history of Botox. It’s kind of interesting. Um, you know, Botox is done by over 1.5 million, um, injections
in the United States a year. Um, and it’s going up and up and up. It’s actually probably closer to 1.7 at
this point. Um, I don’t know with COVID, they’re all rushing in now, but,
Lori Gerber D.O. (02:35):
And, you know, we kind of look at the world or at least I look at the world and I can’t believe that there
was even a time before Botox, but, um, you know, it was not always used for cosmetic purposes. It only
became cosmetic in 1996. Um, and it had a really strange kind of evolution and, you know, started with
food poisoning and then in the optometry ophthalmology world, and even the U S military to back up a
little bit, um, in 1895, there was a Belgium bacteriologist who discovered, um, what we would call
Clostridium botulinum, which is botulism. Um, and he discovered it in home cured ham. So think back to
when, you know, we’re canning our own foods or we’re making our own foods and, you know, it was
linked to botulism. And that’s why I think a lot of people are scared of Botox or Botox or other brands,
and really that’s the bug, right?
Lori Gerber D.O. (03:29):
That’s the actual bacteria, but we’re not, we’re not really talking about that bacteria. We’re talking
about the protein that it makes. Um, so it caused food poisoning, found a lots of strains. There are
actually seven strains of botulinum, um, and they labeled them very creatively, a through G and four of

them, a, B, E, and F were actually found to cause sickness. The rest of them were not. So, you know, we
have this, this bug that causes sickness with the protein that it makes, and then we have these other
proteins that actually just don’t do anything like that in the human body. Um, so if we fast forward to
world war two, um, Dr. Edward Shantz was commissioned by the U S army actually to study bachelor
botulinum toxin a to see if it could be used in the military. Um, and actually he actually was able to
purify it into a crystal form for use in the U S army as a biologic.
Lori Gerber D.O. (04:24):
So, um, I find that to be a little bit disturbing and interesting. Um, so the crystal form was created at
which it would be Botox a and then in 1953, um, we actually started using very small amounts, Dr.
Vernon Brooks to, um, the, uh, hyperactive muscles. So anything that was like, um, ropey or tight, and
think about a neck that might be tight or a shoulder that might be tight to relax the muscle. And he w he
showed that it could be used to actually cause muscular relaxation. So that’s kind of the door that
opened to Botox as our botulinum, as an injectable product, um, for muscle relaxation. And in 1978,
serendipitously the year I was born, um, Dr. Scott was given permission by the FDA to start testing, um,
botulism on humans. So he re um, published his results in 1981 that small doses of botulinum toxin
could be safe for what we would call strabismus, which I know, um, for those of you that are watching,
listening to this live, you can’t see me, but which is basically, um, the eye not being able to go in the
same direction.
Lori Gerber D.O. (05:37):
So it’ll actually track in the, in the wrong direction, um, like a lazy eye, if you will, and that they could
actually get relief from that. And they could get relief from neck spasm, space and shoulder, and even
vocal cord spasm. So we’ve been using this drug everywhere, um, really, to be honest, probably longer
than any other, um, cosmetic injectable in the market. And then the big boy Alor GYN came along in
1988. And don’t, you wish you were Dr. Scott because Dr. Scott, his rights to distribute got bought out
by Allegan. Um, and he had named this drug called AKI Lyneham cause it was mainly ocular. Um, but it
was later named obviously Botox and it was used for the same purposes and got FDA approval for the
strabismus, which would be the eye, um, tracking issues, um, like a lazy eye and the eyelid muscle
spasm, which are known as blepharospasm.
Lori Gerber D.O. (06:34):
So, you know, both Cox became the new name and obviously they’re a powerhouse and a great
advertiser and, um, have really kind of cornered the market on, on what we call neuro toxins. Um, I’m
going to talk about some of the other ones, cause I did get a bunch of questions on those, um, prior to
the show. So I’ll bring that in in a minute. Um, but in 1990, um, this is really where kind of, I think the
tide turned, um, Botox was successfully employed in using it for writers, cramps, bladder spasm, um,
excessive sweating under the arms. And most notably actually in the beginning was in cerebral palsy
children, um, to help relax the muscles. So, you know, the most popular use of Botox is actually, which is
facial was actually found by accident. I’m a Canadian ophthalmologist, Dr. Jean Carruthers, um, was
treating with Botox in the way that, you know, was on label all the time.
Lori Gerber D.O. (07:35):
Um, and for the eyelids and saw that the frown lines in between the eyes were actually getting better.
Um, and that they were looking younger over time. So she published a, um, study and saying that
treating blepharospasm or directly Botox could treat brow wrinkles. So, um, by 1997 it became kind of a

crazy across the United States. Everybody had taken notice of using the off-label, um, that way and the
drugs spiked so fast that actually, if you can believe it, the United States ran out of Botox. Um, not unlike
what was happening to us, um, during the snow in Texas recently, um, during COVID, if anybody is out
there remembering that we were unable to get Botox for several days and it created a massive backlog
of Botox in the country. Um, so that’s how it became what I would say from not mainstream to
mainstream cosmetic.
Lori Gerber D.O. (08:36):
Um, they actually do have two umbrellas, which is, would be a medical side and a cosmetic side. So it is
still used across the country and the world for, um, neck kind of what we would call dystonia, which is
where the muscles started to tighten. And they contract frown lines in between the eyes, um, under our
sweat underarm, really severe muscle spasms in different parts of the hands fingers, elbows. Um, it can
be used in Ms. Chronic migraines is a big one. It is FDA approved for migraine therapy and works
excellently, um, in the bladder for urinary incontinence. And, um, what we would call upper limb
specified spasticity, which, um, would be kind of in voluntarily moving, um, upper limbs and trying to get
them to relax, um, and obviously forehead crow’s feet and in between the eyes. So, um, there are the,
all the approved temporary treatments with Botox.
Lori Gerber D.O. (09:33):
Um, there is talk now of using Botox to treat depression. Um, they’ve also been using it for irregular
heartbeat after bypass procedures, um, scalp injections for, um, keeping actually hairstyle from the kid.
This was the basis glands and the sweat glands are releasing to keep hair, um, less greasy, um, foot pain
with high heels. So like neuromas it’s been used in, so there’s tons and tons of ways to use Botox. And I
think, um, ways that we don’t use it that I think are under-utilized, um, is down the neck. And I don’t
know, let me go back to my screen so you guys can see me. So in the neck we get these bands and these
bands are called platysmal bands and to soften those bands and actually get some of the necklace lines
gone, maybe even some of the, um, chin drooping gone, or even jawline slimming, right.
Lori Gerber D.O. (10:24):
We can slim the, the muscle that bites, um, and choose our food. Um, we can also slim the other
muscles that are around there to give us a straight or contour or a slimmer contour. Um, and by the
same token, we use it for TMJ, which is the jaw joint, um, by treating the muscles around the, um, the
muscles of mastication or how, when we chew, um, so that you don’t have that effect of tightness, or
maybe as much grinding at night, it gives you a great relief, um, for about four to six months. So, you
know, I think that, uh, chin dimpling, I did miss that one, the call I call it the thinkers face and some of
the downturns of the mouth, um, are really, um, important ones really popular right now is called a
gummy smile. So I actually have one I’m going to give you guys on video a smile.
Lori Gerber D.O. (11:15):
And what you do is you actually put a little bit of, um, neurotoxin or Botox, right at the top edge of the
lip. And that actually keeps the lip sitting a little bit lower so that it reduces the amount of, um, teeth
showing or gums showing when you smile. Um, duration again, for most of these therapies is about four
to six months. Um, most of the muscle movement stuff is about four months, six months for, um, I do
find sweating lasts about a half a year, six months. The rest of it’s probably closer to four, depending on
how strong you go and what kind of, um, numbers you use. And I get lots of questions about pricing. I

think this is probably one of the biggest things I get asked when someone comes into my office and
pricing is per unit. So per unit is a tiny little droplet.
Lori Gerber D.O. (12:04):
All right, each area that I treat is probably about one to two units. Um, and I do a bunch of pokes. So
every place I poke you, you’re getting a couple units give or take. So those units to me are the best way
to quantify how much you owe, you know, how much you’re going to pay if you do it by area. The
problem is, is everybody needs a different amount per area. So there is a huge fluctuation in the number
of units that people will use. And if you’re paying by area, it, you might be paying the same as somebody
else that doesn’t use as many units. So that is one way to kind of understand your treatment and to be
an educated patient is to know how many units you’re getting for the price point that you’re, that you’re
at. And I mean, for example, our office right now is $13 a unit, um, at the events and parties, it’s around
$11 a unit, depending on the region.
Lori Gerber D.O. (12:59):
And, you know, let’s just say, I’m going to make it easy, use 20 units. And at a party it’s $220. Most
people use between, I would say, 12 to 30, 40 units, depending on how many areas they’re treating. Um,
so that should give you a little bit of an idea. It all should be diluted pretty consistently, unless there are
reasons to dilute differently, but it should be diluted pretty consistently. However, physicians dilute
their own vials. Um, so, you know, I think it’s important to see and know how your physician is diluting
your vials. How much are they drawing up into a syringe and what is that syringe equivalent to? Okay, so
that way you don’t get ripped off. I mean, let’s be honest, not everyone’s straightforward and honest,
um, and that is one of the easiest ways to make extra money in this industry. So I think that’s really
important.
Lori Gerber D.O. (13:54):
Um, the other question I get asked a lot is, you know, how do I avoid droopy eyelids? And I think that is
a very big question that, um, really qualified injectors should understand, and the place where you can
get droopy, there’s a nerve above your eyebrow that comes in usually about midway or two-thirds of
the way laterally, um, from your, um, the inside part of your eyebrow. And that spot is the nerve that
holds your brow up your lid up, sorry. And that lid, if it gets too close or Botox gets too close to that
spot, it can actually leave you with a heavy eyelid or even a little bit of a, uh, what we call a ptosis or a
droop. You can get that from coming too far over the brow and close down towards the eyebrow. And
you can also get that by doing in between the eyes.
Lori Gerber D.O. (14:48):
And it would seem like how counterintuitive that you can get in between the eyes. But remember
everybody’s anatomy is a little bit different where that nerve sits. So I think it’s really important. Um,
everybody’s got a little depression, so everybody take your finger, put it above your eyebrow, feel that
little Ridge line above you’ll actually feel a little divot. Um, it’s actually a little tender spot. That spot is
where your nerve comes out. If you have wrinkles right above that spot, they are the hardest ones to get
rid of. So I encourage you to look at your face and your doctors should know we stay about two fingers,
breaths away from that area and less we know your face, and we know the tolerance for your body to,
um, get Botox in that area. After about two weeks that I’ve seen a patient, I definitely will bring them
back in two weeks and say, especially the first time, and if they still have crinkling there that they don’t

like, um, especially if they have a lot of movement in their forehead around that area, I’ll have them
come back and I’ll put a little drop in.
Lori Gerber D.O. (15:47):
So that is something that I think is critical. Now, the other question I got, um, is how do you get rid of a
droopy eyelid, um, once it’s there. And that is a tricky question. Once it’s already there, you really can’t.
Um, but you can soften it or less than the length with, um, some naphthalene eyedrops. There’s a
couple of brands over the counter that you can put in several times a day and literally just rub the
eyelid. Um, I’ve kind of a, is one of them that we use and you put it in several times a day and just
rubbed that lid or that Ridge line to try to stimulate that nerve to work. Um, it’s always going to be more
tired in the morning when that happens and as the day goes on, it’ll be okay. And then before sleep, it’ll
start to troop again.
Lori Gerber D.O. (16:32):
So that’s, um, that’s the best way to do that. So, um, what if you can’t use Botox? I did get asked that
question and I think there’s a lot of reasons. One, your forehead’s too small, you get too heavy, um,
gives you headaches. Um, it doesn’t make you feel good. You get flu. Like, and in that case, I actually
really like the new smooth threads they’re called PDO threads. And they actually slide in, um, to the
forehead in different directions. I like to go vertically to actually counteract some of the horizontal lines.
And I like to go on an angle almost like a hashtag. Um, and they actually create college in areas. So they
slide in and they dissolve like suture over about a year, but they build college in over about six weeks
and that college, and you can just keep building on so about every four months or so, throwing those
threads in is a really nice way to counteract some of what’s going on up in the forehead.
Lori Gerber D.O. (17:31):
Um, there’s obviously lasers and microneedling and all these things. Um, Morpheus is a great option
that we can talk about. We’re going to do another episode on that. But, um, that to me is a really nice
alternative. Um, there is always the other brands of neurotoxin, um, [inaudible] and they work
differently. There are a little bit of different shaped molecules. Um, and if you’re not having a great
reaction to one molecule, it’s not to say you’re going to have the same reaction to every molecule. So
that is something that I do encourage people to try. Um, Dysport is a little to me, a little bit of a stronger
hold it, quick, kick in and a quick kickoff. And then Xeomin is a, um, a slower kick in slower kickoff. It
lasts about the same as, um, Botox and Dysport. And so those are my they’re kind of my go-to
alternatives.
Lori Gerber D.O. (18:32):
Um, and you know, when you are, when you’re trying to decide if you’re going to try another neurotoxin
to me, honestly, if, if you got droopy or heavy, um, I would back off my units, a ton, try to half of what
you tried, cause anything’s better than nothing. Even if we lighten the muscle load and we strength the
muscles down, that’s my first go-to. So that’s how I would start. And then honestly, I would probably try
another toxin. And after that I would probably use the threads. Um, the threads can be used everywhere
guys. So I think I underestimated the value of PDO threads for a long time. Um, and it’s one of those
things where I have used them now in several good chunk of patients and the lift, the, um, the college
and deposition is just, it’s amazing. So, um, I love it.
Lori Gerber D.O. (19:21):

I highly recommend you try them. Um, they can be used in the jawline jowl, chin, neck, anywhere that
you feel like you’re, I joke and you’re melting. Um, you can use them. So I’m going to switch gears.
Anthony just logged on. Hi, Anthony. Um, I will bring him in, in a couple of minutes and I just want to go
through the fillers and kind of give you a little bit of an overview cause I got, I actually just got a couple
of messages about fillers, so let’s, let’s get a little bit into that. Um, fillers are broken down into
hyaluronic acid, which is a natural college and precursor. Um, there is, um, there actually are still
collagen fillers, which we don’t really use. Um, here, there’s something called PMMA, which most
people know as Artefill, um, in the United States and there’s calcium hydroxyl appetite, which is radius
on the marketplace and there’s something called PLLA and PLLA is Sculptra.
Lori Gerber D.O. (20:20):
So I’m going to focus on the ones that I use most frequently, which is the hyaluronic acids and the
calcium hydroxyl appetites. The other ones that I spoke of little longer lasting have more of what we
would call a granuloma or a scar tissue reaction. So you can get, um, some kind of firm nodules out of
them. So they’re not quite as safe of a profile. You do have to do some allergy testing, um, with one of
them. So I’m going to focus on hyaluronic acids, because I think that they have the most diversity. And
I’m going to give you guys the analogy that I use it’s Goldilocks and the three bears. So you’re picking a
thin blanket or a thick blanket or bed I should say, and anywhere in between there. So when you look at
ha fillers or I look at ha fillers, really, I think it’s up to the physician to tell you what filler you’re going to
put in where, because honestly, guys, you don’t know, so you’re not going to notice a difference.
Lori Gerber D.O. (21:19):
It’s going to be something that the injector will notice when they’re going in there. Um, and then after
the fact it’s going to have to do with downtime and firmness and was it the right filler for the area? Did
you get the result you wanted? I just got a patient today that texted and said, Hey, you know, I did
fillers. She’s in upstate New York. Obviously didn’t come to me. This go around and she didn’t get the
results she wanted. I asked her what air areas she treated. She said SHEEX. And then she told me that
she used, um, regular Juvederm. So, Voluma is the thickest. It should have been used in cheeks, jaw line,
um, chin, anything that needs like what I would call like a more three-dimensional contour, whereas
you’re going to pull it out in a third dimension. It is still hyaluronic acid.
Lori Gerber D.O. (22:05):
It’s still dissolvable. You can put in stuff and get rid of it. Then there is the Juvederm, which is a little bit
thinner comes in ultra and ultra plus, but those don’t go with it steep. So they’re really not what I would
consider. Like building block fillers. They are like, caulk is probably the easiest way to describe it. They fill
in dead spaces like folds down around the mouth, what we call marionette lines or folds around the
nose. Um, maybe a little bit of fine line and wrinkles and that kind of thing and lips, um, they can be
used a little bit for fullness, but the problem is, is they don’t last as well. When you put them in deeper
tissues, just like people that say that their lips don’t last. Sometimes when it’s put in the wrong layer,
that filler is not going to last.
Lori Gerber D.O. (22:49):
It doesn’t stay there unless it’s in the right layer. So, you know, injector dependent for sure. And then
there’s what we would call the thinner fillers. And that would be Volbella and Valore. And they are
thinner. They are a little bit like Apple sauce and oil they’re different than peanut butter, right? So they
just have a much different consistency and those fillers are better for very fine detail areas. So really fine

lines above the lip. Um, maybe some really tiny downturns around the mouth. If someone just wants a
subtle stretch of the lips and not new volume, we can use those two. So to me, those are the best
options for maybe a female. That’s a little bit older in her sixties, maybe even seventies that really
doesn’t need a lip, but just needs to stretch out some of the, um, the lines that are giving her like the
smoker’s line appearance.
Lori Gerber D.O. (23:37):
So, um, you know, the Goldilocks and the three bears approach for me is, is going thick to thin and
thinking about downtime. Um, I love arnica. Everybody asks me not how not to bruise. Um, I know as an
athlete, I use arnica like crazy too. It’s a natural anti-inflammatory, um, topical or oral. I like to take it
orally for my bruising patients or AF before or after. So what that means is you take it three days. I tell
people like it’s candy, they’re mints, you pop it under your tongue. It’s going to dissolve you do it two,
three, four, five times a day, as many times a day, as you can remember for three days and then avoid
all your anti-inflammatories. So any multivitamins antioxidants, everybody that’s taken the vitamin CS
and the bees right now that are trying to be healthy and immune savvy.
Lori Gerber D.O. (24:28):
Um, give me three days without those and that ibuprofen. naproxen all those things go without saying
because they make you bleed in bruise. So, um, if you don’t want me to put a needle in there and bruise,
you give me the best shot. So that’s what I say. Um, after the fact they both work gel and arnica tablets
work great to kind of eat away. They chomp away at that bruise a little bit more quickly. Um, so that is, I
got to the bruising. I got to the types of fillers. Let’s talk about radius really quick, and then I’ll bring
Anthony. And so radius is people are scared of radius. I actually love radius. Um, I started training on
radius before you could even push radius through a syringe. I mean, it was like literally like concrete
guys. I mean, I would shake trying to get this stuff into somebody’s space and now it’s, it’s much more,
um, aqueous it’s, it’s got 30% of calcium hydroxy app hydroxyl appetite.
Lori Gerber D.O. (25:24):
Um, and 30% is what we would call an aqueous carrier and they actually have lied to Cain in there as
well. So you don’t have a ton of what we would call a, um, a synthetic compound. It’s not like the whole
entire jealous synthetic compound. And I think that’s where people get scared is they think this is
massive thing. That’s not real, that’s going in my cheek. And I will tell you that it does give a decent
amount of volume. So when you’re trying to pull up a cheek, especially in someone that has some aging,
or even with some, um, you know, chronic immune diseases where you get some facial wasting radius
can be a life changer. Um, and in all honesty, these products can be layered. So I love radius first, if
we’re going to have a choice Voluma over top, again, that cheek lift, um, and then some of the thinner
materials you never are, at least I never, and you shouldn’t ever really use radius in the nose.
Lori Gerber D.O. (26:17):
Um, I love doing non-surgical nose jobs, but, um, non-surgical nose job with a filler that can’t be
dissolved is a quite scary endeavor. Um, we like to have things near all the blood vessels that, uh, we can
get rid of. So, um, if you’re going to do a non-surgical nose job or a kind of like a little bit of a rhinoplasty
with filler, we would use Voluma, um, that Voluma again, dissolvable it’s the thicker of the two filler or
three fillers. And that’s my favorite. When we talk about fillers, the only one I didn’t bring up is Bella
taro. And we talk about their ability to absorb water. Um, it’s a little hard to explain, but anybody that’s

been watching the news with COVID and seeing these filler reactions with COVID vaccine can maybe
understand how this works. All the fillers want to absorb water and collagen.
Lori Gerber D.O. (27:11):
And when they do that, they actually have a certain predisposition. Each one has a certain amount that
they like to absorb. And Bella taro has the lowest absorption of water and, um, therefore it’s best under
the eye. So when we think about kind of getting puffy eyes, you know, you wake up in the morning of
your allergies or your swollen Belotero is the best for that area because it has such massive water
fluctuations. Um, so that is the only spot that I, I love Belotero for under, I use it a little around the lips,
um, but it’s really uncomfortable in the mouth. So I love it for under eye, very thin. It’ll get you about six
to nine months. The rest will get you about nine to 12. So it’s a little bit of a, uh, less of a longevity, but,
um, doesn’t have as much water.
Lori Gerber D.O. (27:56):
And then one more thing. Cause I just got it since I just said about the COVID vaccine and fillers. Um,
okay, so let’s, let’s talk about this. So there are case reports of fillers expanding with Kobe vaccine, um,
meaning they get swollen, they get puffy guys. This happens with like allergies, sinus infections, colds,
anybody that wakes up in the morning and their lips are swelling girls that has their lips filled the same
scenario. Um, it’s an immune reaction, it’s an inflammation reaction and it’s a water fluctuation
reaction. So, you know, the first couple of days that you get that vaccine, when your immune system’s
revved up, you’re basically fluid overloaded. They’re going to swell. Um, not everybody’s does, but the
there, the possibility is definitely there, but the great news is it goes away really quickly and it deflates
anti histamines, Benadryl Clarins or tech, um, all of the kind of traditional or the RD hist, which is a
natural, anti-histamine all helped to get rid of the, um, the swelling reaction.
Lori Gerber D.O. (28:57):
So, um, yes, it’s there, um, Botox and all the other neurotoxins have not been a problem. I’ve been
getting asked that question a bunch too. Um, they have no interaction, um, with the vaccine, although I
would not get it the same, um, within probably about seven days of your vaccine, just to give your
immune system a fair chance, um, and not have any interaction with, um, your immune system. So on
that note, I am going to welcome Mr. Anthony, are you un-muted Anthony? I am. Thank you. I hope you
can hear me well. Yeah, I can. I’m going to turn down my headphones a little bit, cause you’re a little
loud in my ears, but that’s good. All right. So, so now that you’ve gotten an education on the fillers. Sure.
Well,
Anthony Accardo (29:42):
I wrote down arnica because every, every athlete in a certain age, he wants to recover and build as
much anti-inflammatory properties as quickly as possible. So, uh, that one I wrote that I wasn’t aware of
that one. So thank you for that education.
Lori Gerber D.O. (29:59):
Yeah. Arnica is great. Um, I am a huge arnica gel fan, especially I actually keep arnica gel in my tri bag,
um, in transition. So, um, for those that I did not give Anthony a proper introduction. Um, this is
Anthony Accardo, so he is not only a neighbor, but a friend and a founder of the Bucks County Triathlon
Club. Um, in 2012, right? June of 2012, um, he is a sommelier guys. I told you, I promise you why
where’s yours. Okay. There we go. Um, and he is the co-founder of the tail trails for tail trails, retails

festival, um, which anyone that loves the dog. I mean, you have to go to that one cause it’s so much fun.
And you’re a sales manager for allied beverage group in New Jersey and, um, wholesale wine and spirits
company. Right. And it’s former Somalia and general manager.
Lori Gerber D.O. (30:53):
And I just went through rats for the first time, the other day. So really it was, it was, I live, I don’t know
what 20 minutes, but it was wonderful. So, um, we have about 25 minutes or so. Um, he’s got a ton of
races. I’m not even going to go through all his races cause he’s got so much to talk about. I’m going to let
him talk about himself a little bit. Um, and then if we want to talk about triathlons and his races at the
end, we can, I don’t want to cut them short. So, um, I guess first question is who are you, Anthony?
What do you, what are you doing on the show today?
Anthony Accardo (31:26):
Well, thank you again and it’s an honor to be here. Um, so I guess like most men, women in their late
thirties to early forties, when you started being in a restaurant business, uh, it was so tough to stay
healthy and it was so tough to not pack on the pounds and, and stay active. I was an athlete in high
school, but probably took 20 plus years off, get fat and happy and, and drunk very often more, a little
too often than you should in the restaurant business. And it got to the point where I needed a change.
Um, my wife, Amy, who, you know, very well, uh, was started getting in shape, uh, when she turned
about 38 39, um, I was about a year behind her and she was really bugging me. I’ll never forget. There
was a one day she came down and I’m just laying on the couch after a long night of work.
Anthony Accardo (32:20):
And it was a Sunday morning and she said, come on, there’s a 5k right in the park. It’s literally a half mile
out our door. Why don’t you come and do it with me? I said, are you out of your mind? It only took a
few months after that before I said, well, I better do something. Um, and get this life balance back. And
then I was fortunate enough to get out of the restaurant business. I’ll get into the wholesale beverage
distribution business, which has afforded me to have a little bit more regular hours, um, have my
weekends where I can race and train with a group, um, get myself back in shape. Um, but I did, I was
able to keep the wine side of things intact because I’ve always been very passionate and a lover of wine.
And I think like my mom taught me years ago, anything in moderation in anything and balance is not
unhealthy.
Anthony Accardo (33:14):
So I try to enjoy these days, wine, food training and, and life in balance. And, um, you know, it’s, it’s
been a blessing that we were able to found. BCTC kind of out of a need where there was triathletes in
the area and triathlon was starting to become more popular and they were getting together in more
informal groups. And I got to give a shout out and a credit to Tom Dylan, and I’ve done this many times.
And if you been at one of our meet and greet events or, or heard me speak, you always hear a little bit
about this story. So I apologize if you’ve heard it. So Tom Dylan started an informal river swim group up,
uh, just North of new hope out of Virginia forest rec area. And it’s something now that we’ve been doing
for, for 12 plus years. Um, so it was a group of about six to eight people and they’d all get together and
swim in the river.
Anthony Accardo (34:10):

And it was just such a great comradery. And, um, you know, out of that group, we really founded, um,
bucks County triathlon club. Uh, I also got to give credit to Mark Eiler, who’s moved out of the area.
Some of you may know him, some of you may not. He moved up to, um, to New Hampshire. Uh, he was
an integral part of also founding our club and getting things going and, and providing the energy that we
needed to, to really put out group training events and keeping consistency, um, and dragging people out
of their comfort zone to come out and jump in that river and swim a mile down, which I know the first
time I did it, I was scared to death. I didn’t sleep the whole night before and it’s just a simple training.
Um, you know, and that’s the other thing too.
Anthony Accardo (34:58):
I think part of the reason why I founded the club was because, you know, the first few races I did, I
didn’t know anyone. I was scared to death and just to have people to talk to and to gather with and to
encourage, um, is, is such a huge part of what makes our sport great. And most triathletes and general
athletes in general, um, are very, very supportive. Of course we’re all competitive, but at the end of the
day, we’re very supportive and we want to see each other do well. Um, to me I’ve always said I’d rather
come in somewhere, you know, in, in the, of the pack and have my teammates and bring more people
out and race with a group than if I was there alone. And I actually won the race. I don’t think I’d enjoy it
as much as I do racing and, um, you know, training and racing with, with our fellow teammates.
Lori Gerber D.O. (35:55):
Yeah. I mean, I agree. I, so I had some like serious fears of the water when I started with this club and,
um, I decided I was going to do an iron man and I didn’t know how to bike and I didn’t know how to
swim, so, and I could barely run. So, um, if I can do an Ironman and I did finish one, I finished Louisville
about, gosh, it’s almost been five years. Um, yeah, I know. I can’t believe it’s been so awesome. I know,
but it was forever, but this team is really, that was the only reason I did it. I mean, in all honesty, I
would’ve never gotten through my rides. I’ll never forget my first long ride. And Anthony was like,
literally let’s go up this Hill. We were like 30 miles in or something. And I just looked at him.
Lori Gerber D.O. (36:35):
I was like, you’re crazy. He waited. And I walked my bike halfway up and they kept coming back to get
me because I was slow as slow as a snail. Um, and this, the water swims are amazing. I mean, kayaker in
the water, you know, how buoys and, you know, you all, we all use pills, pull buoys now. Um, but the
river swim for anyone that’s looking to get into this sport. Um, it really helps get over your fears of open
water, um, which in a very supportive manner. I mean, it’s not like throwing you in there and just kind of
letting you go, cause there’s a current, I think in the Lake, you don’t get that same effect to be honest.
Um, and I’ve done plenty of Lake training and, um, but when you’re in a current, um, and you maybe
don’t know exactly where you’re exiting and you can’t see your marks where you’re, when you’re
swimming, um, it makes a really big difference. So, um, that’s my 2 cents on the matter, um, I started
this sport cause I was scared of swimming. I got sucked out in a rip current. So, um, yeah, that’s why I
started this. So my question for you is I’ve seen new training around the neighborhood. Good for you.
Um, what have you been doing, you know, post COVID during COVID, how are we moving forward? Kind
of combining two of your questions here, but um, yeah. What, what are we doing here to kind of move
forward?
Anthony Accardo (37:57):

So we put out, um, for any member and even for non-members we put out our training agenda, we put
it out on our Facebook closed group page. Um, and we email it to all our members. And every week we
have several, uh, events where there’s opportunities to get together, to train as a group. So generally on
Tuesday we train with our partner club, uh, the bucks County Roadrunners. So we do a Tuesday workout
over in the, uh, Yardley area, um, at McCaffrey’s we meet it’s called Nick Tuesday. Um, Wednesdays,
we’re going to start the river swim. We were supposed to start tonight, but the storms and the weather,
it, it was just a little dicey. So we’re going to start them next week. There’s two sessions of four 30 and a
six to try to accommodate everyone’s schedule. Um, as you said, you have to have a pull buoy and that
makes all the difference in the safety in the world.
Anthony Accardo (38:48):
The fish and boat commission, um, says, listen, we have no problem with you guys swimming in the
river. We just want to make sure you’re safe and visible to the, to the boaters and, and to each other,
even it’s just a good safety measure. So that’s why we require this, the swim buoys, plus it really, our
insurance really likes that, that we do that. Um, it’s just a way to stay visible and safe. And then, uh,
there’s also new speed work now, too. So we used to do speed work Wednesday mornings. Now we
swap that there’s still a small group that does, but there’s Tuesday night and Tuesday morning speed
work with the bucks County Roadrunners, um, Thursday night there’s Hills with the Roadrunners. And
then Saturday we do a group ride and those usually a handful of people that will run off the bike, but it’s
we’re, our groups are starting to get bigger now that the season’s getting here.
Anthony Accardo (39:39):
So we do have two rides. We have an a and a B ride. So no matter what your pace, um, now we’ve
gotten some criticism in the past. We are triathletes or not. We’re not cyclists. So we ride, yes, it’s okay.
If you have a TT bike or tri bike, you can come out to our group. Sometimes we don’t necessarily strictly
follow the rules, that cyclist file and how they ride in a single line. Um, but again, we’re triathletes and
we want to have fun. We’ll ride anywhere from 30 or 40 miles up to 80 or, or, or a hundred miles
depending on the, on the ride. And it’s usually loops. So if you don’t feel comfortable doing the long
ride, we’ll circle back around, we’ll make sure you get back to where we started. And then we do
another, another loop. And then Sundays,
Lori Gerber D.O. (40:31):
It really is right because I mean, there’s days where he just bonk and you just can’t keep it. Exactly Alan.
So, um, and no one wants to get picked up,
Anthony Accardo (40:41):
Right? Yeah. And Sundays, we try to mountain bike. We, um, you know, we like to be, or to offer, I
should say some different type of, we’re not just a strictly, you know, swim, bike run on the road. We
like, we run trails, we bike on the canal. We, we mountain bike in Nockamixon and Washington Crossing
in Wissahickon. Um, and we have a good little group of mountain bikers. So if you’d just like to mountain
bike, it might be worth it to come check us out and join our club. Cause we do a lot of that. Yeah. I know
you’re gambling.
Lori Gerber D.O. (41:16):

I’m going to try that’s my next endeavor guys. I I’m kind of overrode biking. I’ve been over it for a bit. So,
um, yeah, I’m going to mountain bike. So whoever wants to come out. So really quickly, what’s the
website for the bucks County track club.
Anthony Accardo (41:30):
It’s a box code tri club dot. So it’s B U C K S C O T R I C L U b.com. But if you Google bucks County,
triathlon club, or even BCTC, it, it comes up. So we’ve been fortunate. We’ve been doing this now for,
for, you know, going on nine years. So we’ve, we’ve built, uh, a nice sort of presence on online
Lori Gerber D.O. (41:56):
To join this. Um, just cause we are going have some questions about COVID and number of people and
all that stuff to join your, to join the events, you have to be a member. Right, right. Um, so, you know,
just so you guys know there’s, there’s not thousands and thousands and thousands of active members,
you know, we’re, you know, we’re a big club, but not so big that we can’t accommodate COVID
requirements essentially. Um, so, and what’s, what’s the cost yearly,
Anthony Accardo (42:25):
It’s 60 for an individual at $65. A family membership is $85. And then for collegiate, um, we have, we
instituted a few years back a collegiate program. So now I know with COVID, a lot of colleges are
different, but during normal times you’re pretty much done with school from may till, till about August
or September. So we do a May to September membership, and that is, is discounted to $25. So if you’re
a college, if you’re in college and we have a few members that have taken advantage of that, we’re still
trying to grow that, that area of our, of our, um, membership
Lori Gerber D.O. (43:05):
Max, if you’re listening, I’m going to put you in. So he texted me a few minutes ago, my 19 year old, he’s
going to use, I’m going to make him do something this summer. There we go.
Anthony Accardo (43:15):
Good. We’ve had a few, we’ve had two, um, high school students that come up with that came up with
us and fell in love with the sport and got college scholarships. Yeah.
Lori Gerber D.O. (43:25):
It’s a great sport. I mean, and it’s really, the cross training is as amazing and the comradery is awesome
and that’s, that’s one of the things I was going to talk about. So how are we changing? Um, you know,
how are we making the accommodations for COVID and then I’m going to have you talk a little bit about
are the races that are, um, that we’re doing.
Anthony Accardo (43:41):
So we’re lucky where our sport is predominantly outside. And, um, as you said, we’re, we’re, we’re,
we’re not a big club, but we’re not that small either. We have a few hundred members generally to our
group training sessions and I’d love to see the, these numbers improve. We get anywhere between six
and 20, that will come out the river swim, being our most popular group training event. And that’s why
we split it into two sessions at four 30 in the sixth. So we can accommodate more people in a safe
manner. So we do our best to, to social distance, the best we can while we’re training. Um, you know,

there’s, there’s, the CDC does not recommend wearing a mask while running or about training because
it is actually more harmful. Cause you’re, you’re spewing, you build up mucus and everything else in
your, you end up kind of spewing.
Anthony Accardo (44:32):
Um, so we don’t require, and we, we follow the CDC guidelines of not wearing a mask while running, but
we do say, we say distance the best we can. Um, if anyone has any symptoms, um, we ask them to stay
home. We trained in small groups through COVID and, you know, knock on wood. We didn’t have any
incidences. We had no, um, positive, uh, members with positive cases, uh, during training or during any,
any group workouts. So we’ve been, we’ve been pretty fortunate. Um, you know, and also our sport has
gotten, just killed. The big events have gotten killed with, you know, with, with COVID. So the small
events have survived and you know, the other side, I, we, we do, um, some timing and we help, uh,
other organizations like the Roadrunners put on some of their events because we have time equipment
where we can spread people out. So on our race series that we’ll probably talk about in just a few
minutes, we’re able to social distance, everyone at the start and even through the finish and then
spread everyone out. Um, cause all of these events take place outdoors.
Lori Gerber D.O. (45:44):
Gotcha. Yeah. I mean, for those of you that don’t know are new to the sport, I mean Ironman and other
large races have, you know, 2000 people, um, and spectators. So they’ve just been canceled
everywhere. I mean left and right. So, um, the smaller local ones, that’s actually, this is a new series I’m
going to do. I’m going to try to do it every couple of weeks. Um, just a featured local segment, um, just a
feature, local sports, local, um, stores and that kind of thing. So, um, so let’s discuss fees, the beast let’s
bring it out. Let’s, let’s roll it out. Anthony.
Anthony Accardo (46:22):
These came into existence last year and it was a hundred percent virtual series because we wanted to
give our, to motivate people to get out. Right. It was a really tough time. A lot of people were gaining
weight. They weren’t motivated. There was no libraries is so no one was motivated to really go out and
train or do anything, uh, me included. So we founded feed the beast to kind of get out there and
unleash that inner beast that, that wants to run and wants to bike and wants to swim. So we did it
virtually and it was, it was a success. Uh, so now this year we, and, and we waited a little bit to put it out
cause we were trying to make sure we did it right and got our permits and, or I should say made sure we
could get the permits because they’re, they’re really tough with permits right now.
Anthony Accardo (47:11):
You go through the process, they weren’t even allowing you two months ago to submit an application
for permit. So now they’re allowing this and the County has been great. Bucks. County has been great.
We also work on the other side of the river with New Jersey. Uh, excuse me, we’ll have a few, a few
events over there and they’ve been to work with as well. Um, so it’s a nine race series. We, you have to
be a member to join the series and you don’t have to do all the races and you don’t have to be fast fit or
one of the top contenders to join this. Um, it’s really, you know, it’s, it’s fun for everyone. I think
sometimes some of the best, uh, races I’ve done, it’s when I’m a little out of shape and I just find
someone to kind of hold onto and I’m not my best shape. And I just, I pushed myself through. Um, so we
definitely want to encourage that for, for this series. Um, so there’s, there’s three ways that you can
register for the series. There’s three different bundles, there’s a three race bundle, there’s a five race

bundle and then there’s, we call it the beast bundle, which is all nine races. Um, two of the races are
virtual, um, and we’ll, I’ll go through them really quick and cut me off. Okay. So the first,
Lori Gerber D.O. (48:26):
Really quick before you start just tell everyone then great date. So we don’t forget so that somebody,
they want to meet us and they want to say, Hey, are these people real? Yes we are. And we’re kind of
cool. Um, what day?
Anthony Accardo (48:39):
So it’s, it’s um, the 22nd of May and it’s going to be right in Washington crossing park. So that’s a
Saturday. So it’s going to be on the Pennsylvania side, but the general green pavilion, that really nice
pavilion right there in the middle. Um, and it’s going to be a great day. So come out, we have stuff going
from 9:00 AM till five, six at night, we have bike maintenance classes, how to change a flat. We’re going
to have some group runs, a group rides both on and off road, Johnny King Marino and advanced sports
is going to be there leading a foam roller clinic. Guys, bike’s going to be the leading our bike
maintenance clinic. So there’s a lot to do, go to the, to the website and yeah, and you can see the
schedule,
Lori Gerber D.O. (49:17):
But
Anthony Accardo (49:19):
Awesome. So feed the beast. Uh, the first race is, is coming up quickly. It’s May 1st. So it’s in about a
week and a half. Um, and this is fun. This is going to be right on. It’s going to meet right in the field by
canal run West in, in our neighborhood, in Lori’s and mine’s neighborhood, and which is adjacent to the,
to the canal path. So this is kind of like a fun adventure race meets, um, you know, running race where
you have to make your way to Bowman’s tower. So we’re going to put out a map, we’re going to put out
directions, um, but it’s not going to be marked. It’s going to be fun. So you you’ll run down about four
miles down the canal path to you get to the bridge at the other end of Washington crossing park, where
all the little, the goat farms are and the, um, the tower you’ll.
Anthony Accardo (50:10):
We want you to go under the bridge. You can cross the road, but if you do that, you got to be careful. So
there’s a little, uh, trestle crossing where you can cross underneath the road and then figure out your
way up to the top. However you want, you can take trail the road. Sometimes it’s open sometimes it’s
not. So you got to be careful. Um, but, and if you hit that gate and it’s not, you’re going to have to go
around, but that’s going to be a lot of fun. You’re going to, we’re going to ask you to run with your
phone and take a pickup at the top to prove that you were there and then find your way back pretty
much the same way you came. So it’s going to be about a 10 mile race, uh, because this is in, uh, private,
um, we are allowed to have some alcohol here, so we’ll, we’re going to be serving wine.
Anthony Accardo (50:51):
We’re going to be serving beer at the finish. Um, COVID friendly food and this one’s going to be a lot of
fun. So that’s, that’s May 1st, then we’re going to do two time trials. The first one is virtual on May 8th.
We couldn’t get our permit. Jersey is not allowing any permits until after June. Um, so the first one’s
going to be virtual, but we’re going to ride it as a group. Um, and then the second one is September

25th. This is on route 29. It’s a very famous, uh, by TT course, a lot of pros ride this course from French,
from French town down to two bulls Island. Um, and then there’s going to be a 5k there’s three running
races. So the, the, the touch, the tower 10 miler, the, we call it the beast mode, 5k that’s May 20th, and
that’s going to be in core Creek park.
Anthony Accardo (51:42):
And then we’re going to do a peace Valley, 10 K in peace Valley park on June 17th. Those are Thursday
nights as well. So if you’re just a runner, you can do the three race bundle. If you really don’t like to
swim or bike and you know, for your listeners, why don’t we do, we’re going to, if you use code member
20, you’re going to save 20%. So you have to join the club. So there for new members. So if you join the
club and then you put in code member 20 for feed the beast and do at least a three race bundle, you’re
going to save 20%.
Lori Gerber D.O. (52:15):
Cool. So we have like two and a half minutes. So I’m going to just like, just say a little bit really quickly.
We have the AEAs swims, mountain bike races, longer distance, shorter distance. I mean, it’s pretty
much all in here, guys. So, um, you know, it, a little bit of something for everybody, obviously, you know,
even if you buy a bundle and you don’t do the whole button, something happens like this is very low
pressure. We’re not, you know, this is just about getting out after COVID making sure that you’re having
fun with a group of people that are like-minded and want to do the same thing. So, um, you know, I
think the meet and greet is amazing. Um, it’s a really good opportunity. I actually always do a table
there. Um, explain kind of the way it works and about me and all that stuff as well. Um, but it’s a great
way that we do. We have a speaker of the Sierra. No, probably not.
Anthony Accardo (53:04):
No. Yeah, because we’re trying to do it and changing up, it’s going to be a complete outdoor band.
Normally we’d have speakers in the panel. So we’re trying to keep that to a minimum. So for our
sponsors, such as yourself, we’ll have an area of table where you can, people can come to you, you can
talk to them, um, and, and give them your pamphlets and brochures and stuff. Well, as an,
Lori Gerber D.O. (53:26):
As an EndNote, and I know this is kind of like, you know, a cliche, but we have a minute and a half left.
So I want to throw out there that, um, one, Anthony was a SuperSport for coming on here today. Um,
he’s really a great inspiration and it has been literally, I’ve seen you out a bunch. Um, but his is a great
friend. And I think that doing something for yourself and getting out and trying something new is what
COVID, if it’s going to teach you anything, that’s what COVID has to teach you is to be outside your box
because none of this makes sense. So, um, go online box County, try club, sign up, do your 20% off. If
you don’t remember the code, just message me at info at my doctor, laurie.com. Um, or you can actually
email through, I’m sure the bucks County tri website as well, and we’ll sort you out.
Lori Gerber D.O. (54:12):
Um, if you have any questions on the fillers, Botox, all that good stuff, just email the same address, or
you can go on the Instagram, which is Lori Gerber DO. And just, um, let me know and we’ll get you
sorted. I would love to schedule appointments and I can do, um, many consults too at the, um, what’s it
called? The meet and greet and at the, uh, the first day you’re what’s I guess, what are you calling your

open house? A meet and greet. Yeah. Meet and greet. Correct. All right, guys, I’m going to say over and
out, this is Dr. Lori Garver with anti-aging unraveled. Have a good day.