what the experts are saying
Transcription
what the experts are saying
PROMOTIONAL PAGE editorial advisory board ENTER TO WIN A SPA GETAWAY! 01 Cosmetic Dentistry what the experts are saying What’s the biggest beauty innovation for the coming year? “ Cofounder and President of The Nash Institute For Dental Learning 02 Facial Plastic Surgery Dr. Dean M. Toriumi Chicago Facial Plastic Surgeon 03 “ Adhere to an ‘antiinflammatory diet’ to improve skin. Eat anti-inflammatory foods to heal your skin from the inside out. Componeers by Coltene are affordable, direct composite resin veneers that can be placed in one appointment. ” Dr. Ross W. Nash ” Plastic Surgery Dr. Sanjay Grover Newport Beach, CA, Plastic Surgeon; Director, The Center for Aesthetic Plastic Surgery 04 PLASTIC SURGERY Dr. Renato Saltz Plastic Surgeon, Past President of The American Society for Aesthetic Plastic Surgery 05 BEAUTY AND STYLE Frédéric Fekkai 01 02 Internationally Recognized Hairstylist 03 06 DERMATOLOGY Dr. Tina Alster Director of the Washington Institute of Dermatologic Laser Surgery 04 05 06 07 07 Oculoplastic Surgery Dr. Steven Fagien WIN A GRAND PRIZE PACKAGE FROM THE EAU SPA AT EAU PALM BEACH RESORT & SPA almost $1.8 08 09 10 BILLION was spent on skinrejuvenation procedures in 2012 NOW’S YOUR CHANCE TO WIN THE DESTINATION GETAWAY YOU’VE BEEN DREAMING ABOUT! We’re giving away exclusive prize packages consisting of relaxing spa treatments, luxurious accommodations, total wellness, award-winning cuisine, full-body fitness and more. enter now 11 12 source: ASAPS ” 08 HAIR Francky L’Official New York Celebrity Hairstylist 09 Hair Restoration Dr. Craig L. Ziering Renowned Hair Transplant Surgeon 10 COSMETIC DENTISTRY “ Demi-liquid hair color cumulatively improves the condition of hair and makes shine twice as intense as it was before application. Boca Raton, FL, Oculoplastic Surgeon Dr. Laurence R. Rifkin Beverly Hills, CA, Cosmetic Dentist “ We lose a teaspoon of 1 tsp. 11 Hair Color collagen from our faces every year after age 30. Beth Minardi The biggest beauty innovation for the coming year is Juvéderm Voluma XC. It will make millions of Americans look younger. 12 “ New York City Hair-Color Specialist Dermatology Dr. Jeanine B. Downie Montclair, NJ, Dermatologist NEWBEAUTY.COM/GETAWAYS PRIZE DETAILS ONLINE CO_NB34_022-026_FOB_BOA_1126rp.indd 26 NB34_NAT_SPACONTEST_THINNER_1126_ee.indd 1 11/27/13 11/27/13 12:57 12:55PM PM CO_NB33_024 editorial advisory board 01 Aesthetics what the experts are saying Nerida Joy Celebrity Aesthetician 02 PLASTIC SURGERY color shape What’s your go-to tip for taking years off? form “The one treatment I feel is the most effective in reducing age by at least 10 to 15 years is improving tooth color, shape and form through porcelain veneers or all-ceramic crowns.” Dr. Julius W. Few Director of the Few Institute for Aesthetic Plastic Surgery 03 COSMETIC DENTISTRY Dr. Ronald Goldstein Cosmetic Dentist and Author of Change Your Smile 04 HAIR “ I love my T3 Source Showerhead filter. It takes out harmful, drying chlorine and helps both the skin and hair. ” Francky L’Official New York Celebrity Hairstylist 05 Facial Plastic Surgery Dr. Dean M. Toriumi 01 02 03 silicone Chicago Facial Plastic Surgeon 06 COSMETIC DENTISTRY Dr. Thomas J. Balshi 04 “ 05 06 72% 28% 07 saline Keep your hair moisturized and trim it every couple of months. ” 08 09 10 28% of all breast augmentations last year used saline implants; 72% used silicone source: ASAPS Founder of Pi Dental Center 07 NUTRITION Paula Simpson Celebrity Nutritionist 08 SKIN CARE Kate Somerville Founder of Kate Somerville Skin Health Experts 09 PLASTIC SURGERY Dr. Jason N. Pozner Cofounder of Sanctuary Medical Aesthetic Center 10 Dermatology Dr. Jeanine B. Downie 11 12 Montclair, NJ, Dermatologist 13 EYE FIX 11 Mixing the linereducing combo of retinol and caffeine, La Roche-Posay Redermic R Eyes rejuvenates signs of aging around the eye area, minus any irritation. $47, spalook.com DERMATOLOGY “ Dr. Kenneth R. Beer Fall is a great time to restart your medical skin-care routine and consider light-based treatments (IPL) or fractional lasers. ” the “ Resculpting face and lifting the cheekbones can take 10 years off the face. This can be done with hyaluronic acid fillers and the results are immediate. “ Founder and Director of Cosmetic Boot Camp 12 Plastic Surgery Dr. Mark L. Jewell Past President of the American Society for Aesthetic Plastic Surgery 13 Dermatology Dr. Fredric Brandt Dermatologist and Founder of the Eponymous Skin-Care Line 024 NEWBEAUTY fall 2013 NB33_FOB_BOA_0821_mk.indd 24 8/22/13 5:24 PM EDITORIAL ADVISORY BOARD WHAT THE EXPERTS ARE SAYING 01 HAIR COLOR Beth Minardi NEW YORK CITY HAIR-COLOR SPECIALIST “ WHAT’S THE FASTEST WAY TO LOOK YEARS YOUNGER? Wear sunscreen with an SPF 30 every day, rain or shine. ” 02 FACIAL PLASTIC SURGERY Dr. Dean M. Toriumi CHICAGO FACIAL PLASTIC SURGEON 03 DERMATOLOGY Dr. Jeanine B. Downie MONTCLAIR, NJ, DERMATOLOGIST 04 PLASTIC SURGERY Dr. Mark L. Jewell “ ONLY ABOUT 20% Brighten up your hair! Warm, golden highlights boost your natural shade. ” OF ADULTS IN THE U.S. PAST PRESIDENT OF THE AMERICAN SOCIETY FOR AESTHETIC PLASTIC SURGERY 05 AESTHETICS Nerida Joy CELEBRITY AESTHETICIAN 01 02 03 06 DERMATOLOGY Dr. Fredric Brandt DERMATOLOGIST AND FOUNDER OF THE EPONYMOUS SKIN-CARE LINE 07 COSMETIC DENTISTRY 04 05 06 07 since 1997, the number of cosmetic procedures has increased more than 247 percent SOURCE: ASAPS are meeting the government’s recommendation for aerobic exercise and muscle strengthening SOURCE: CDC 08 COFOUNDER AND PRESIDENT OF THE NASH INSTITUTE FOR DENTAL LEARNING 08 HAIR Sean Jahanbigloo CELEBRITY HAIRSTYLIST 09 COSMETICS 10 09 Dr. Ross W. Nash Lee Graff PRESIDENT AND COFOUNDER OF COVER FX 10 11 12 The fastest way to look younger is as simple as 1-2-3: 13 40s 1 syringe of Restylane to the tear troughs IN YOUR “ A ‘giveaway’ sign of aging can often be reflected by deflation of the temples or the back of the hands. A quick fix for this is ‘reflation’ by volume with injectable fillers. “ 2 syringes of Juvéderm to the laugh lines “ With dental implants and prosthodontics, a dramatically younger look can be only a day away. Treat 3 areas of the upper face with Botox PLASTIC SURGERY Dr. Sanjay Grover NEWPORT BEACH, CA, PLASTIC SURGEON; DIRECTOR, THE CENTER FOR AESTHETIC PLASTIC SURGERY 11 OCULOPLASTIC SURGERY Dr. Steven Fagien BOCA RATON, FL, OCULOPLASTIC SURGEON 12 HAIR RESTORATION Dr. Craig L. Ziering RENOWNED HAIR TRANSPLANT SURGEON 13 COSMETIC DENTISTRY Dr. Thomas J. Balshi FOUNDER OF PI DENTAL CENTER ” 026 NEWBEAUTY SUMMER 2013 NB32_FOB_BOA_0522_ee.indd 26 5/22/13 12:45 PM IMPORTANT SAFETY INFORMATION FOR BELOTERO BALANCE® DERMAL FILLER (CONTINUED) NEWBEAUTY EDITORIAL ADVISORY BOARD Indication: BELOTERO BALANCE® is FDAapproved for injection into the mid-to-deep dermis for correction of moderate-to-severe facial wrinkles and folds, such as nasolabial folds. Contraindications: BELOTERO BALANCE® should not be used in patients with severe allergies manifested by a history of anaphylaxis, with a history or presence of multiple severe allergies. BELOTERO BALANCE® contains a trace amount of gram-positive bacterial proteins, and is contraindicated in patients with a history of allergies to such material. BELOTERO BALANCE® must not be implanted into blood vessels. Warnings: Use of BELOTERO BALANCE® at specific sites in which an active inflammatory process (skin eruptions such as cold sores, cysts, pimples, rashes, or hives) or infection is present should be deferred until the underlying process has been controlled. BELOTERO BALANCE® must not be injected into blood vessels of any size. Introduction of BELOTERO BALANCE® into the vasculature may occlude the vessels and can cause infarction of overlying tissue or embolization with resultant necrosis of potentially large areas of distant tissue such as the lip or the nose. Injection site responses to BELOTERO BALANCE® have been observed, consisting mainly of short-term inflammatory symptoms starting early after treatment and with 7 days duration or less. Precautions: The safety or effectiveness of BELOTERO BALANCE® for the treatment of dermal contour defects other than nasolabial folds, such as use in the lips, has not been established in controlled clinical studies. The safety of BELOTERO BALANCE® for use during pregnancy, in breastfeeding females, or in patients under 21 years has not been established. As with all transcutaneous procedures, BELOTERO BALANCE® injection carries a risk of infection. Patients who are using substances that reduce coagulation, such as aspirin, non-steroidal anti-inflammatory drugs, and warfarin may, as with any injection, experience increased bruising or bleeding at injection sites. Patients should inform their physicians if they are taking such substances. Exposure of the treated area to excessive sun, UV lamp exposure, and extreme cold weather should be minimized until any initial swelling and redness have resolved and puncture sites have healed. Adverse Events: The most common side effects seen after injection were swelling, bruising, redness, and hardening that resolve within one week. More rare side effects may include swelling that lasts longer, unevenness or firmness in the area injected, and as with any injection, there may be a risk of infection. Important: For full safety information, please visit www.Belotero.com or call Merz Aesthetics Customer Service at 866-862-1211 Caution: Rx only Copyright © 2012 Merz Aesthetics, Inc. All rights reserved. MERZ AESTHETICS and the MERZ AESTHETICS logo are trademarks of Merz Pharma GmbH & Co. KGaA. BELOTERO and BELOTERO BALANCE are registered trademarks of Merz Pharma GmbH & Co. KGaA. ML00687-00 NAT_NB30_belotero_1/3page_1108_ee.indd 1 022-024_NB31_FOB_BOA_0227_ee.indd 26 DERMATOLOGY DR. FREDRIC BRANDT DERMATOLOGIST AND FOUNDER OF THE EPONYMOUS SKIN-CARE LINE “Today, there’s a better understanding of the elements that give a youthful look. The most natural results involve volumization and recontouring versus ‘pulling,’ which was more popular in the past.” HAIR FRANCKY L’OFFICIAL NEW YORK CELEBRITY HAIRSTYLIST “More than 90 percent of your hair is made up of protein, so you need to have enough protein in your diet to support healthy hair growth.” COSMETIC DENTISTRY PLASTIC SURGERY DR. RONALD GOLDSTEIN DR. JULIUS W. FEW COSMETIC DENTIST AND AUTHOR OF CHANGE YOUR SMILE DIRECTOR OF THE FEW INSTITUTE FOR AESTHETIC PLASTIC SURGERY “The greatest innovation in fillers today is the availability of blunt cannulas. Cannulas provide a way to deliver a filler of choice with little to no discomfort.” What do you think is in store for the future of anti-aging? “The best advice I can give to someone wanting a smile makeover is not only to choose the dentist or office with the most artistic experience but also one with the best track record. Look at the dentist’s website and see if the results you expect are really the ones he or she is showing.” “Things like hormone therapy, nutraceuticals and vitamins will continue to be very important in fighting the signs of aging, while advancements in skin care and sunblock are constantly being made to help us prevent aging before it starts.” PLASTIC SURGERY DR. JASON N. POZNER COFOUNDER OF SANCTUARY MEDICAL AESTHETIC CENTER HAIR COLOR BETH MINARDI NEW YORK CITY HAIR-COLOR SPECIALIST “Hair color containing two important biomimetic proteins will improve hair’s strength, elasticity and moisture levels as it delivers a spectacular color result like never before.” HAIR RESTORATION DR. CRAIG L. ZIERING COSMETIC DENTISTRY DR. THOMAS J. BALSHI FOUNDER OF PI DENTAL CENTER “A new smile is akin to a ‘dental facelift.’ Prosthodontists shape and illuminate teeth that remain forever ageless in both aesthetics and function.” What’s considered “normal” when it comes to hair loss? RENOWNED HAIR TRANSPLANT SURGEON DR. JEANINE B. DOWNIE MONTCLAIR, NJ, DERMATOLOGIST “They key to using any type of injectable is not to ‘chase the lines’ on a patient’s face. That never looks natural. It’s all about the ‘lift, pull and fill’ technique to get the best results.” DR. TINA ALSTER DIRECTOR OF THE WASHINGTON INSTITUTE OF DERMATOLOGIC LASER SURGERY “My favorite noninvasive treatment for the jowl area involves high-intensity focused ultrasound (Ultherapy) of the cheeks and upper neck.” NUTRITION PAULA SIMPSON CELEBRITY NUTRITIONIST “Losing more than the usual 100 hairs per day may signal the presence of a pathological process. Seek professional advice early to prevent thinning and keep as much hair as possible.” DERMATOLOGY DERMATOLOGY “To maintain hair health, follicles need a constant supply of nutrients. Some oral supplements and a balanced diet may provide a nutrient boost to promote strength and texture.” COSMETIC DENTISTRY BEAUTY AND STYLE DR. LAURENCE R. RIFKIN FRÉDÉRIC FEKKAI BEVERLY HILLS, CA, COSMETIC DENTIST “My celebrity smiles are improved by eliminating teeth shadows from harsh studio lighting. Crooked teeth increase these shadows. Orthodontics or veneers are the best solutions.” INTERNATIONALLY RECOGNIZED HAIRSTYLIST “Heat styling or chemical processing damages the natural proteins in a woman’s hair. Products that contain keratin can defend against breakage and repair fragile strands.” 2/12/13 11:23 AM 2/27/13 12:32 PM NEWBEAUTY EDITORIAL ADVISORY BOARD Important JUVÉDERM Treatment Considerations ® A Brief Description of Indications for Use, Contraindications, Warnings, Precautions, and Adverse Events for JUVÉDERM® Injectable Gel Indication: In the United States, JUVÉDERM® injectable gel (including JUVÉDERM® Ultra, JUVÉDERM® Ultra Plus, JUVÉDERM® Ultra XC and JUVÉDERM® Ultra Plus XC) is indicated for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds). Contraindications: JUVÉDERM® injectable gel should not be used in patients who have severe allergies marked by a history of anaphylaxis or history or presence of multiple severe allergies. JUVÉDERM® should not be used in patients with a history of allergies to Gram-positive bacterial proteins. JUVÉDERM® Ultra XC and JUVÉDERM® Ultra Plus XC should not be used in patients with a history of allergies to lidocaine. Warnings: JUVÉDERM® injectable gel should not be injected into blood vessels. If there is an active inflammatory process or infection at specific injection sites, treatment should be deferred until the underlying process is controlled. Precautions: The safety of JUVÉDERM® for use during pregnancy, in breastfeeding females, or in patients under 18 years has not been established. The safety and effectiveness of JUVÉDERM® injectable gel for the treatment of areas other than facial wrinkles and folds (such as lips) have not been established in controlled clinical studies. Patients who are using substances that can prolong bleeding, such as aspirin or ibuprofen, as with any injection, may experience increased bruising or bleeding at injection site. Patients should inform their physician before treatment if they are using these types of substances. As with all skininjection procedures, there is a risk of infection. JUVÉDERM® should be used with caution in patients on immunosuppressive therapy, or therapy used to decrease the body’s immune response, as there may be an increased risk of infection. The safety of JUVÉDERM® in patients with a history of excessive scarring (e.g., hypertrophic scarring and keloid formations) and pigmentation disorders has not been studied. If laser treatment, chemical peel, or any other procedure based on active dermal response is considered after treatment with JUVÉDERM® injectable gel, or if JUVÉDERM® is administered before the skin has healed completely after such a procedure, there is a possible risk of an inflammatory reaction at the treatment site. Adverse events: The most commonly reported side effects are temporary injection-site redness, swelling, pain/tenderness, firmness, lumps/bumps, and bruising. Most side effects are mild or moderate in nature, and their duration is short lasting (7 days or less). Important: For full safety information, please visit www.juvederm.com or call Allergan Product Support at 1-877-345-5372. CAUTION: Rx only. APC80EN11 NB30_FOB_BOA_1121ks.indd 24 DERMATOLOGY DR. FREDRIC BRANDT DERMATOLOGIST AND FOUNDER OF THE EPONYMOUS SKIN-CARE LINE “There are more natural bleaching alternatives, including products that are developed with botanical ingredients. But, none of these treatments will work unless you are diligent about applying UVA/UVB broad-spectrum sunscreen with an SPF 30 or higher daily.” COSMETIC DENTISTRY DR. THOMAS J. BALSHI FOUNDER OF PI DENTAL CENTER “Nocturnal clenching and grinding can abrade enamel and shorten teeth. A custom bite guard will prevent aging smile anatomy.” HAIR FRANCKY L’OFFICIAL NEW YORK CELEBRITY HAIRSTYLIST “Many foods provide benefits to the hair. Bananas, beer, oats and raisins make the hair stronger and thicker while oysters help keep hair shiny.” COSMETIC DENTISTRY DR. IRWIN SMIGEL THE FATHER OF AESTHETIC DENTISTRY “Daily flossing is vital for healthy gums, preventing periodontal disease and for overall health. For those with dental work, flossing removes bacteria around the edges of the restorations and under the gumline to eliminate the germs that can lead to periodontal disease, swollen gums and recession.” HAIR COLOR PLASTIC SURGERY BETH MINARDI DR. JULIUS W. FEW NEW YORK CITY HAIR-COLOR SPECIALIST DIRECTOR OF THE FEW INSTITUTE FOR AESTHETIC PLASTIC SURGERY “It is important to continue to eat fresh fruits and vegetables during the winter so that our bodies and hair have a source of vitamin B and biotin, which help combat winter’s drying effects.” BEAUTY AND STYLE FRÉDÉRIC FEKKAI “The use of retinoids topically and selective lasers are very effective at peeling away layers of aging, allowing hands to match a youthful-appearing face and neck.” Is there such a thing as anti-aging hair care? “The concept of addressing hair that is aging is becoming more prominent. We are seeing ingredients in hair care to combat biological, mechanical and environmental stressors.” DR. JEANINE B. DOWNIE MONTCLAIR, NJ, DERMATOLOGIST “My winter skin advice is stay away from hand sanitizers. They dry out your skin on your hands and can make them more chapped.” “I often recommend a combination of body contouring treatments, including CoolSculpting (for larger pockets of fat), Liposonix (for smaller layers of fat), Thermage RF (for skin tightening), and VelaShape (for cellulite).” DERMATOLOGY DR. TINA ALSTER DIRECTOR OF THE WASHINGTON INSTITUTE OF DERMATOLOGIC LASER SURGERY PLASTIC SURGERY DR. JASON N. POZNER COFOUNDER OF SANCTUARY MEDICAL AESTHETIC CENTER “With acne scars, the treatment of choice is fractional devices— fractional lasers or fractional radio frequency work best.” NUTRITION PAULA SIMPSON CELEBRITY NUTRITIONIST INTERNATIONALLY RECOGNIZED HAIRSTYLIST DERMATOLOGY What is the best body treatment post-pregnancy? “Even the modest amounts of minerals in drinking water are beneficial. Calcium and magnesium are important for strong bones and magnesium also helps regulate your blood pressure.” COSMETIC DENTISTRY DERMATOLOGY DR. LAURENCE R. RIFKIN DR. KENNETH R. BEER BEVERLY HILLS, CA, COSMETIC DENTIST FOUNDER AND DIRECTOR OF COSMETIC BOOT CAMP “Smoking not only stains your teeth but also causes wrinkles to your lips, which can be made worse by sun damage. Avoiding these two will help keep your smile youthful.” “There are few things that are more important than hydration. A hydrated epidermis serves as a great barrier, protecting the skin from damage.” 11/21/12 5:31 PM NE W BEA U T Y E D ITORIAL A D V ISORY B OAR D guest advisors cosmetic dentistry hair Francky L’Official d r. laurence R. rifkin beverly hills, Ca, cosmetic dentist “Subtle reshaping is a conservative way to enhance your natural beauty as short, stubby teeth can age your look.” New York Celebrity Hairstylist “After the beach, pool and the sun, hair is dryer. The best thing is to do a deep moisturizing treatment and get a trim.” dermatology cosmetic dentistry d r. fredric brandt d r. irwin smigel Dermatologist and Founder of the eponymous skin-care line the father of aesthetic dentistry “Past the age of 45, the neck becomes a prime concern in the cosmetic patient. My combination of using Botox with Ulthera is proven to be a successful, nonsurgical option for the sagging neck.” How important is the nose to facial balance? “Our teeth are the foundation of our face. Aesthetic dentistry is a practical way to create illusions to improve and enhance a person’s smile and facial characteristics. The results speak for themselves: a beautiful smile, renewed confidence, and a fresh, more youthful appearance.” “The nose is all about proportion and gender. It’s one of the first things you see when you look at someone’s face and leaves subconscious notes with your mind.” plastic surgery dr. julius w. few Past President of the American Society for Aesthetic Plastic Surgery “While excellent outcomes are experienced with facial rejuvenation surgery, some patients find benefit from tissue fillers to correct volume loss in the face.” dermatology aesthetician d r. tina alster NERIDA JOY Director of the Washington Institute of Dermatologic Laser Surgery “I recommend highly intense, focused ultrasound as a noninvasive alternative to tighten and lift sagging jawlines.” What’s new in hair restoration? hair restoration dr. craig l. ziering Renowned Hair Transplant Surgeon dermatology hair color dr. jeanine B. downie beth minardi Montclair, NJ, dermatologist “Anti-aging for the chin and neck begins with proper diet and exercise. The chin and neck are areas that are slow to recover from weight fluctuations.” 026 NEWBEAUTY NB29_FOB_BOA_0824tg.indd 26 celebrity aesthetician “Hormone imbalances from stress cause painful pimples to appear on the face. Stress that affects our stomachs shows up on the skin as painless white bumps mainly in the mid-cheek area.” New York City hair-color specialist “The more you keep the hair cuticle closed, the more you protect your hair. To achieve this, do not scrub it dry; squeeze the water out and pat the hair with a towel to remove moisture.” Raychel Wade celebrity makeup artist “Advanced glycation end products accelerate aging by altering collagen and elastin structures. Research into AGE inhibition may provide the next wave of anti-aging technologies.” kelly dobos cosmetic chemist “The exciting innovation for makeup, which is included in the good BB creams, is the ever-increasing efficiency of peptides.” jane iredale president and founder of her eponymous mineral makeup line “I think detoxifying the skin is super effective for most skin types.” diane hibbard skin care director burke williams day spa nutrition paula simpson Celebrity Nutritionist “The Laser Cap is an effective nonsurgical therapy, which stops hair shedding and slows thinning.” “I absolutely love BB creams because while they are multifunctional (provides SPF, moisturizes and primes), they are also incredibly easy to use—they are here to stay.“ Director of the Few Institute for Aesthetic Plastic Surgery plastic surgery r. mark l. d jewell We rely on our editorial board to provide insight for every issue. These six industry experts offered input in this issue. “To most efficiently refuel energy depleted muscles, consume a small portion of simple carbohydrates (such as dried fruit) within 15 minutes after exercise. To repair and renew muscle mass, consume a balance of carbohydrates to proteins within two hours post-exercise.” “An exciting skin-care innovation this year is performing ablative fractional laser treatments on skin cancer repairs at the time of repair, rather than after.” dr. joel cohen englewood, co dermatologist “CoolSculpting is a new revolutionary, nonsurgical contouring treatment that freezes stubborn fat, which then is naturally eliminated from your body.” Dr. marina peredo smithtown, ny dermatologist FALL 2012 8/24/12 4:21 PM