2020 has arrived! As we enter this new decade, what big trends in both surgical and non-surgical cosmetic procedures will the new ‘roaring ‘20s’ bring? To find out, we tapped some of the biggest names in dermatology and plastic surgery to get their takes on what hair, face, and body trends we can expect to see in medical aesthetics in 2020.
2020 Hair Trends
No longer just about treating hair loss once it happens, hair restoration procedures can have a preventative effect as well.
1. Platelet-Rich Plasma (PRP) to Prevent Hair Loss
PRP is now considered standard protocol for hair growth, says board certified dermatologist Rita Linkner, MD, of Spring Street Dermatology in NYC. The treatment, which works for both men and women (Kourtney Kardashian documented her experience with the procedure on Keeping Up With the Kardashians), involves injecting platelet-rich plasma from the patient’s own body into the scalp to repair damaged hair follicles and encourage fuller, thicker growth.
The treatment’s mechanism of action and injection protocols are being demystified daily, as the topic continues to come up in cosmetic journals. “PRP’s use as adjuvant treatment to lasers and as a stand-alone injectable has been gaining traction and will only continue to rise come 2020,” Dr. Linkner says.
2020 Face Trends
From innovative uses for Botox® and dermal filler to advances in skin tightening, there is an array of minimally invasive advances to address any number of complexion concerns on the horizon.
2. PRP Skin Resurfacing
Surprise! Platelet rich-plasma is also used on the skin. “The use of PRP with small amounts of additives, like neuromodulators and hyaluronic acid, delivered with handheld microneedle chambers to provide mesotherapy to the superficial structures of the skin can provide complexion improvements that were only previously seen with laser resurfacing,” Dr. Linkner says of the technique that is often colloquially referred to as the ‘vampire facial.’
3. New Filler Products
New York City-based board certified plastic surgeon Umabreen Mahmood, MD, says the U.S. Food and Drug Administration (FDA) will likely approve several new soft tissue fillers in 2020 that are already used abroad in Europe, “which will be an exciting addition to the current portfolio of fillers.”
4. No-Downtime Laser Rejuvenation
New year, new lasers! Board certified dermatologist Claire Chang, MD, of Union Square Laser Dermatology says that 2020 is all about Picosecond lasers. One of the newest lasers on the market, it can be used for everything from overall skin rejuvenation and skin brightening to the targeted treatment of fine lines, brown spots, melasma, acne scars, and unwanted tattoos. It has minimal downtime and is very well tolerated, she says.
5. The “LitLift”
Manhattan-based board certified facial plastic surgeon Dara Liotta, MD, says that one of the biggest non-surgical requests she receives at her practice is for general facial optimization with fillers and neurotoxins. Dubbed “the LitLift,” Dr. Liotta says “millennials, in particular, don’t want to look like someone else.” Instead, “they just want to ‘dust’ a bit of filler and Botox® around the face to make them look like their best selves without makeup,” she says. #NoFilterJustFiller is one of her favorite hashtags to see patients use after an appointment with her. “I like to say that the new trend for 2020 is to be a bit ‘high maintenance’ in my office chair once or twice a year in order to be ‘low maintenance’ all year long,” she explains.
6. Minimally Invasive Skin Tightening
Dr. Chang believes minimally invasive skin tightening procedures like Ultherapy® will continue to be on the rise in 2020. “As the global life expectancy increases, many patients are searching for non-surgical, preventative treatments to start in their twenties, thirties, and forties to avoid or delay the need for more aggressive surgical procedures in the future,” she says.
Ultherapy® uses microfocused ultrasound to stimulate collagen deep in the skin, causing a skin-tightening effect to prevent and treat sagging, loose skin. “With the advent of treatments like Ultherapy, which have been shown to be safe and effective in skin tightening and lifting, patients are reaching for less invasive rejuvenation options,” Dr. Chang says.
7. Preventative Injectables
Board certified dermatologist and founder of Spring Street Dermatology Sapna Palep, MD, says the light use of neuromodulators (think: Botox®, Dysport®, Jeuveau®, and Xeomin®) and fillers early in life has been clinically shown to have anti-aging benefits. “We see those results commonly in patients proactively using injectables in their twenties and thirties to resolve mild aesthetic issues, rather than investing in plastic surgery later in life as a full overhaul,” Dr. Palep explains. With the technical advancements of neurotoxins and fillers lasting longer and having additional flexibility within the skin, it’s possible to achieve natural results without a lot of product. It is important to note that less is always more and the earlier you begin small aesthetic procedures, the less maintenance will be required over time, she adds.
8. Bespoke Lip Augmentation
At her Manhattan practice, Dr. Liotta offers a custom, non-surgical lip treatment she calls “couture lips” that she expects will continue to gain popularity in 2020. “Lips are always ‘in,’” she shares. “More and more patients are willing to pay a bit more for a perfect, couture, natural-looking lip.”
The anatomy of the lip and mouth area is actually quite complicated area. The lips are composed of a number of different parts, including the philtral columns (i.e. the vertical lines that run from the cupid’s bow to the nose), the vermillion border (where you’d put lip liner), and the body of the lip itself (where you put lipstick). “If you feel your own lips, you’ll appreciate that each of these areas have a different stiffness, and move differently,” Dr. Liotta explains. After analyzing the lips at rest and in movement, Dr. Liotta creates a custom lip augmentation plan using anywhere from one to three types of filler — plus or minus Botox® — to help create the perfect pout.
9. Microneedling with Radiofrequency
Whether you look at is as radiofrequency reaping the benefits of microneedling or vice versa, Dr. Palep says the combination of the two treatments is seriously amplifying results. “A wound-healing process ensues,” she says of the technique. “Results peak through within two weeks.” The procedures are blood-free due to the coagulation effects of the needles, which means patients rebound quickly post procedure. RF microneedling treatments like Vivace® further up the ante with the addition of red and blue LED light, which further speeds up the anti-acne and brightening effects. Another add on? PRP. “The complement of PRP to this laser treatment also minimizes downtime while maximizing results,” Dr. Palep says. “That increased efficacy is well-received by millennials.”
10. Masseter Botox® for TMJD and Jaw Slimming
“2020 is all about mixing wellness and beauty, and masseter Botox® is a great example of this,” Dr. Liotta says of the off-label use of the neurotoxin that can treat temporomandibular joint disorder (a.k.a. TMJD or TMD) and slim the jaw. The masseter muscle sits at the back of the mouth at the angle of the mandible (i.e. angle of the jaw) and is one of the muscles activated during chewing. “In people who grind or clench their teeth, it’s extra tension in this muscle that’s the culprit,” Dr. Liotta points out.
She says that Botox® can be used both functionally to temporarily weaken the masseter muscle (the main teeth-grinding muscle) and improve the pain of TMJD. “When Botox® is used to relieve the pain of TMJ and tooth grinding, patients can expect some pain relief in as little as one to two weeks,” she says. Cosmetically, Botox® can be used to thin the masseter muscle and take away a square look to the angle of the jaw, softening the look of the lower face. In that case, the maximum effect is not seen for six to eight weeks, Dr. Liotta notes.
2020 Body Trends
The body contouring trend is here to stay, and 2020 will see the evolution of both surgical and non-surgical techniques.
11. Non-Surgical Body Contouring
“For 2020, trends in plastic surgery are towards a more sophisticated body experience where skill, technology, and human touch blend,” says New York City-based board certified plastic surgeon Ryan Neinstein, MD, who has seen an uptick in body treatment requests.
In his practice, non-surgical body sculpting options include EmSculpt® (to help define abs and buttocks) combined with skin tightening and lymphatic drainage massages. “Here people get the combination of modern technology with the traditional warmth and professional feel of human touch,” he says. To complement those services, patients enter into a weekly body treatment program at the practice and undergo light therapy (LED or infrared) to maintain the results. “These treatments help detoxify, recover, and firm the body from the wear and tear we all go through,” he says.
Dr. Mahmood, meanwhile, notices that patients are increasingly bothered by skin laxity of the face, abdomen, arms (to name a few), but may not be ready to undergo a facelift or abdominoplasty. As a result, non-surgical skin tightening options using radiofrequency and heat are becoming increasingly attractive options.
12. Reshaped Rears
For over a decade now, a plump, shapely rear has been the aesthetic in the U.S. But Dr. Neinstein says he has started surgically reshaping overly filled buttocks from the Brazilian Butt Lift craze. “We are now reducing and sculpting these buttocks to give a more athletic and feminine look,” he says.
13. Body Shaping with Botulinum Toxin
Many beauty trends travel to the U.S. from overseas, and South Korea is one of the pioneering countries when it comes to aesthetics, Dr. Chang says. “Dermatologists in South Korea were using platelet-rich plasma (PRP), oral tranexamic acid, threadlifts, and botulinum toxin for jawline slimming for years before we were in the United States,” she notes.
Next up? Botulinum toxin treatments for other body parts. “In my practice, I place botulinum toxin injections to slim the muscles of the neck, shoulders, calves, and thigh bulge for body contouring,” says Dr. Chang. The effects can be seen in as little as four to six weeks and last an average of six months. “An increasing number of patients have started asking for this treatment recently,” she says. “And it will likely rise in 2020.”
14. VelaShape III for Cellulite
VelaShape III is a procedure used to reduce the appearance of cellulite and provide circumference reduction of the thighs by using a combination of technologies that deep-heat fat cells and surrounding tissue. The technology has improved in regard to the delivery of the energy to provide more wattage, which speeds up the heating of the tissue more comfortably for patients, says board certified dermatologist Jennifer Chwalek, MD, of Union Square Laser Dermatology. Each thigh requires just 15 minutes of treatment, though a series of one treatment a week for three or four weeks is recommended. Patients will see results after the third treatment, and Dr. Chwalek notes it’s particularly popular in the summer or before winter beach vacations.
15. Body Injectables
“Dimples, cellulite, stretch marks, and lax skin can all be targeted with Sculptra®, which is in the process of running FDA trials to approve these off-label uses,” says Dr. Linkner. Because there is no laser that can currently address these issues, customizable injections are needed to fill this niche, she adds. Because of the semi-permanent nature of polylactic acid, or PLLA, Sculptra® results last anywhere from two to five years, which she believes is the strongest draw for clients.
16. Muscle Contouring
The philosophy surrounding body contouring is shifting, and the focus is now on refining muscles, says Dr. Palep. “With technologies like FlexSculpt that work to exercise key core muscles groups, we sculpt patients in a way that can’t be achieved with a trainer in the gym,” she explains, adding that refinement means even those with BMIs under 25 who might not be ideal candidates for fat-contouring machines can now non-invasively treat something for which liposuction was once the standard. “No downtime and quick treatments make this lunchtime procedure one of the most popular offered at Spring Street Dermatology,” she says.
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