After a year that was — to put it mildly — not anyone’s favorite, we’re all looking forward to 2021. The silver lining? If nothing else, an extended socially distant work from home period (for those lucky enough to be able to) has afforded us the time and space to heal in peace from more aesthetic treatments than we may have considered in the past. As the new year approaches, what big trends in both surgical and non-surgical cosmetic procedures will it bring? To find out, we tapped the biggest names in cosmetic dermatology and plastic surgery to get their take on what’s new and next for face and body.
In June, we declared eyes are the new lips as a result of COVID-19 face coverings, and that trend is here to stay. But that’s not all 2021 has in store for the face.
1. All About Eyes
We’re calling it now: 2021 will continue to be an eye opener. “Who knows how long masks will be part of our daily ensemble,” says Dara Liotta, MD, a double board certified facial plastic and reconstructive surgeon in New York City. She predicts patients will choose to combine “minor eye-optimizing surgeries” that “provide natural-looking, permanent results” (think: upper eyelid blepharoplasty) with non-surgical enhancements (like the Botox® Brow Lift and lateral cheekbone and under eye filler) to “lighten and brighten the area around the eyes.” Optimizing the eyes can do wonders for making us look better rested, less stressed, and more put together. “More and more patients will be willing to come and sit in my office chair once or twice a year for a little ‘high maintenance’ tweakment in order to be ‘low maintenance’ all year long,” she says. In her experience, it’s all about the ability to “ditch the undereye concealer and the strobing makeup that just gets all over our masks anyway.” True story.
2. Couture Lips
Just because eyes are having a moment doesn’t mean lips are a thing of the past. 2020 saw the release of Restylane® Kysse, a hyaluronic acid-based lip filler from Galderma, and Dr. Liotta expects non-surgical pout procedures to continue to be in demand. “Lips are always ‘in’ and more and more patients are willing to pay a bit more for a perfect, couture, natural-looking lip,” Dr. Liotta says. Despite the popularity, lips can be a complicated area of the face to treat. “When you really analyze the lips, they’re composed of a number of different parts,” she explains. There are the philtral columns (the lines from the peak of the cupid’s bow up toward the nose), the cupid’s bow, the vermillion border (i.e. where you’d apply lip liner), and the body of the lip itself (where you’d put lipstick). “If you feel your own lips, you’ll appreciate that each of these areas have different stiffnesses, and move differently,” Dr. Liotta says.
After analyzing the lips — both at rest and movement — she designs “a custom plan for lip augmentation” using one to three different types of fillers, plus or minus Botox®. Dubbed “Couture Lips,” the procedure rings in around $3,000 because more than one type of filler is involved. “It’s expensive, but so worth it,” she says.
If you are looking for a natural, long-lasting alternative to synthetic dermal filler, nanofat is a whole new level of facial fat injections. “Because the market has now gotten really used to doing facial fillers, people are realizing how much money and what a commitment filler is,” says Lisa Cassileth, MD, a board certified plastic and reconstructive surgeon and founder of Cassileth Plastic Surgery in Beverly Hills. One of the problems with traditional fat is that it can be lumpy or bumpy — not as smooth as a filler. But new technology helps to eliminate that concern. “Nanofat takes the fat and processes it, smoothing it out to a milkshake-like consistency that is similar to what a Juvederm® or hyaluronic acid injection might be,” she notes. Oh, and did we mention it’s permanent? “A big plus is that you can have a long-term placement of the nanofat,” Dr. Cassileth says. “It looks and acts like an injectable, but it never goes away”
4. Masseter Botox®
2020 was rough, and its trials and tribulations have minted a whole new group of teeth grinders and jaw clinchers, Dr. Liotta says. “2021 is going to be about mixing wellness and beauty,” she notes, and masseter Botox® is a great example of this. The masseter muscle is one of the muscles activated during chewing, and it’s located at the angle of the mandible (jaw). “In people who grind or clench their teeth, it’s extra tension in this muscle that’s the culprit,” Dr. Liotta explains. She says that Botox® can be used both functionally to weaken the masseter muscle (the main teeth-grinding muscle) and improve the pain of TMJ from teeth grinding and cosmetically to thin and soften the jaw from a hypertrophied (or overgrown) masseter muscle. “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,” Dr. Liotta says. When Botox® is used to reduce masseter muscle hypertrophy cosmetically, the maximum effect is not seen for six to eight weeks, she adds.
5. Surgical Profile Makeover
To maximize results, Dr. Liotta predicts her patients will “stack more small surgical procedures to optimize their look in a more permanent way.” One of the most popular combinations? Rhinoplasty alongside a chin implant and submental liposuction, she says, because they’re easy to combine in terms of surgical logistics and recovery. “The combination of the three requires treatments takes around 2.5 hours of operating and about 10 days of downtime,” she notes.
Our experts are expecting lots of surgical and non-surgical body contouring requests in the new year — plus, a modern take on breast implant removal.
6. Emsculpt Neo
“One of the big things that's coming up is next-generation bodies,” says Anne Chapas, MD, a board certified dermatologist and medical director of Union Square Dermatology in New York City. EmSculpt has been a leader in this new muscle building space, and the EmSculpt Neo uses radiofrequency to simultaneously eliminate fat. “It's one of the only devices that, in 30 minutes, will be doing two treatments at once,” she says. It uses radiofrequency energy to break down the fat cells and electromagnetic waves to stimulate the underlying muscles to build muscle. She points to a study from the American Society for Dermatologic Surgery (ASDS) that showed an average of 30 percent reduction in subcutaneous fat. “Even after one month, the fat reduction in particular usually takes about 90 days,” Dr. Chapas explains.
New York City-based board certified dermatologist Paul Jarrod Frank, MD, sees the EmSculpt Neo being similarly influential. He says the original EmSculpt does for body shaping and muscle definition what Botox® did to wrinkles and muscle movement — and it’s a game changer. He has two EmSculpt machines at his practice and uses them after liposuction. “I do it for fitness people, instructors, and people who hit a wall after injury,” he says. It’s most effective for those “who have been exercising for years, have great bodies, and just want better,” he notes.
The pandemic has created space and time for many things, one being an opportunity to recover and heal while working remotely. “For the first time, working moms and dads are able to refocus their energy on self and family without the day-to-day work and travel grind,” says Ryan Neinstein, MD, a board certified plastic and reconstructive surgeon of Neinstein Plastic Surgery in NYC. His practice’s signature liposculpting procedure, which combines fat-melting technology (VASER) and skin-tightening technology (J Plasma), has seen a 75 percent increase in demand as of late. “We constantly hear ‘I finally have time to take care of myself and the pandemic has made me realize I deserve to feel good,’” he says.
8. High-Definition Liposuction
Another body contouring procedure on the rise? High-definition liposuction. “A procedure born out of South American ingenuity has permeated onto Park Avenue,” Dr. Neinstein says. While most of his practice’s patients seek a lean look, new techniques allow muscle definition, too. “By using artistic skill with our technology, we can now melt the fat down to just a few cells under the skin,” Dr. Neinstein says. “For athletic patients with a great underlying muscular framework, we can now create a hill and valley concept that gives a sexy and athletic look.”
9. Pectoral Muscle Repair
Breast implant removal made headlines in 2020 (thanks, Chrissy Teigen!). In 2021, Dr. Cassileth believes there will be a demand to not just remove the implant but also restore beautiful breasts. “No one ever repairs the pectoralis muscle because it was never considered a critical part of the implant removal,” she laments. While muscle repair isn’t required for explanting, she considers it a necessary complement for every under-the-muscle-implant removal she performs. “The pec muscle is not only attached to your sternum and ribs, it’s also attached to your arm,” Dr. Cassileth explains, adding it’s what allows you to do a pushup. When you cut into this muscle, it can weaken by 10 to 20 percent. “Now that so many more women are doing pushups, pilates, or plank positions, they are really noticing that their pec muscle strength isn’t close to what it was prior to implant,” she shares. “If the muscle is left unrepaired after explanting, it can actually be weaker without the implant since there isn’t tension holding it tighter.” Repairing the pectoral muscle allows patients to “live a full life,” she says.
10. TruBody System
Dr. Chapas says that the TruBody System from Cutera will be a big body sculpting trend for 2021. It’s a two-step system that removes fat, rebuilds muscle, and renews the skin by combining the truSculpt® iD and truSculpt® Flex technologies. Using radiofrequency technology, the devices heat up the body to 45 degrees Celsius in 15 minutes to reduce about 24 percent of the fat right below the skin. “What we're finding in some of these kinds of technologies is that heating the fat is also getting those muscles revved up to work, so they have better metabolism,” Dr. Chapas explains. You can do multiple areas at once with TruBody. “It's really popular to do the abdomen and the arms or the front of the legs or the buttocks and the back of the legs,” she says, adding a series of about four treatments are usually needed for best results.
Emsella uses electromagnetic energy to deliver thousands of supramaximal pelvic floor muscle contractions in a single session. Originally used by gynecologists and urologists to treat incontinence, the technology is now being used for sexual wellness and body strengthening. “We found that when this treatment is used in conjunction with other things, like an abdomen treatment, you're creating an enormous amount of core strength, development postural improvement, and, yes, those sexual health improvements for both men and women,” Dr. Frank explains. Emsella is yet another example of the intersection between functional and aesthetic medicine. “A lot of women and men are doing it, and it's not something you can see,’ he shares. “It's something that you feel; it affects the functioning of your life.”
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