shutterstock 1377590150

All scars form for the same reason — a [surgery](https://aedit.com/aedition/minimizing-scars-after-surgery), [burn](https://aedit.com/aedition/how-to-treat-first-second-third-degree-burns), cut, [acne spot](https://aedit.com/concern/acne-scars), or trauma of some sort occurs, which signals a dermal healing response that recruits inflammatory cells. “Living animals all have a natural ability to attempt restoration of function and repair damage to the body after an injury.” explains [James Beckman, MD](https://aedit.com/provider/james-beckman-md-34641), a board certified plastic and reconstructive surgeon and founder of [Therapon Skin Health](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Ftheraderm.net%2F). “Whether it is skin, other tissue, or even entire organs, scar formation is the first step.” The purpose? “It serves to cover open areas, preventing bacteria from entering and keeping tissues from drying out,” he says.

When you consider the state our bodies would be left in without the ability to scar, it’s a pretty remarkable phenomena. “If our skin would not scar, we would be walking around with big open wounds, which is why scarring is a necessity,” says [Gregory Buford, MD](https://aedit.com/provider/gregory-buford-md-1015), a board certified plastic and reconstructive surgeon in Englewood, CO. “It’s just that society has determined that it’s not pretty.” He likens scars to a kind of biological glue. 

With that said, there is no rhyme or reason to how the body responds to injury, which means you can be left with some pretty [unique scars](https://aedit.com/concern/scars). If you are unhappy with the appearance of a scar — no matter where it came from — there are ways to minimize it. Read on for both at-home and in-office [scar solutions](https://aedit.com/procedure/scar-solutions).

## **What Determines the Appearance of a Scar**
Even on the same person, no two scars heal the same. As [Jessica Weiser, MD](https://aedit.com/provider/jessica-weiser-md-34640), a board certified dermatologist in New York City, explains, there are several reasons why scars settle uniquely, including: 

- Extent of the injury
- Location of the wound
- Genetics
- Body’s collagen response (i.e. how much of the protein, which is like the building block of skin, is made)

“When new collagen forms, the bundles fill in a wound in the dermis (the second layer of skin),” she says. When just the right amount of collagen is produced, the scar is flat; too much collagen leads to thick, rope-like raised scars and keloids. All scars start red and, as they mature, transform to pink and then white. 

Like a good piece of real estate, the end result is all about location, location, location — certain parts of the body are better equipped to handle the formation of a scar than others. “Luckily, on the face, there is a good blood supply, so the area tends to heal more readily there,” says [Amanda Doyle, MD](https://aedit.com/provider/amanda-doyle-md-31526), a board certified dermatologist at Russak Dermatology Clinic in New York City. The same cannot be said the further south you go. “As you get towards the waist and further down, the blood supply is farther from the heart, so it takes a lot longer to heal because of the location,” she shares. 

Another factor that affects scarring is tension. “In areas like the shoulder or the back, there is a lot of pulling and tugging, and that can lead to a wider-looking scar because of constant tension in that location,” Dr. Doyle adds.

## **Types of Scars**
Scars are like snowflakes — no two are identical. At the most macro level, scars can be classified into two categories:

1. **Sunken (a.k.a. atrophic)**: “Sometimes, there is an absence of fat or other underlying structures that the body cannot fill in and scars end up atrophic or indented,” Dr. Doyle explains. 
2. **Raised (a.k.a. hypertrophic)**: “In other circumstances, the body stimulates an overly exuberant response that causes excess scar tissue clinically appearing as raised or keloid-type scars, which are typically the most challenging ones to treat,” she says. “Even with treatment, they may recur or may not respond as readily.” 

Moving to a more micro level, there are specific types of scars within those initial classifications:

### **Atrophic Scars**
- **Ice Pick Scars**: Deep and narrow but small, ice pick scars almost always have a tie to [nodular or cystic acne](https://aedit.com/concern/acne). Resembling a puncture wound of sorts, ice pick scars are commonly categorized as indented skin and occur on the cheeks.
- **Boxcar Scars**: Rounder in shape and resembling more of a crater, boxcar scars are wider than an ice pick scar but not as wide as rolling scars. They are often due to acne, and the deeper they are, the harder they are to treat. 
- **Rolling Scars**: Reminiscent of a pit but with undefined edges, the more common rolling scars give the area an almost wavy texture and can worsen with age due to a loss of elasticity and collagen in the skin. 

### **Hypertrophic Scars**
While not all hypertrophic scars are keloid scars, keloids are perhaps the best known raised scars. They are also considered among the most difficult to treat. Keloids tend to be wide, large, and puffy and occur after a surgery, cut or wound, or even piercing. As Dr. Buford explains, keloids grow outside of the boundaries of the scar and are technically tumors (tumors, by definition, are a growth in the skin and can be noncancerous). 

Keloids tend to be more common in people with darker skin (but any [skin tone](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types) can develop them). “Although keloid scarring generally tends to happen in Asians and African Americans, we don’t fully know why it affects certain skin tones,” Dr. Doyle says. “It’s related to the whole inflammatory process and collagen being re-formed in those areas of injury.” For whatever reason, some people experience that inflammatory response a little more robustly than others, and, “particularly in those two populations, we see it more frequently,” she adds.

## **At-Home & In-Office Scar Treatments**
Scars don’t subscribe to a one-treatment-fixes-all method. Each class of scar responds differently to treatment, which is why picking the right procedure is important. To get the best result, Dr. Doyle recommends an in-person evaluation so your doctor can fully evaluate the size, color, and texture of the scar. Most scars can show improvement, even if that means taking a mix-and-match approach. “There’s no silver bullet or monotherapy that makes scars look perfect,” Dr. Buford cautions. “We can’t always remove a scar in its entirety, but we can take the red out, modulate the scar, and make it thinner.” 

Whether your scar is fresh or more mature, the [first rule of scar care](https://aedit.com/aedition/scar-minimizing-skincare-to-use-after-surgery) is to make sure to always protect it from the sun with [sunscreen](https://aedit.com/aedition/best-sunscreens-of-2021) to prevent discoloration and improve its appearance. From there, below are the most effective treatment options for each scar type:

### **1. Topical Scar Gels** 
- **Best For:** Scars that are less than six months old
- **The 411:** If a scar is newer, faint, and pretty small, you may be able to treat it with a cocktail of over-the-counter topical ingredients like [vitamin C](https://aedit.com/aedition/guide-to-topical-vitamin-c-in-skincare), [retinol](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare), and hydroquinone or a specifically formulated [scar cream](https://aedit.com/aedition/scar-minimizing-skincare-to-use-after-surgery), which contains a cocktail of effective ingredients.
- **Find It In:** [Avène Cicalfate+ Scar Gel](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.dermstore.com%2Fproduct_Cicalfate%2BScar%2BGel_85402.htm) & [Visha Skincare Advanced Correcting Serum](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.vishaskincare.com%2Fproducts%2Fadvanced-correcting-serum-with-illuminotex)

### **2. Silicone Gel Sheets** 
- **Best For:** Minimizing closed, raised surgical scars
- **The 411:** These specially designed self-adhesive sheets (they’re somewhat reminiscent of a mega bandage) work well for pretty much all types of scars. Not only do they act as an occlusive dressing (read: seals in moisture by creating a barrier), but they also regulate pressure on the scar. Dr. Beckman says that silicone gel sheets have an unexplained effect to keep both the scar and skin surfaces from becoming raised, unsightly, or painful.
- **Find It In:** [Embrace Scar Sheets](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.embracescartherapy.com%2Fshop-by-product) & [Aroamas Professional Silicone Scar Sheets](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.walmart.com%2Fip%2FAroamas-Professional-Silicone-Scar-Sheets-Soften-Flattens-Scars-Resulting-Surgery-Injury-Burns-Acne-C-section-more-Soft-Strips-3-1-57-8-Sheets-4-Mont%2F696436019)

### **3. Polyurethane Dressing**
- **Best For:** Hard, red, & raised scars
- **The 411:** A flexible, waterproof pad of sorts, “polyurethane dressings, while initially used for wound healing, have been shown in a [few smaller studies](https://pubmed.ncbi.nlm.nih.gov/19440173/) to positively impact the scar surface, improve the microcirculation and improve scar color, firmness, and thickness,” Dr. Weiser says. As she explains, polyurethane is “an alternate ingredient to silicone but behaves in the same way as an occlusive dressing.”

### **4. Steroid Injections**
- **Best For:** Keloids & thick, raised, itchy, or painful scars that are fully healed 
- **The 411:** Performed by your dermatologist or plastic surgeon, steroid injections use cortisone to take down scar thickness. Some even contain very small amounts of 5-fluorouracil (5-FU), a cancer drug that reduces fibroblast activity and, in turn, hinders the progression of scar tissue. There is the potential for the injection site to darken, but, when cortisone is injected into a keloid, Dr. Beckman says that the steroid softens and weakens the scar.

### **5. Hyaluronic Acid & Biostimulatory Fillers**
- **Best For:** Sunken & indented scars, like ice pick acne scars
- **The 411:** For the past few years, doctors have been [injecting fillers](https://aedit.com/procedure/acne-scar-treatment-dermal-fillers) like Juvéderm® and Belotero® Balance to treat scars. “Dermal fillers help add volume to level a sunken scar with the surrounding tissue,” Dr. Weiser says. Depending on the patient’s preference, “hyaluronic acid fillers can be used for immediate improvement or biostimulatory fillers can be used to stimulate collagen production around the scar like a scaffold,” she adds. Some doctors, like Dr. Buford, pair hyaluronic acid filler with platelet-rich plasma (PRP) to level up the scar and change the character of the overlying skin. Just like using filler in the face for aesthetic and anti-aging purposes, the results are not permanent and need to be repeated.

### **6. Neurotoxins**
- **Best For:** Surgical scars & scars that occur in a bony area
- **The 411:** One of the newer ways to correct scars is with [neurotoxin](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) (think: Botox® or Dysport®), which can be injected into the scar to reduce muscle tension on scar tissue. “Using Botox® or other neuromodulators to reduce or eliminate muscle contraction in and around the scar has been shown to reduce hypertrophy and also to decrease fish-mouth or spread scars,” Dr. Weiser shares. Dr. Buford agrees. “Botox® is effective in a variety of scars,” he says. “When I place it in fresh scars all over the body, the scars tend to heal a little nicer.” But that doesn’t relegate the off-label use of Botox® just to body scars — it works on facial scars, too. “We know one thing that is consistent about scars is that they heal best under as little tension as possible,” he reiterates. “So, if you inject Botox®, you can relax the area to some degree. It’s a little trick, and it only works on certain areas.” 

### **7. Laser & Light Treatments** 
- **Best For:** Acne scars, keloids, raised or flat scars, red & discolored scars
- **The 411:** Light-based and [laser](https://aedit.com/procedure/acne-scar-treatment-laser-resurfacing) therapies stimulate new collagen to lessen the look of the scar. Light-based treatments, like [IPL](https://aedit.com/procedure/ipl) (intense pulsed light) and [BBL](https://aedit.com/aedition/benefits-of-bbl-hero-for-sun-damage-hair-removal) (broadband light), work well on scars on lighter skin. [Pulsed dye lasers](https://aedit.com/procedure/pulsed-dye-laser) (these target blood vessels in the skin) are best for reducing redness in scars, while [resurfacing lasers](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing) can soften the scar’s appearance and coloration. “These lasers involve the creation of controlled microscopic wounds in a specified percentage of the skin, which induces a wound healing response,” Dr. Weiser explains.

### **8. Microneedling**
- **Best For:** Superficial surgical & acne scars
- **The 411:** Perhaps the treatment du jour for unwanted scars, particularly acne scars, [microneedling](https://aedit.com/procedure/microneedling) (a.k.a. collagen induction therapy) creates microscopic wounds in the skin to stimulate new collagen that, in turn, smooths out the skin and the surrounding scar. It can also be [coupled with PRP](https://aedit.com/procedure/microneedling-with-prp) to further enhance the results. “Microneedling — especially with PRP — does work, and there are [studies](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4509584/) that show its efficacy,” Dr. Buford says.

### **9. Subcision** 
- **Best For:** Acne scars
- **The 411:** One of the most reliable ways to pull a deep scar out from under the skin and make it more flush with the surface is with [subcision](https://aedit.com/procedure/acne-scar-treatment-subcision). “This classic technique requires inserting a hypodermic needle into the skin directly beneath the scar to loosen and break the fibers that connect the scar to the tissue underneath it,” Dr. Weiser explains. “While this primarily helps to lift indented scars, it can also be helpful to release the collagen at the site of needle insertion to trigger a further healing response.”

### **10. Radiation Therapy**
- **Best For:** Stubborn keloids
- **The 411:** One of the more under-the-radar scar treatments is radiation therapy, which, [although promising](https://www.ncbi.nlm.nih.gov/books/NBK499973/), is strictly reserved for keloid improvement. “It’s used as a last resort for very challenging keloids,” Dr. Weiser says. If you are wondering how this therapy relates to cancer treatments, it is similar. “Radiation treatments entail the use of ionizing radiation — used for cancer/tumor treatment — usually externally applied to destroy existing collagen-producing cells and limit production of new ones,” she explains.

### **11. Scar Relaxation**
- **The 411:** Performed using a digital rotary tattoo machine to safely injure the skin and then repair it, this unique scar reduction method gives up to 80 percent improvement over six to 12 months and transforms almost every type of scar into soft, smooth skin. Scar expert Linda Dunn Carter, who invented [The DC Method](https://lindadunncarter.com/) over a decade ago, first abrades the skin down to the dermal layer to create new tissue while simultaneously forcing any dark pigment to purge. The tattoo machine breaks the bands of connective tissue that make up the scar to incite new, healthy tissue formation.

### **12. Scar Revision Surgery**
- **The 411:** Usually performed as the result of a poor surgical scar (think: [after a C-section](https://aedit.com/aedition/invasive-non-invasive-procedures-to-fix-appearance-of-c-section-scar)), surgical scar revision works best when a piece of the original scar is excised. But here’s the kicker: anytime you treat a scar with surgery, it will result in another scar — albeit a potentially thinner and flatter one. “Remember, the only way to erase a scar is to cut it out and replace it for another scar,” Dr. Bufford cautions. “But, sometimes, we can replace the old scar with a better-hidden one.”

## **The Takeaway**
Scarring is like a young child that you want to control but can’t. While scarless procedures sound promising, they’re far from reality, and you can’t do much to prevent occasional nicks and scratches. Fortunately, there are more treatment options to choose from than ever before for virtually every type of scar. 

*All products featured are independently selected by our editors, however, AEDIT may receive a commission on items purchased through our links.*

Aesthetics

They say that every scar tells a story, but not every story needs to be retold. Here’s everything you need to know about improving that stubborn scar — no matter the cause.

How To Treat Every Type Of Scar

Scar Wars: How To Treat Every Type Of Scar

shutterstock 1650779743

The beauty industry is notoriously ugly on the planet. Although the market is working on improvements, there are still a lot of blurred lines in eco-messaging and strategy. It’s estimated that personal care and beauty items make up a [third of the landfill waste](https://www.theguardian.com/sustainable-business/2014/nov/18/online-shopping-holidays-packaging-waste-recycling), and the harsh reality is that many beauty products have a short lifespan that leads to a landfill finish. But that’s not to say all is lost. Consumers (i.e. you!) are more educated than ever before and are expecting more from the brands you purchase from, and we’re here to shed light on the steps you can take to clean up your beauty routine and make it [more sustainable](https://aedit.com/aedition/guide-to-sustainability-and-recycling-beauty-products) — without feeling overwhelmed by the process.

## **5 Tips Towards Sustainability**
As we mentioned, there is a new generation of beauty brands to go along with a new generation of buyers that is taking action. Take [Taos Aer](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Ftaosaer.com%2F). The personal care brand was co-founded by Kristine Keheley, a formulator and expert in anhydrous products, who is working to offer more earth-friendly deodorant. “We use a waterless formulation to create the cleanest product possible and use minimally processed ingredients,” she explains. Working in an anhydrous way allows for [water conservation](https://www.un.org/waterforlifedecade/scarcity.shtml). Below, Keheley shares her tips for what to look for from brands and how to refine your own beauty habits.  

### **1. Do Your Research**
The landscape of sustainable beauty can be hard to navigate with so-called greenwashing being a prevalent issue. Some brands utilize fear-based tactics in their marketing to position their products as non-harmful alternatives, but a lack of clarity around verbiage is often what causes the most confusion. As we’ve covered, there are [no formal definitions](https://aedit.com/aedition/what-clean-green-natural-mean-for-beauty-makeup-skincare-products) of what terms like ‘green,’ ‘clean,’ or ‘natural’ mean, and a product doesn’t necessarily need to be free of synthetics or waterless to be environmentally conscious. Instead, the entire manufacturing and production process needs to be taken into account to ensure a truly eco-friendly outcome. 

Wondering whether the brands you are purchasing from practice what they preach? Do your homework. Dig deeper into their ethos and strategy when it comes to farming or ingredient sourcing to understand if they align to your values. More often than not, all it requires is an online search. Brands like [Thrive Natural Care](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fthrivecare.co%2F) and [True Botanicals](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Ftruebotanicals.com%2F), for example, are finding ways to sustainably grow and replenish resources through regenerative farming. 

And, if you are curious about the use of water in products (a quick look at the ingredient list will show that it often comes up first), Keheley offers this explanation: “Water is where bacteria can grow, so, by removing water, you can help create a safe space and reduce microbial growth. Waterless products will contain more of the ingredients you want with less filler.”  

### **2. Use Only What You Need**
It’s easy to be tempted by a sale or the innovation of a new product (we’re all guilty of it!), but nobody needs an expansive routine if the products they currently use are working. It’s also worth noting that [all beauty products have a shelf life](https://aedit.com/aedition/shelf-life-of-makeup-mascara-lipstick-foundation) that dictates how long they are stable and effective after opening. Lasting anywhere from three to 24 months (depending on the type of product), certain makeup, serums, sunblocks, and creams should be used consistently so that they don’t expire before you finish them. Try using each product as it is intended and only replacing it once it’s empty — you’ll be cutting down on waste *and* ensuring you’re using them at the peak of their effectiveness.

### **3. Reduce Packaging**
It’s not just the paper, glass, or plastic that your skincare comes in but the manufacturing systems in place to produce everything from the ink to the glue that makes for a large carbon footprint. “What’s been lagging in the 20 years of my career is interest on behalf of the packaging companies to offer sustainable options – they haven’t come up with good solutions yet,” Keheley explains. 

Fortunately, there have been some recent improvements in this sector that have her hopeful, though it’s a process that requires effort from both manufacturers and consumers. Limiting the need for single-use products (more on that below) will allow for a longer lifespan and decrease demand. [Plus](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fcleanwith.plus%2Fpages%2Fsustainability), a new personal care brand, is attempting to take packaging out of the equation all together. Its biodegradable body wash is waterless and comes in fully dissolvable packaging that breaks down into water, carbon dioxide, and organic matter.  

### **4. Opt for Reusable Products**
Perhaps the best way to get the most from your products and to reduce the cycle of repurchasing is to find ones that are reusable. Common of many [Asian skincare and makeup brands](https://aedit.com/aedition/best-skincare-brands-products-from-asia), companies around the globe are increasingly offering refillable solutions that allow you to replace part of the product instead of the whole thing. 

Rihanna’s Fenty Skin, for example, only makes you purchase the outer packaging of her cult-favorite [Hydra Vizor Invisible Moisturizer Broad Spectrum SPF 30 Sunscreen](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.sephora.com%2Fproduct%2Ffenty-skin-hydra-vizor-moisturizer-broad-spectrum-spf-30-sunscreen-P467249%3Ficid2%3Dproducts%2520grid%3Ap467249) once. When you run out of the product, you can simply purchase a refill at a reduced price. Dior, meanwhile, updated the tubes of its iconic [Rouge Lipstick](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.sephora.com%2Fproduct%2Fdior-rouge-dior-lipstick-P467760) to be refillable across 45 matte, metallic, and satin shades. And then there are brands like L’Occitane that offer convenient refills for household staples that have been in particularly heavy rotation this past year, [hand soap](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.loccitane.com%2Fen-us%2Fverbena-jumbo-duo-666876.html).

### **5. Recycle**
Recycling isn’t as easy as placing a used bottle into a bin. Despite our best intentions, many items never find their way to a recycling plant, and a [recent study](https://advances.sciencemag.org/content/3/7/e1700782) showed that only nine percent of the world's plastic was recycled. But that doesn’t mean beauty brands aren’t stepping up to help tackle this issue. Retailers like [Credo](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fcredobeauty.com%2Fblogs%2Fclean-scene%2Frecycle-your-empties-with-credo) and [Detox Market](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.thedetoxmarket.com%2Fpages%2Fclean-beauty-recycling) offer programs to help patrons recycle properly and diminish ‘wish-cycling.’

If you’re keen on recycling from home, there are a few factors to keep in mind — especially when it comes to the components of your used products. “Most products are made with mixed material, which makes them harder to process by recycling plants,” Keheley notes. Mirrors and magnets, for example, often interfere with the recycling process, and Luxe Botanics has a great [video](https://www.youtube.com/watch?v=uW0E7uJsMGI) that is worth watching to understand more about taking bottles apart for easier disposal. 

## **Eco-Minded Beauty Products to Try** 
If you’re interested in reducing your reliance on single-use products, making your eye creams last longer, or getting the most from the skincare you already have, check out the products below that can help clean up your beauty routine. 

### **Taos AER Deodorant** 
![AEDIT-Taos](//images.ctfassets.net/zw35sfestf1t/5g5P7afdHGpWSAI2sYrKt8/4fa87c7007af1f5061a99ff7cccdcff1/AEDIT-Taos.png)
Long-lasting and genderless, this deodorant not only keeps you smelling fresh, but it is also kind on the planet. Great for sensitive skin, it is made without water and with ethically sourced ingredients. $19, [taosaer.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Ftaosaer.com%2Fcollections%2Fall%2Fproducts%2Fdeodorant-lavender-myrrh) 

### **Dieux Skin Forever Eye Mask** 
![AEDIT-Dieux](//images.ctfassets.net/zw35sfestf1t/7s9brWUJLmNNm3EPOSuN4p/34c6d1fc6e86908116b8a39de6f4af18/AEDIT-Dieux.png)
These darling eye patches not only make for fun selfies — they can also help you get the most out of your eye creams. Decreasing the evaporation of product and locking in moisture in an area that needs it, the reusable silicone patches are meant to stand the test of time. $25, [dieuxskin.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.dieuxskin.com%2Fproducts%2Fforever-eye-mask)  

### **Common Heir Vitamin C Serum** 
![AEDIT-CommonHeir](//images.ctfassets.net/zw35sfestf1t/2QgoHOo7efooUdGrWemjV4/6d04a3abbd1b22c72bfb8d7d02e61fd0/AEDIT-CommonHeir.png)
Vitamin C is a finicky ingredient to formulate with, and it requires just as much attention once it enters your home (be wary of light and oxidation!). Common Heir is working to reduce waste of spoiled product and useless packaging with these biodegradable vegan capsules that brighten the complexion and are good for the planet. $88, [commonheir.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fcommonheir.com%2Fproducts%2Fvitamin-c-serum) 

### **Izzy Zero Waste Beauty Zero Waste Mascara**
![AEDIT-Izzy](//images.ctfassets.net/zw35sfestf1t/01sKaTHI06stFn2Xs1zXjN/63a5ee3552a5a068bdf1bdd0094f0c4f/AEDIT-Izzy.png)
Zero-waste, carbon-neutral, and 100 percent recyclable, this is the first-of-its-kind beauty innovation that will change the way you purchase mascara. No more throwaway tubes, every component is made to be reused or recycled by the professionals (just send the mascara back in the mailer it came in). Opt-in for a membership to receive a high-quality mascara on a regular basis or try it out once – the entire process is simplified and your lashes will love it. $39, [yourizzy.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fyourizzy.com%2Fpassword) 

### **Nurse Jamie Face Wrap**
![AEDIT-NurseJamie](//images.ctfassets.net/zw35sfestf1t/GtVZ6gFw6wxOmJ5lBKXOO/1e4dadd829b7fa5141ecaf0be340824b/AEDIT-NurseJamie.png)
Say ‘goodbye’ to single-use sheet masks and ‘hello’ to a reusable face mask that lets you look good and feel good. Allowing for easy and comfortable absorption of product, this mask enhances the efficacy of your existing skincare, which means less waste and more improvements in your skin. After you’re done, simply wash it and leave it out to dry for your next self-care Sunday. $30, [dermstore.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.dermstore.com%2Fproduct_FaceWrap%2B_74773.htm)  

### **Beautyblender Biopure Sustainable Makeup Sponge**
![AEDIT-Beautyblender](//images.ctfassets.net/zw35sfestf1t/2QCGfvM2zVd8U5UNQuQ05T/77ad1f62e5a9ab25eb903f5ba948740f/AEDIT-Beautyblender.png)
The brand’s new BioPlush foam is 60 percent plant-based thanks to renewable sugarcane that boasts the same cushion and coverage of the OG sponge — but with more eco-friendly production. The updated process includes less synthetics, minimal water, and more post-consumer recycled materials (for the outer packaging) at the same price point as the original. $20, [sephora.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.sephora.com%2Fproduct%2Fbeautyblender-biopure-sustainable-green-makeup-sponge-P468345) 

### **KVD Good Apple Skin-Perfecting Foundation Balm**
![AEDIT-KVD](//images.ctfassets.net/zw35sfestf1t/1Sfw7eDJEz6GbcdVVzX98d/663847d5a10d64fb8a25ab6a602d09f5/AEDIT-KVD.png)
It made waves on social media for its flawless finish, but the real beauty of this vegan foundation balm is its revolutionary design. Made without a mirror, magnet, or metal (components that are not recyclable), the compact is fully recyclable and does not require any disassembly. $38, [kvdveganbeauty.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.kvdveganbeauty.com%2Fface%2Ffoundation%2Fgood-apple-skin-perfecting-foundation-balm%2F20050.html) 

### **Plus Body Wash** 
![AEDIT-Plus](//images.ctfassets.net/zw35sfestf1t/3pNxC8llbXYrSd0V9FcF81/25612bea955c3af9e2a1e8e32810c002/AEDIT-Plus.png)
As we mentioned, packaging is a major pollutant, so Plus decided to forego it altogether with these biodegradable papers. The dissolvable wrap is made from wood pulp and the body wash itself requires only a little water to transform into a scintillating lather. Available in scented and unscented options, it’s a great option for both travel and at-home use. $17, [cleanwith.plus](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fcleanwith.plus%2Fcollections%2Fall) 

### **Oui The People The Single** 
![AEDIT-OuiThePeople](//images.ctfassets.net/zw35sfestf1t/6RqmWZbuPx1p59JWWrTsbV/f11092049751f5a392616f78dde9c91c/AEDIT-OuiThePeople.png)
Want to avoid the pink tax and having to constantly repurchase a new razor once the old one loses its edge? This rose gold safety razor provides a smooth shave, reduces razor burn, and comes with 10 replacement blades that can be easily disposed of. $75, [ouithepeople.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.ouithepeople.com%2Fproducts%2Frose-gold-safety-razor)  

### **Clean Circle Reusable Bamboo Velour Skincare Pads**
![AEDIT-CleanCircle](//images.ctfassets.net/zw35sfestf1t/58u1vdW9XVwLVTC4SXaEp6/430c85681ccbfcc39c0dc8784dc8ff0c/AEDIT-CleanCircle.png)
At this point, we know that single-use makeup remover wipes are one of the most wasteful items in a beauty routine, so why not swap them out for a more sustainable option? These 100 percent bamboo velour rounds also come with a drawstring pouch to ensure they don’t get lost in the wash. $22, [clean-circle.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fclean-circle.com%2Fproducts%2Freusable-bamboo-velour-skincare-pads) 

### **Fenty Beauty Day + Night Moisturizer Refill Bundle** 
![AEDIT-FentySkin](//images.ctfassets.net/zw35sfestf1t/5mt2PEy9AlGTaLmqLhWDyC/cd821608a4427b890c311b6bd18c0a71/AEDIT-FentySkin.png)
Let’s be honest, we all love cute packaging. But, what can make it harmful is that it’s often not refillable and goes to waste. Enter: Rihanna’s Fenty Skin. The brand offers a few refillable options (including this A.M./P.M. duo) in its skincare collection for guilt-free shopping. $56, [fentybeauty.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.fentybeauty.com%2Fday-night-moisturizer-refill-bundle-spf-moisturizer-night-cream%2Fam-pm-moisturizer-duo-refill.html) 

*All products featured are independently selected by our editors, however, AEDIT may receive a commission on items purchased through our links.*

Beauty

In honor of Earth Day, we’re breaking down sustainable ways to clean up your beauty routine and the products that can make it more eco-friendly.

How To Make Your Beauty Routine More Sustainable

shutterstock 795630103

You found out that you need to have a medically necessary procedure. You and your provider have submitted all of your necessary documentation and insurance has approved your case. While you’re not necessarily thrilled about going under the knife, there just so happen to be a few cosmetic tweaks that you’re interested in making to that same part of the body you already scheduled to have surgery on. So, can you blend functional and aesthetic surgeries? We asked the experts.

## **Functional vs. Aesthetic Procedures**
First things first, you may be wondering what the difference is between functional and aesthetic procedures? The best way to understand it is to look at these two definitions from the [American Medical Association (AMA)](https://www.ama-assn.org/): 

- **Cosmetic Surgery**: Performed to reshape normal structures of the body in order to improve the patient’s appearance and self-esteem.
- **Reconstructive Surgery**: Performed on abnormal structures of the body, caused by congenital defects, developmental abnormalities, trauma, infection, tumors, or disease.

Another way to put it? A functional procedure is one that you probably *need* to have, whereas an aesthetic procedure is one that you *want* to have. As you may have guessed, functional procedures are more likely to be [covered by insurance](https://aedit.com/aedition/insurance-coverage-for-plastic-surgery-cosmetic-procedures) than cosmetic ones. 

While it may sound straightforward enough, there is actually quite a bit of gray area. Many procedures have dual purposes and can treat both functional *and* aesthetic concerns. For example, patients who have [trouble breathing](https://aedit.com/concern/breathing-issues) due to a deviated septum (medically necessary) and are also unhappy with the appearance (aesthetic) of their [asymmetrical or crooked nose](https://aedit.com/concern/nose-angle) could address both concerns with the [same rhinoplasty surgery](https://aedit.com/aedition/difference-between-cosmetic-rhinoplasty-vs-functional-rhinoplasty).

## **Blending Functional & Aesthetic Procedures**
Rhinoplasty isn’t the only procedure that has functional and aesthetic benefits though. And, if you are curious as to what other plastic surgery fits the bill, we’re breaking down six of the most common: 

### **1. Rhinoplasty (a.k.a. nose job)** 
While we often think of rhinoplasty as a way to improve the appearance and [shape of the nose](https://aedit.com/concern/nose-shape), it also can help with breathing problems. “It is a very well understood scientific fact that the nose is the primary organ for delivery of oxygen to the body,” explains [Oren Friedman, MD](https://aedit.com/provider/oren-friedman-md-1609), a double board certified facial plastic and reconstructive surgeon and director of facial plastic surgery at the University of Pennsylvania. “The nose humidifies, filters, and warms the air we breathe, so that, when the air reaches the lungs, it is primed for gas exchange, allowing for oxygen to reach important functional regions of our bodies and brains.” Needless to say, the proper function of the nose is medically necessary. “It is essential that people be able to breathe through their noses, and, as such, insurance companies should cover surgery to correct a patient's nasal breathing surgery,” he adds.

How does this relate to aesthetic concerns a patient may have? If a patient has a major nasal shape deformity that is directly contributing to their inability to breathe through the nose, the surgeon will correct it as part of the functional rhinoplasty procedure. According to Dr. Friedman, nasal deformities that need to be corrected in order to improve the breathing function include cleft lip nasal deformities, nasal defects following cancer removal, and traumatic defects as with a dog bite.  

### **2. Abdominoplasty (a.k.a. tummy tuck)** 
For patients with a [body mass index (BMI)](https://www.dukehealth.org/treatments/weight-loss-surgery-candidate) of 35 or higher, [weight loss procedures](https://aedit.com/aedition/what-its-like-to-get-plastic-surgery-after-bariatric-surgery-weight-loss) (e.g. gastric sleeves, lap gastric bands, gastric bypass, etc.) are often covered by insurance. This is especially true if it is coupled with medical complications, like diabetes, heart disease, or pulmonary hypertension. Procedures like an [abdominoplasty](https://aedit.com/procedure/abdominoplasty) (to remove [excess fat](https://aedit.com/concern/excess-fat) and skin) and panniculectomy (to address extra skin) may also qualify as medically necessary in certain patients, though it is not as common as the weight loss treatments. 

But complementing a significant weight loss isn’t the only functional benefit of abdominal surgery. “[Body contouring](https://aedit.com/procedure/body-contouring-solutions) procedures such as a tummy tuck often provide much more than aesthetic outcomes and may actually improve function,” explains [Gregory Buford, MD](https://aedit.com/provider/gregory-buford-md-1015), a board certified plastic and reconstructive surgeon in Englewood, CO. “When we tighten the abdominal muscles, the overall core is made more functionally competent.” 

As a result, he says patients “will often report improvement in chronic back pain” and has also seen patients comment that “bladder function has improved.” While these benefits will probably not qualify the procedure for insurance coverage, Dr. Buford notes that a good number of his tummy tuck patients experience health improvements in addition to the cosmetic benefits. 

### **3. Blepharoplasty (a.k.a. eyelid surgery)** 
Eyelid surgery is another procedure that can be performed for cosmetic or functional reasons — and, in some cases, both. [Lower](https://aedit.com/procedure/lower-eyelid-blepharoplasty-transconjunctival-approach) and [upper eyelid blepharoplasty](https://aedit.com/procedure/upper-eyelid-blepharoplasty) surgeries can treat loose or sagging skin, under eye bags or puffiness, and eyelid droopiness.

Functionally, a blepharoplasty may be medically necessary when excess skin impedes vision. Dr. Friedman says that when the degree of eyelid droop is so extensive that it obstructs a patient's ability to see, insurance usually covers the eyelid surgery. “Failure to see well is a hazard to the patient and to those around the patient, and, as a result, functional surgery should be performed for health reasons,” he explains. 

If vision is not impaired, don’t expect the procedure to be classified as functional. “At times, patients do not like the heavy appearance of their eyelids and may want to have skin removed from the upper eyelids,” Dr. Friedman notes. “In such cases of cosmetic dissatisfaction, insurance should not cover the procedure.” Depending on the patient’s goals, a blepharoplasty can help with [rejuvenation](https://aedit.com/procedure/eye-rejuvenation-solutions) or [reshaping](https://aedit.com/procedure/eyelid-correction-solutions) the eyes.

### **4. Breast Surgery**
No, your standard [breast augmentation](https://aedit.com/procedure/breast-augmentation-solutions) — be it with [implants](https://aedit.com/procedure/breast-augmentation-with-implants), [fat transfer](https://aedit.com/procedure/breast-augmentation-with-fat-transfer), or some [hybrid](https://aedit.com/aedition/hybrid-breast-augmentation-with-implants-fat-transfer) of the two — is not functional. But breast surgery encompasses a wide range of procedures, some of which are considered medically necessary. Mastectomy, breast reconstruction, and breast reduction are three such treatments. 

As per the [1998 Women’s Health and Cancer Rights Act (WHCRA)](https://www.cancer.org/treatment/finding-and-paying-for-treatment/understanding-health-insurance/health-insurance-laws/womens-health-and-cancer-rights-act.html), health insurance plans that cover [mastectomy](https://aedit.com/aedition/what-to-expect-before-during-after-mastectomy-breast-cancer) (whether it’s for breast cancer prevention or treatment) must also cover [breast reconstruction](https://aedit.com/aedition/comprehensive-guide-to-breast-reconstruction-nipple-reconstruction-after-breast-cancer) — in the form of prostheses (like breast implants) — for both breasts. In these cases, providers do not need to document health problems or trials of alternative treatment as is usually custom in insurance cases. 

In the case of [breast reduction](https://aedit.com/procedure/breast-reduction-and-revision-solutions), addressing the size of the breasts can have a true impact on the patient’s quality of life. “When we reduce a woman's breasts, our goal is not only to achieve functional improvement (e.g. less weight and, so, less pressure on the lower back and neck) but to also create an aesthetic outcome that is attractive,” Dr. Buford says. “In this sense, breast reduction is likely one of the best examples in plastic surgery where form meets function to achieve an endpoint that creates benefit for our patients on multiple levels.”

### **5. Otoplasty (a.k.a. ear surgery)**
In order to understand the functional benefits of [otoplasty](https://aedit.com/procedure/otoplasty), it’s important to understand the functional benefits of the outer ear. “The external ear serves the primary function of funneling sound to the middle and inner ear in order to aid in hearing,” Dr. Friedman explains. “Repair of deformities that cause poor hearing should generally be covered by insurance.” 

[Cosmetic ear surgeries](https://aedit.com/aedition/otoplasty-ear-pinning-benefits-for-large-prominent-ears), as you may have guessed, are usually paid for out of pocket. “Aesthetic ear deformities often present as children and adults expressing that their ears protrude from their heads too far, making their ears stand out,” he says. “Patients sometimes come in stating ‘I get bullied for my funny looking ears’ or ‘my ears look like dumbo ears.’” Despite the mental health component to such concerns, Dr. Friedman shares that “otoplasty to correct these types of cosmetic deformities are generally not covered by insurance.”

There are, however, certain exceptions. “At times, children are born with excessively small ears [or] with no identifiable ears at all,” he notes. “These ear deformities require reconstruction of the missing ear and should be covered by insurance.” 

### **6. Botox®**
While it’s not a surgery, we’d be remiss not to mention the therapeutic benefits of a certain cosmetic injectable. As you likely know, [Botox®](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) is a form of botulinum toxin type A (BoNT-A) that is used in aesthetic medicine to reduce the appearance of fine lines and wrinkles caused by facial expressions (think: forehead lines and [crow’s feet](https://aedit.com/procedure/periorbital-botox)). But the neurotoxin is approved by the United States Food and Drug Administration (FDA) to treat medical conditions as well. 

Therapeutic uses for Botox® include the treatment of [migraines](https://americanmigrainefoundation.org/resource-library/botox-for-migraine/), [hyperhidrosis](https://aedit.com/procedure/botox-for-hyperhidrosis) (read: excessive sweating), and eye spasms (to name a few). “I treat a good number of patients with Botox® who report additional benefits such as reduced local sweating and an overall reduction in migraines,” Dr. Buford shares. “For these patients, the additional benefits often vastly outweigh the cosmetic improvements and are literally life changing.” In such cases, insurance may cover the cost of routine Botox® treatments.

## **How to Find the Right Provider**
The most important part of any procedure — functional or aesthetic? [Finding the right provider](https://aedit.com/aedition/finding-the-right-plastic-surgeon-dermatologist-or-cosmetic-dentist) to ensure you receive the best and safest treatment for your needs. “Choosing the right surgeon is always the most important predictor of success for a surgical procedure,” Dr. Friedman says. During the research and [consultation](https://aedit.com/aedition/questions-to-ask-your-doctor-during-plastic-surgery-consultation) process, be sure to inquire about how often they perform the procedure(s) you are interested in and ask to see [before and after photos](https://aedit.com/aedition/importance-of-before-and-after-photos-in-plastic-surgery). 

No matter what area you are looking to treat, it is important that the surgeon has extensive knowledge of anatomy and how the body works. “A surgeon who understands the functions of the facial sense organs — the nose, the eyes, the ears — is well suited to safely and comprehensively achieve the best possible surgical outcomes,” Dr. Friedman says. “Knowing the nose, eyes, and ears inside and out allows us to insure success in both form and function.”

In choosing a [board certified](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) plastic surgeon, you are often, well, blending the best of both worlds. “The beauty of plastic surgery is that it is essentially an art,” Dr. Buford concludes. “And, when form meets function, art is ultimately achieved.”

When you think ‘plastic surgery,’ you probably don’t think ‘medically necessary.’ But there are certain procedures that can provide dual functional and aesthetic benefits. Here’s what you need to know.

Blending Functional And Cosmetic Procedures In Plastic Surgery

What It Means To Blend Functional And Aesthetic Procedures

haley-lawrence-6ugQ978v-zg-unsplash

From facial thirds (and fifths!) to the infamous golden ratio, pop culture has been seeking facial harmony’s magic formula for millennia. Between the ancient Greeks, Renaissance artists like Leonardo da Vinci, and [today's social media set](https://aedit.com/aedition/march-2020-study-shows-relationship-between-social-media-cosmetic-surgery), there's no shortage of hypotheses about what constitutes a well-balanced countenance. But the whopping number of requests for Kate Middleton’s nose (once deemed to be the “world’s most perfect”) proves that many people still don’t have an accurate grasp of the concept.

In a nutshell, facial harmony is about [ideal proportions, not perfection](https://aedit.com/aedition/plastic-surgery-results-are-about-proportion-not-perfection). “It’s not so much about direct measurement; proportions are way more important,” says [Jason Roostaeian, MD](https://aedit.com/provider/jason-roostaeian-md-449), a board certified plastic and reconstructive surgeon and associate clinical professor at UCLA. “When we’re evaluating a face, you’re really looking at that face relative to itself.” In other words, the measurements of individual facial features are less important than the interaction between those features, and we’ve gone straight to the experts to better understand what that means for facial aesthetics.

## **What Is Facial Harmony?**
When we think of facial harmony, most of us think about beauty — but it’s really much more basic (in every sense) than that. “It really comes down to the fact that the most attractive faces are those where everything falls into the average,” Dr. Jason explains. “Philosophically speaking, when one part falls out of the norm, it’s alarming for potential disease.” If a person has a deficient jaw, for example, it’s an indication of certain ailments, he adds.

And, when it comes to attraction, it’s all about survival of the species. “If, in essence, what we’re doing is looking for a partner to mate with, the ideal mating partner is somebody who seems ‘normal’ across the board,” he says. In the most primal sense, we’re programmed to gravitate toward facial symmetry and harmony because they convey good health.

As it relates to aesthetic medicine and plastic surgery, providers have — no surprise here — a very precise understanding of facial proportion. “We mean balance and a subjective sense of normalcy,” explains [Jacob Unger, MD](https://aedit.com/provider/jacob-unger-md-2649), a Nashville-based board certified plastic and reconstructive surgeon and assistant professor of plastic surgery at Vanderbilt University. “If you overly highlight a feature or ignore a feature in the face, it will draw the eye negatively.” 

Sure, a surgery or procedure may focus on one part of the face, but the goal of said treatment is balance. “We aim for improvement in facial aesthetic surgery, but the key to doing it well is understanding facial anatomy and relationships,” Dr. Unger says.

### **Facial Harmony vs. Beauty**
Before we move on, you might be wondering: is facial harmony the same as beauty? According to our experts, the basic tenets of facial harmony have remained largely unchanged. Beauty standards, on the other hand, are infamously ever-changing. “Harmony is less subjective than beauty,” Dr. Unger shares. As he explains it, beauty evolves with the times and trends, but harmony and proportion are less beholden to what is en vogue. “Balance, harmony, and the golden ratio has indicated what is naturally aesthetically pleasing to the human eye and mind since it was first described — and that was thousands of years ago,” he says.

But how do modern beauty trends (think: super plush pouts) fit in with the idea of facial harmony? “There are certain features that you may want to augment compared to average because they have some underlying innuendo with them,” Dr. Jason explains. “But it’s very clear to see that, when it gets too out of proportion, you lose the attractiveness again.” In other words, cosmetic surgery can push certain boundaries to meet beauty standards, but only to the point where the enhancement or augmentation is not disrupting the overall harmony of the face.

## **How Does Plastic Surgery Achieve Facial Harmony?**
“We, as plastic surgeons, must take a holistic approach towards facial beauty and harmony,” Dr. Unger explains. And that often requires a bit of patient education. “We have to make sure we are not just improving the one item that may be the focus for the patient, but explaining how the structures of the face are interrelated,” he continues. As such, candidates must understand that “gentle adjustments in the surrounding areas” may be needed in order to ensure the desired results of more refined shape will look, as he describes, “elegant and balanced.” 

That holistic view ensures facial features remain proportional to each other. “Within a structure like the nose, any expert will explain that just because you don’t like something — a [dorsal hump](https://aedit.com/procedure/nose-bump-solutions), for instance — doesn’t mean that correcting that one issue will look good,” Dr. Unger says. “In fact, it will probably look very unnatural, unbalanced, or not harmonious if you impact one particular concern. This is because everything is interrelated.”

If you’re getting the sense that facial plastic surgery is like aesthetic Tetris, you’re on the right track. “Once you make one move, it may change the proportions and, therefore, you have to make the other move to make the two meld together better,” Dr. Jason says. Essentially, it's all about finding the sweet spot between enhancement (whether it's highlighting or downplaying a feature) and rejuvenation. “This deep understanding of the face is what sets [board certified plastic surgeons](https://aedit.com/aedition/difference-between-plastic-surgeons-and-cosmetic-surgeons) apart from untrained practitioners who do not have deep training or experience in overall facial shape, anatomy, and symmetry,” Dr. Unger adds. That lack of expertise is what leads to “many of the strange looking faces, lips, and cheeks we see walking around all the time,” he says.

The net net: When it comes to finding facial harmony, the whole is indeed much greater than the sum of its parts. Below, we break down some of the most common surgical combos that achieve a more balanced facial appearance:

### **NOSE + CHIN**
Evaluating patients for [rhinoplasty surgery](https://aedit.com/aedition/reinventing-rhinoplasty-whats-different-about-modern-nose-jobs) provides a perfect example of how surgeons consider facial harmony on both a macro level (how a feature relates to all of your other features) and micro level (how a feature’s individual elements relate to each other). “When you fine-tune or reshape a feature that the patient does not like, it will likely require changes to the related parts of the nose or face to ensure everything is balanced and looks appropriate together,” Dr. Unger notes. An example? “A big dorsum, when reduced, will likely expose a too broad nasal tip or too full tip because the relationship will be off,” he says.

Changing the nasal proportions can also [highlight the eyes](https://aedit.com/aedition/popularity-of-eyelid-surgery-cosmetic-eye-procedures-during-covid-19) and make the [chin appear more prominent](https://aedit.com/aedition/best-chin-augmentation-enhancement-procedures). It may happen naturally — “sometimes, adjustments to the nose alone are sufficient to meet a patient’s aesthetic goals,” Dr. Jason says — or it may require a bit more refinement. “Other times, we also need to perform a [chin augmentation](https://aedit.com/procedure/chin-enhancement-solutions) to get the results they want,” he adds. “A nose looks more or less prominent based on where the facial plane sits relative to it, so bringing the chin forward can also make the nose look less prominent.”

### **EYES + BROWS**
Another common area where proportions are particularly important? The eyes. [Blepharoplasty](https://aedit.com/procedure/upper-eyelid-blepharoplasty) (a.k.a. eyelid surgery) is one of the most popular surgical procedures for both women and men seeking to restore a more youthful, awake appearance. But removing eyelid skin isn’t always the best (or sole) solution. “Some patients who come in thinking they want blepharoplasty don’t actually have much excess eyelid skin,” Dr. Jason explains. “Instead, what they have is a sagging brow that’s making the lids look heavy.” If the surgeon simply cut away the skin without elevating the brow, the results will not be optimal, he says. As a result, [eye rejuvenation](https://aedit.com/procedure/eye-rejuvenation-solutions) often involves pairing eye and brow procedures.

### **UPPER + LOWER FACE**
The term ‘facelift’ can be confusing because the procedure focuses on restoring the lower to midface and jawline (i.e. the dreaded jowls) — not the entire face. [Facelift surgery](https://aedit.com/aedition/popularity-of-facelift-cosmetic-surgery-for-aging-sagging-neck) alone works well for patients whose concerns are relatively isolated to those areas. But, for those who also have significant signs of aging in the upper face (think: above the cheekbones, the eyes, and brows), a facelift by itself may leave them looking unbalanced. 

As Dr. Jason explains, if you’re getting a facelift, a [brow lift](https://aedit.com/aedition/theres-more-to-a-brow-lift-than-meets-the-eye) often makes sense, too. “You don’t want to make it look piecemeal or unharmonious because you lifted one part and left the rest,” he shares. Patients with a sagging brow, for example, may end up looking, as he describes, “squished in the middle” without the complementary treatment. 

## **Is AI the Future of Evaluating Facial Harmony?**
[Artificial intelligence](https://aedit.com/aedition/study-shows-how-artificial-intelligence-is-bringing-objectivity-to-aesthetics) (read: machine learning) is emerging as a compelling tool for objectively evaluating the elusive trifecta of beauty, youth, and proportion in the human face. But, according to our experts, automated facial analysis still can’t replace the eye of an expertly trained plastic surgeon — and it maybe never will. 

“It is still an analog approach that is honed with education, training, and experience to create shapes and contours that highlight and accentuate without overly stylizing and, thus, looking artificial,” Dr. Unger says. So, while he admits AI may help us better articulate what experts create with their eye and technique, he maintains that we are “likely very far away from a complete algorithmic or pre-planned approach that can be easily enacted on an actual human created from a computerized map.”

At the end of the day, the ‘art’ of plastic surgery cannot be underestimated. “This is what I tell my patients all the time — especially with rhinoplasty — it truly is art, and it doesn’t really matter what anybody else says,” Dr. Jason explains. “At the end of the day, only you can decide what you think looks good.” Regardless of how far the technology comes, honestly portrayed [before and after results](https://aedit.com/aedition/importance-of-before-and-after-photos-in-plastic-surgery) are still the most important factor when [choosing the right plastic surgeon](https://aedit.com/aedition/finding-the-right-plastic-surgeon-dermatologist-or-cosmetic-dentist) and, by extension, the right aesthetic for you.

Expert Opinion

Facial harmony is about proportion, not perfection, and we’ve gone straight to the experts to better understand what that means for your next plastic surgery consultation.

Importance Of Facial Harmony And Proportion In Plastic Surgery

The Importance Of Facial Harmony In Aesthetic Medicine

shutterstock 1407664622

It’s estimated that around 20 percent of the population has some degree of needle phobia. Known medically as trypanophobia, fear of needles comes in different forms — ranging from a fear of the pointy object itself to anxiety around being injected. For people with trypanophobia, the prospect of getting [Botox®](https://aedit.com/aedition/everything-you-need-to-know-before-getting-botox-for-the-first-time) or [fillers](https://aedit.com/aedition/what-to-know-before-getting-lip-filler-for-the-first-time) or even considering a surgery that involves [intravenous (IV)](https://aedit.com/aedition/iv-nutrient-drip-therapy-for-skincare-wellness) medication can be overwhelming. But this doesn’t make the results of these procedures any less attractive, so finding ways to make the thought of treatment less stressful may be helpful. 

Uncertainty around what kind of needles are used, how [painful](https://aedit.com/aedition/how-much-plastic-surgery-really-hurts) a procedure will be, and what to expect during the injection process can all increase anxiety levels for any patient but especially for those with needle phobias. Here at AEDIT, we know that knowledge is power, and we’ve consulted with plastic surgeons and patients alike to better understand the different needles used in aesthetic medicine and how to manage fears.

## **Injectable Needles 101**
When you’re looking into having a cosmetic surgery or treatment, you will come across a lot of procedure-specific medical jargon. As it relates to needles, ‘injectables’ is an umbrella term that refers to procedures that inject a product into the skin or body (think: [neurotoxins](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin), [filler](https://aedit.com/aedition/everything-you-need-to-know-about-dermal-fillers), [Kybella®](https://aedit.com/procedure/kybella), [Qwo™](https://aedit.com/aedition/qwo-cellulite-injectable-treatment-fda-approved), etc.). “There are different types of needles used for cosmetic injectables, and there are different brands, too,” says [Kian Karimi, MD](https://aedit.com/provider/kian-karimi-md-17458), a double board certified facial plastic and reconstructive surgeon in Los Angeles. Below, a quick vocabulary lesson:  

- **Needle**: A hollow, slender, sharply pointed instrument used for injection.
- **Gauge**: A needle’s gauge refers to the size of its opening. The higher the gauge, the smaller the diameter.
- **Syringe**: The syringe is the plastic pump that is attached to a needle to perform an injection. In the case of dermal filler, syringes often come pre-filled and your practitioner will choose which gauge of needle to use depending on your specific needs.
- **Cannula**: A cannula is a thin, flexible tube that is inserted via needle to administer medication or product. When a cannula is placed, the needle used to insert it is removed.

As Dr. Karimi explains, injectables come with needles in an array of sizes (usually ranging from 27-gauge to 30-gauge), and he says some providers will further customize treatment. “Some injectors like to transfer filler into even smaller syringes with 31- or even 32-gauge needles,” he notes. “But it really comes down to the thickness of the filler to determine which needle would be most appropriate.”

Neuromodulators like Botox®, for example, can often be injected with some of the tiniest needles on the market (a 31- or 32-gauge), which minimizes discomfort. Thicker and more viscous fillers (think: Juvéderm® and Restylane®), meanwhile, may require a larger 30-gauge or 27-gauge needle. As such, dermal filler injections are generally considered to be a bit more uncomfortable than neurotoxins.

### **Needle Alternatives**
As defined above, cannulas can serve as an alternative to needles. “Using a microcannula is different from using a needle,” says Dr. Karimi, who specializes in using DermaSculpt microcannulas. “The difference between a needle and a microcannula is that only one poke is made through the skin with a needle, then the blunt-tip microcannula is used to artistically place the filler in different tissue layers.” 

He has been teaching microcannula use for some 10 years now and estimates he has educated thousands of providers. “Overall, there are many advantages to using the microcannula,” he notes. They include less [bruising](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox) (a typical side effect of facial fillers) and less chance of injecting into a blood vessel, which can cause serious complications. “Although using a microcannula to inject fillers does not eliminate the risk of complication, it does decrease it to a very significant degree,” Dr. Karimi says. They also allow for a more “artistic” result, he adds.

## **Overcoming a Fear of Needles**
“Fear of needles is completely normal, although in some cases it can be quite extreme,” Dr. Karimi admits. To combat it, he and his team employ a variety of calming tactics — beginning the moment someone enters the practice — to make patients more comfortable. “We use great customer service, hearing the patient’s fears and anxieties, nice music, and friendly injectors,” Dr. Karimi shares. He’s also developed his own line of [CBD wellness](https://broadway.aedit.com/aedition/use-of-cbd-cannabinoids-products-in-wellness-fitness-recovery) products, [HealMD](https://www.healmd.us/), which he says has “significantly reduced anxiety in our patients before the procedure.”

Once it comes time for treatment, Dr. Karimi has a few go-to distraction techniques. “We often recommend patients not look at the needle or think about something else while the injections are being performed,” he says. What’s more? “We use distraction methods such as having an assistant tap the shoulder of our patients while the injections are being performed or other [vibration mechanisms](https://aedit.com/aedition/everything-you-need-to-know-before-getting-botox-for-the-first-time) that can help distract from the discomfort,” he adds.

In the case of more invasive procedures (think: combining filler with a [thread lift](https://aedit.com/procedure/thread-lift) or [laser treatment](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing)), minimal sedation may be offered. “When we are performing more significant combination therapies, we offer nitrous oxide gas inhalation during the procedure, which is a 50-50 mix of nitrous oxide and oxygen,” Dr. Karimi explains. “[It] can really help the patient get through the procedure without any lasting intoxicating effects as the gas wears off in just a few minutes.”

## **Patient Perspective**
Jessica conquered her needle phobia and now has regular appointments to top-off her fillers and Botox®. She tells us how [hypnotherapy](https://aedit.com/aedition/hypnotherapy-for-cosmetic-surgery-sedation-recovery-pain) and exposure therapy helped her to overcome her fear of needles and improved her life for the better.

<Dialogue>
  <Question party={The AEDITION}>
    When did your needle phobia start and how did it affect you?
  </Question>
  <Response party={Jessica}>
    It started when I was a pre-teen. I was having a series of medical tests and went from being a little uneasy about having needles near me — I mean, who isn’t?! —  to having severe panic attacks before having my blood drawn or having any other procedure that involved needles.
  </Response>
  <Question party={The AEDITION}>
    How did you overcome your fear?
  </Question>
  <Response party={Jessica}>
    My motivator for combatting my fear was my desire to become a nurse. Of course, I couldn’t be a nurse who was too scared of needles to be in the same room as anyone having an injection. So, I looked into my options and found an incredible therapist who, over a series of sessions, worked on finding the root of my phobia and practicing hypnosis to help me combat it. As I progressed, I went from being able to hold a needle to being able to give blood without feeling any more than some nerves just as anyone else would. As I’ve gotten older, the shift in my approach has also meant that I have been able to take full advantage of cosmetic injectables to keep my face looking nice and youthful.
  </Response>
  <Question party={The AEDITION}>
    Do you have any advice for anyone who is struggling with the same phobia?
  </Question>
  <Response party={Jessica}>
    For me, the most important step was facing the fact that I needed to do something about the problem. After that, being referred by a friend to a great therapist was nothing short of life-changing. Finding a therapist you connect with and who has experience treating phobias is important. I think having an end goal was key for me. If that end goal is [having your lips done](https://aedit.com/aedition/what-to-know-before-getting-lip-filler-for-the-first-time) or getting those frown lines seen to, then more power to you! Injectables are amazing, and I’m so glad I’m able to have them as a happy side effect of working to combat my phobia in the past.
  </Response>
</Dialogue>

## **The Takeaway**
It’s perfectly normal to feel some nerves prior to a cosmetic procedure, but, if you have a fear of needles, this can be exacerbated. Depending on your level of concern, methods ranging from meditation and therapy (talking and/or exposure) to even anxiety medication may be recommended to help manage your fears. Another tact? [Consult with your aesthetic provider](https://aedit.com/aedition/questions-to-ask-your-doctor-during-plastic-surgery-consultation) — they are often equipped with tips and tools to both educate and empower patients. “All in all, we assess each patient to see what level of anxiety they have about the procedure or procedures and discuss all the options with them,” Dr. Karimi shares.

About 20 percent of the population has some degree of needle phobia. Since knowledge is power, we’re breaking down the different needles used in aesthetic medicine and how to manage fears.

Guide To Needles And Cannulas Used For Cosmetic Injectables, Botox, Fillers

Needles 101: A Guide To The Tools Used For Cosmetic Injectables

joshua-hanson-e616t35Vbeg-unsplash

If you’ve ever read an article about aesthetic procedures on The AEDITION, you know we *always* encourage you to look for or ask to see before and after photos during the research and [consultation process](https://aedit.com/aedition/questions-to-ask-your-doctor-during-plastic-surgery-consultation). Why? Because they offer the chance to visualize a provider’s experience and aesthetic, in addition to being a great way to better understand what kind of results are possible. 

With the rise of [social media](https://aedit.com/aedition/march-2020-study-shows-relationship-between-social-media-cosmetic-surgery) (specifically, Instagram and TikTok), images and videos of patients before and after a procedure have become an indispensable educational and marketing tool for aesthetic providers. But how do you know if you can trust what you see? From what to look for to best practices, we’re breaking down everything you need to know about before and after photos in aesthetic medicine.

## **The Value of Before & After Photos in Aesthetic Medicine**
As it turns out, before and after photos are as much for the provider as they are for the patient. “Photos are critical in plastic surgery,” says [Jason Roostaeian, MD](https://aedit.com/provider/jason-roostaeian-md-449), a board certified plastic and reconstructive surgeon in Los Angeles. “They show the result in part so we can see it but also so we can be better surgeons.” As he explains, plastic surgery is a “visual art,” and before and afters give providers a chance to critically view their work and their technique across patients. 

And then there is the patient component. The imagery allows patients to get a sense of how often a provider performs the procedure(s) they are interested in, if they operate on people who share similar traits, and what their overall aesthetic is. In some cases, these photos — especially the ones featured on social media or a provider’s website — may serve as the patient’s first impression of the provider. They are looked at during the research and discovery phase (i.e. before a consultation is scheduled). The commercial value of these photos means there could be pressure to make results look as optimal as possible. Balancing business interests with [transparency and ethics](https://aedit.com/aedition/how-plastic-surgeons-balance-patients-cosmetic-surgery-desires-and-safety) is, needless to say, crucial. 

## **Are Before & After Photos Regulated?**
There are rules that govern patient photos, including before and after images. Firstly, patient confidentiality means that the provider must ask the patient for permission before sharing any photos. The gray space existis in how the photos are taken and where they can be shared once patients sign off.

In a [2018 article](https://journalofethics.ama-assn.org/article/when-advertising-plastic-surgeons-individual-brand-unethical/2018-04) in the *AMA Journal of Ethics*, the authors examine the issues of social media advertising for plastic surgeons in particular. The current lack of regulation surrounding the promotion of before and after photos on social media means that the onus is on the providers to represent their work honestly. In turn, it’s up to patients to look at the images with a level of caution. While there have been varying efforts to regulate the practice, no formal guidelines have been enacted to standardize the practice of taking and sharing before and after photos of cosmetic surgery results.

With that said, many providers take great care to ensure their photos are as accurate as possible. Practicing so-called ‘photographic hygiene’ is a good start. This includes:

- Setting up a dedicated photo space 
- Using a standardized backdrop
- Having controlled lighting 
- Maintaining consistent space between the patient and camera
- Taking and sharing multiple angles 

These steps go a long way toward allowing prospective patients to look at a provider’s work in a more complete manner. 

## **How to Look at Before & After Photos**
If you are wondering whether or not you can trust the before and after photos you see on social media, the answer is not simply yes or no. Instead, you should look at the images critically, and Dr. Roostaeian recommends the following: 

### **1. Be Mindful of Editing**
“As a doctor, you know when people use photoshop,” he says. But how is a patient to know? Try to compare several different photos of the same procedure; it can often help you spot which ones have been manipulated. Natural skin texture is a good indicator, too. If skin appears unnaturally smooth, it could be an indicator that the photo has been edited.

### **2. Look for Multiple Angles**
Best practices indicate that providers will take multiple photos from multiple angles of the same patient. “Look for six angles, including side views,” Dr. Roostaeian notes. “And make sure the photos are taken straight, not crooked.” While providers may only post a single angle on social media, they often feature more on their website. If you are interested in seeing more, message them or call their office.

### **3. Be Wary of the Zoom Effect**
We’re not talking about [the Zoom effect](https://aedit.com/aedition/aedit-survey-reveals-how-2020-altered-aesthetic-landscape) from our increased time on video calls, but rather the impact zooming in or out can have on how the before and after will present. As Dr. Roostaeian explains, using zoom can distort features, making them look bigger. On the flip side, zooming out can make features look smaller. A good rule of thumb is to observe whether all the photos of a particular procedure have been taken from the same distance.

### **4. Value Video**
“Video tends to be lower quality, so it’s more difficult for the patient to see results than in a still photo,” Dr. Roostaeian says. So while videos should not replace before and after photos, they can complement them. Even if you might not be able to see the patient in the same level of detail, you may be able to get a better sense of proportion and perspective. 

### **5. No Makeup Makeup**
Is the patient wearing makeup in some photos but not others? The reality is that it isn’t always possible for providers to get makeup-free before and after photos of every patient (and it may not even be necessary to). It is, however, worth keeping in mind that the results of some procedures may be affected by makeup.

## **The Takeaway**
When viewing before and after photos on social media or on a provider’s website, it’s important to do so with an informed eye. While the imagery is undoubtedly important, there is another important factor to consider when choosing a plastic surgeon or cosmetic dermatologist: [recommendations](https://aedit.com/aedition/category/how-i-found-my-plastic-surgeon). Dr. Roostaeian suggests reaching out to your network for referrals and to hear directly from patients about their experience.

With the rise of social media, before and after images have become indispensable tools for aesthetic providers to attract patients. But how do you know if you can trust what you see?

Importance Of Before And After Photos In Plastic Surgery, Aesthetic Medicine

Everything You Need To Know About Before And After Photos

pablo-merchan-montes-N UXC2w cwQ-unsplash

Chemical peels are making a comeback. After years of taking a backseat to high-tech, high-priced [lasers](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing) and the social media-fueled [microneedling](https://aedit.com/aedition/difference-between-professional-microneedling-at-home-dermarolling) craze, the humble (yet oh so powerful) peel promises a relatively quick, affordable, and versatile alternative for correcting a cadre of complexion woes.

Chemical peels have been around for millennia. An ancient Egyptian medical text known as the Ebers Papyrus (1550 BC) describes the technique, and Cleopatra herself is said to have bathed in sour donkey milk (which contains lactic acid) to smooth her skin. The Greeks and Romans, meanwhile, used corrosive limestone and grapes (tartaric acid) for the task.

From the first use of trichloroacetic acid (TCA) in the 1880s to the fine-tuning of the phenol peel in the early 2000s, peeling techniques have come a long way. In the current climate of [DIY](https://aedit.com/aedition/dangers-of-diy-at-home-dermatology-beauty-treatments) and [discreet downtime](https://aedit.com/aedition/influence-of-covid-19-face-masks-on-medical-aesthetics-trends), we wanted to explore — yep, layer by layer — the possibilities the modern peel provides.

## **What Is a Chemical Peel?**
Just as it sounds, chemical peeling (a.k.a. chemexfoliation or chemical exfoliation) uses a solution (typically an acid) to strip away the skin’s outer layers in a controlled manner. This destruction to part or all of the epidermis and, sometimes, part of the dermis [stimulates the skin’s regenerative process](https://aedit.com/aedition/ultimate-guide-to-skin-resurfacing-procedures), including the production of collagen and elastin. Some peels are self-neutralizing, meaning that they lose all their potency on their own, while others require intervention to stop the action of the ingredients. Over time (usually within a week) the skin begins to peel and flake off, revealing smoother skin beneath. 

How deep a peel goes depends upon several factors: 

- Acid type
- Acid concentration
- Application technique 
- Skin thickness
- Sebum production
- Skin barrier health

Generally speaking, the higher the concentration of acid or other active ingredients, the stronger the peel. Similarly, applying more solution to the skin, leaving it on longer (in some cases), and overlapping in certain areas will typically result in more layers of skin cells being removed. Professional chemical peels can be classified into one of three categories depending on their potency:

1. Superficial chemical peels
2. Medium chemical peels
3. Deep chemical peels

Below, we’re breaking down everything you need to know about each type.

### **Superficial Chemical Peels**
Also known as ‘lunchtime peels’ or ‘light peels,’ [superficial chemical peels](https://aedit.com/procedure/superficial-chemical-peels) remove only the layers of the epidermis — you know, those dead skin cells that build up and can make skin look dull. Depending on their makeup, some very superficial peels only remove the stratum corneum of the epidermis, while others go deeper to reach the basal layer. These treatments can be performed by an aesthetician, board certified physician, or [even at home](https://aedit.com/aedition/what-its-like-to-try-a-medical-grade-chemical-peel-at-home) (though it’s best to consult your dermatologist beforehand when going the DIY route).

Superficial peels are used to treat a variety of complexion concerns, including:

- Fine lines
- Acne and acne scarring
- Pigmentation (both hypo and hyper)
- Uneven texture
- Dullness

There are many types of superficial peels. Depending on your [Fitzpatrick skin type](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types) and the concerns you are looking to correct, you may receive one of the following: 

- **[Alpha Hydroxy Acid (AHA)](https://aedit.com/aedition/guide-to-topical-alpha-hydroxy-acids-in-skincare)**: Most commonly lactic or [glycolic acid](https://aedit.com/procedure/glycolic-peel), but also citric, malic, mandelic, and tartaric, concentrations of AHAs vary from 10 to 70 percent. Neutralization with a basic solution is required. Depending on formula and technique, may be suitable for Fitzpatrick types I to VI.
- **[Trichloroacetic Acid (TCA)](https://aedit.com/procedure/tca-peel)**: Used for over 100 years, a concentration of about 6 to 25 percent produces a superficial TCA peel that’s self-neutralizing. Lower potencies are typically suitable for all Fitzpatrick types.
- **[Salicylic Acid](https://aedit.com/procedure/salicylic-acid-peel)**: This [beta hydroxy acid (BHA)](https://aedit.com/aedition/guide-to-beta-hydroxy-acids-salicylic-acid-in-skincare) is often used to treat acne and also has anti-inflammatory properties. Concentrations usually range from 20 to 30 percent and is typically suitable for Fitzpatrick skin types I to VI.
- **[Modified Jessner’s Solution](https://aedit.com/procedure/jessners-peel)**: The first blended acid peel, it originally contained 14 percent lactic acid, 14 percent salicylic acid, and 14 percent resorcinol (later replaced by TCA). The self-neutralizing peel can address a range of concerns — from acne to aging — for Fitzpatrick types I to VI.
- **Blended Acid Peels**: These peels are popular because they combine different acids at lower concentrations to address a myriad of concerns with (potentially) fewer side effects. The makeup of blended peels varies to accomodate a patient’s specific needs and goals.
- **[Retinoids](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare)**: You might not realize it, but these vitamin A compounds — commonly known as retinol (in lower potencies) and tretinoin (prescription-strength) — are considered peeling agents because they induce cell turnover. Though suitable for Fitzpatrick skin types I to VI, higher concentrations can cause irritation and dryness.

With so many options to choose from, consulting with your provider or aesthetician will ensure you receive the best treatment for your needs.

### **Medium Chemical Peels**
[Medium chemical peels](https://aedit.com/procedure/medium-depth-chemical-peels) penetrate the entire epidermal layer to exfoliate cells within the papillary dermis. Though some states allow aestheticians to perform moderate peels, it’s important to consult with a board certified dermatologist or plastic surgeon beforehand to avoid possible complications and unwanted outcomes.

Medium peels produce more noticeable results than light peels, making them well suited for:

- Acne scars
- Fine lines and wrinkles
- Sun damage (like liver spots)
- Uneven skin tone
- Actinic keratoses (rough patches that can lead to skin cancer)
- Skin laxity

The most commonly used types of medium peels include:

- [TCA](https://aedit.com/procedure/tca-peel) in concentrations of about 20 to 35 percent 
- [Glycolic acid](https://aedit.com/procedure/glycolic-peel) in concentrations of about 35 to 50 percent 
- [Modified Jessner’s solution](https://aedit.com/procedure/jessners-peel) applied in multiple coats for deeper penetration

### **Deep Chemical Peels**
As the name suggests, [deep chemical peels](https://aedit.com/procedure/deep-chemical-peels) go the deepest and provide the most dramatic results. That also means they carry the highest risks. These peels remove the entire epidermis and the papillary dermis and may also penetrate down into the reticular dermis. Deep dermal peels may only be performed by a highly trained, board certified provider.

Appropriate for Fitzpatrick types I to III, deep peels address the most significant skin concerns, including:

- Acne scars
- Fine lines to deep wrinkles
- Sun damage
- Uneven skin tone
- Pre-cancerous growths
- Skin laxity

Though TCA in concentrations of 50 percent or more are capable of inducing a relatively deep peel, the most powerful chemexfoliating treatment is the Baker-Gordon Peel. Developed in the 1960s, the formula was composed of [phenol](https://aedit.com/procedure/phenol-peel) (an acid) mixed with [croton oil](https://aedit.com/procedure/croton-oil-peel) (an ancient purgative derived from the seeds of the croton tiglium plant) to resurface the skin. The results were impressive, but it sometimes resulted in unwanted hypopigmentation and a waxy, unnatural appearance to the skin.

Modern Baker-Gordon formulations adjust the amount of croton oil used to give practitioners more control over peel depth. Combined with pre-treatment regimens designed to mitigate pigmentation problems, this new generation of deep peel is experiencing a resurgence of sorts thanks to its effectiveness and relative ease (no bulky, expensive laser necessary!).

## **How to Prepare for a Chemical Peel**  
Depending on the type and degree of chemical exfoliant being applied, chemical peel prep can vary from a simple cleanse to weeks of pre-treatment prescription skincare. A good rule of thumb is that the more intensive the peel, the more involved the regimen beforehand. Here’s a general breakdown of what your provider may suggest pre-peel:

- **Skincare**: Your doctor may recommend switching to a mild cleanser and increasing your moisturizer application to keep skin calm and hydrated.
- **Retinoids**: A vitamin A exfoliant — either over-the-counter or a prescription like Retin-A — will help slough off dead cells to provide a more even peel result.
- **Bleaching Agent**: Suppressing the skin’s melanocytes with a topical bleach like hydroquinone can help mitigate post-procedure pigmentation problems.
- **Sunscreen**: Keeping your skin protected from the sun is crucial both before *and* after a chemical peel.
- **Medication**: Certain drugs (including oral contraceptives, some antibiotics, and Accutane) can make skin more prone to pigmentation problems and sun sensitivity, so you may need to temporarily stop taking them pre-and post-treatment.
- **Preventative Antivirals**: Whether you can recall having a history of cold sores or not, most of us have been exposed to the herpes simplex virus (HSV), so many docs prescribe a course of antiviral meds to ward off a possible outbreak.

Your provider should provide all of this pre-op care information during the consultation and booking process.

## **What It’s Like to Get a Chemical Peel**
Before beginning your chemical exfoliation procedure, your practitioner will prep your skin by cleansing and degreasing it, usually with alcohol, acetone, or both. To make the procedure more comfortable, numbing cream may be applied. Some superficial peels don’t require any topical numbing at all, while deeper peels require local anesthetic, IV sedation, or [general anesthesia](https://aedit.com/aedition/everything-you-need-to-know-about-anesthesia). It all depends on the depth and area being treated. 

Once your skin is prepped, your provider will brush on the solution as evenly as possible. Self-neutralizing peels like TCA quit working in a matter of seconds, while continuous peels like glycolic acid must be timed and neutralized when necessary. When the peeling agent is applied, the skin begins to take on a white, frosted appearance. The degree of frost is an indication of the depth of the peel. Your doctor may reapply the peeling solution in certain areas (around the mouth, for example) where wrinkling is deeper. The frost makes it difficult to discern exactly how deep the peel is penetrating, so the provider’s experience and skill here is critical.

## **Recovering from a Chemical Peel**
With just about any type of chemical peel, you can expect to experience some degree of burning, itching, redness, swelling, and flaking afterwards. Recovery from a superficial peel may only last a couple of days, whereas a medium peel can take about a week. Deeper peels require about two weeks of downtime, with some swelling and redness hanging around for weeks (if not months) longer.

“You can have a peel where your skin doesn’t truly peel off but rather flakes very unnoticeably, or you could do a deep peel where your skin sheds to the point where you may have to trim some of the dead skin from your face,” explains [Julie Russak, MD](https://aedit.com/provider/julie-russak-md-4645), a board certified dermatologist and founder of Russak Dermatology in New York City. “It all depends on your personal goals, what issue we are treating, and your at-home care — we can customize all treatments for your needs.”

Taking care of your skin during the healing process is crucial to achieving a successful result. Follow your provider’s post-treatment instructions exactly, [keeping skin clean and hydrated](https://aedit.com/aedition/skincare-after-facial-plastic-surgery-procedures). And, however tempting, don’t poke, pick, or peel your fragile skin. For medium and deep peels, stay out of the sun until your wounds are healed. At that point, it’s safe to apply a [sunscreen with SPF 30 or higher](https://aedit.com/aedition/best-lightweight-non-greasy-sunscreens-to-wear-indoors) and a color-correcting concealer formulated for post-procedure skin. 

## **Chemical Peel Risks** 
Although it may seem like a simple procedure (hey, all you have to do is brush on a little fruit acid!), chemical exfoliation carries serious risks. Your chance of having a successful outcome depends heavily on the skill and knowledge of your provider, as well as your skin type and medical history. Many peels are not suitable for [darker skin tones](https://aedit.com/aedition/the-best-skin-treatments-for-dark-complexions). Discussing your complete medical history during a thorough skin exam can help decrease your chances of experiencing complications, including:

- Infection (viral, bacterial, and fungal)
- Prolonged erythema (a.k.a. redness) 
- Increased sun sensitivity (sunscreen is a must!)
- Exacerbation of skin conditions ([psoriasis](https://aedit.com/aedition/what-its-like-to-live-with-and-treat-psoriasis), [eczema](https://aedit.com/aedition/best-skincare-products-to-treat-eczema-flare-ups-in-the-winter), [rosacea](https://aedit.com/aedition/what-its-like-to-live-with-and-treat-rosacea), melasma)
- Dyschromia (both hypo- and [hyperpigmentation](https://aedit.com/aedition/what-its-like-to-treat-hyperpigmentation-with-skincare-cosmetic-treatments))
- Scarring (if skin is too damaged to repair itself normally)
- Blistering 
- Milia (white, cyst-like bumps)
- Lines of demarcation (when peel solution is applied unevenly)
- Cardiac complications (though rare, phenol peels can cause temporary heart arrhythmia)

And for those who need another reason to quit, both [smoking and vaping](https://aedit.com/aedition/impact-of-cigarette-smoking-vaping-on-skin-hair-teeth-health) inhibit healing and cause wrinkling — especially around the eyes and mouth — which defeats the purpose of getting a peel in the first place.

If you’re considering a chemical peel, talk to your doctor before taking the plunge.

There’s a reason chemical peels have been around for millennia — they treat a wide array of skin concerns without any fancy equipment. Here’s what you need to know.

Guide To Medical-Grade Chemical Peels: Treatment, Benefits, Recovery, Risks

The Ultimate Guide To Chemical Peels

shutterstock 1537515995

The term ‘laser’ — short for light amplification by stimulated emission of radiation — includes a host of technologies aimed at everything from correcting complexion concerns to zapping warts and cancerous lesions. There are lasers for [tattoo removal](https://aedit.com/procedure/laser-tattoo-removal), lasers for getting your glow on, and lasers that [remove unwanted hair](https://aedit.com/procedure/laser-hair-removal) (to name just a few).

We’ve touched on the [different types of lasers](https://aedit.com/aedition/ultimate-guide-to-skin-resurfacing-procedures) before, so here’s a recap:

- **Ablative**: These lasers removed some or all of the epidermis.
- **Non-Ablative**: Lasers that leave the skin intact, while heating the dermis to stimulate collagen and elastin production.
- **Fractional**: These lasers have a pixelated energy beam that dissipates some of the heat.
- **Non-Fractional**: The laser beam remains focused and concentrated to treat smaller areas.

Different combinations of the above (think: [ablative fractional](https://aedit.com/procedure/ablative-fractional-lasers), [ablative non-fractional](https://aedit.com/procedure/ablative-nonfractional-lasers), [non-ablative fractional](https://aedit.com/procedure/nonablative-fractional-lasers), [non-ablative non-fractional](https://aedit.com/procedure/nonablative-nonfractional-lasers)) make a laser better suited for different concerns. Non-ablative [pulsed dye lasers](https://aedit.com/procedure/pulsed-dye-laser) like the Vbeam®, for example, are great for treating vascular lesions (i.e. broken capillaries and stretch marks). A non-ablative fractional laser like [Clear + Brilliant](https://aedit.com/procedure/clear-brilliant) is commonly called a ‘lunchtime laser’ because it produces only very slight inflammation (the ‘glow’) with minimal downtime. The tradeoff, of course, is less dramatic results.

When it comes to the big guns (so to speak) — those lasers capable of actually resurfacing the skin in the most technical sense — we’re talking about [ablative carbon dioxide (CO2)](https://aedit.com/procedure/ablative-co2-laser) and [ablative erbium](https://aedit.com/procedure/ablative-erbium-laser) lasers. Treatments with these technologies are also known as a laser peel, laser vaporization, and lasabrasion. The trend has been toward using the fractional varieties, like [Fraxel® Re:pair](https://aedit.com/procedure/fraxel-repair) (CO2) and erbium YAG (a.k.a. Er:YAG, which stands for yttrium aluminium garnet, for you science-y types).

## **Ablative Laser Skin Resurfacing 101**
Let’s back it up for a minute: what do these ‘amplification radiation’ tools really do to your skin? “Lasers are light waves that attack certain targets,” explains [Jason Roostaeian, MD](https://aedit.com/provider/jason-roostaeian-md-449), board certified plastic surgeon in Los Angeles. “There are certain lasers that attack redness and certain lasers that attack any dark pigmentation. Those are generally for tattoo removal, red spots, or taking redness out of scars.”

So, where do the skin resurfacing lasers come into play? “Then there’s skin resurfacing lasers, which attack water,” he continues. “A carbon dioxide laser is more like a general nuke bomb that causes more heat in the area and has more thermal injury.” There is an increased risk of [hyperpigmentation](https://aedit.com/aedition/what-its-like-to-treat-hyperpigmentation-with-skincare-cosmetic-treatments) after treatment because that thermal injury can also destroy melanocytes (the skin's pigment cells), he adds. Erbium lasers, meanwhile, have a “higher affinity for water,” which means they cause “less thermal damage,” Dr. Jason says. Typically, this results in a quicker recovery time compared to carbon dioxide lasabrasion.

The net net? With ablative laser resurfacing, we’re talking about creating a controlled burn to the skin to stimulate the healing process, generate elastin and collagen production, and, ultimately, produce brand spanking new skin cells.

### **What Concerns Does Ablative Laser Resurfacing Treat?**
Erbium and CO2 lasers address a myriad of aesthetic skin concerns, including:

- Fine lines and wrinkles (especially on the forehead, around the mouth, and under the eyes)
- Chickenpox and acne scars
- Sun damage
- Age spots (a.k.a. liver or sun spots)
- Warts 
- Certain birthmarks
- Sebaceous hyperplasia (tiny bumps — often on the nose — as a result of inflamed oil glands)

“Ablative resurfacing is a good option for people who have surface changes to the skin such as extensive sun damage, dark spots, large pore size, fine lines and wrinkles,” says [Adriana Lombardi, MD](https://aedit.com/provider/adriana-lombardi-md-12670), a board certified dermatologist and founder of the Skin Cancer & Cosmetic Surgery Center of New Jersey.

### **How Ablative Laser Skin Resurfacing Works**
Laser skin resurfacing machines vary, but they’re essentially vertical, box-like contraptions on wheels with some type of wand or handheld attachment that offer customizable treatment options. “You can control the depth based on the settings of the laser,” Dr. Jason says. “You can up the energy and it’s going to go a little bit deeper.” 

In addition to the machine’s settings, the degree of resurfacing is also dependent on the technique of the practitioner. “If you keep doing passes, it’s going to go deeper and deeper and deeper,” he explains. The trick is to create as little overlap as possible with each pass to ensure an even result.

We went down the rabbit hole for a second and wondered: how deep is too deep? “You don’t want to go so deep to the point where you’re causing true scarring,” he says. To explain that sweet spot, [let’s revisit skin anatomy 101](https://aedit.com/aedition/ultimate-guide-to-skin-resurfacing-procedures)…

### **How Deep Ablative Laser Skin Resurfacing Goes**
Human skin is composed of two layers: the epidermal (outer) layer and the dermal (inner) layer. The former contains mostly keratin and dead skin cells and the latter is made mostly of collagen and elastin. We’ve covered the five layers making up the epidermis already, so now let’s delve — *ahem* — deeper into the two layers that make up the dermis:

- **Papillary**: The superficial of the two dermal layers, it’s composed of highly vascular connective tissue.
- **Reticular**: A thicker and denser layer of connective tissue that makes up the majority of the dermis.

The dermis contains blood vessels, nerve endings, hair follicles, and glands. This layer supports the epidermis, helps regulate body temperature, and serves as an important physical and immunological barrier. It’s important that you don’t do too much damage to this layer or your skin won’t be able to regenerate. But certain skin concerns call for maximum penetration. “For deep wrinkles around the mouth, you need to go deep into the dermis,” Dr. Jason explains. “We tend to go down to the reticular and papillary juncture at the most.” In case you were wondering, this is precisely why you need to visit a highly trained, [board certified](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) plastic surgeon or dermatologist for any laser treatment.

If you paid attention during our [primer on the five epidermal layers](https://aedit.com/aedition/ultimate-guide-to-skin-resurfacing-procedures), you might be wondering how the epidermis ‘magically’ reappears after it's burned off. According to Dr. Jason, there are still enough skin cells left in the dermis after treatment (in the recesses of the hair follicles, for example) for your epidermis to gradually rebuild itself.

### **Preparing for Ablative Laser Skin Resurfacing**
With any type of laser skin treatment, it’s best to consult with a board certified provider. Ablative laser resurfacing absolutely requires the expertise of a board certified plastic surgeon or dermatologist, however, the rules governing exactly who can perform laser treatments vary from state to state. In California, for example, it has to be a medical professional (read: not an aesthetician). Regardless of the regulations, do your research and find someone with extensive experience.

During your [consultation](https://aedit.com/aedition/questions-to-ask-your-doctor-during-plastic-surgery-consultation), talk to your provider about your medical history. Treatment can trigger outbreaks like herpes and [eczema](https://aedit.com/aedition/best-skincare-products-to-treat-eczema-flare-ups-in-the-winter). Your [skin type](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types), as well as any skin conditions like [rosacea](https://aedit.com/aedition/what-its-like-to-live-with-and-treat-rosacea) and melasma will certainly affect your treatment plan. You’ll also need to stop certain medications, including drugs and [supplements](https://aedit.com/aedition/vitamins-supplements-to-avoid-before-cosmetic-surgery) that inhibit blood clotting (think: aspirin, ibuprofen, [vitamin E](https://aedit.com/aedition/guide-to-topical-vitamin-e-in-skincare), turmeric).

### **What It’s Like to Get Ablative Laser Skin Resurfacing**
In a nutshell, you’ll be asleep for the entire procedure. Due to the pain involved, [general anesthesia](https://aedit.com/aedition/everything-you-need-to-know-about-anesthesia) — though not absolutely required — is the standard of care for ablative CO2 and erbium YAG laser skin resurfacing. Dr. Jason says that it’s too difficult to numb the face with topical anesthetic to the degree necessary to keep the patient comfortable.

Depending upon the area(s) being treated, laser skin resurfacing can take anywhere from 30 minutes to two hours, and it will set you back somewhere in the neighborhood of $2,000 to $3,000. Unless you’re undergoing more extensive plastic surgery at the same time, it’s an outpatient procedure.

### **Recovering From Ablative Laser Skin Resurfacing** 
“We have many different types of lasers, so what to expect afterwards and how much downtime there is depends on the type of laser you are receiving,” explains [Julie Russak, MD](https://aedit.com/provider/julie-russak-md-4645), a board certified dermatologist and founder of Russak Dermatology Clinic in New York City. Intensive laser skin resurfacing isn’t exactly a ‘set it and forget it’ cosmetic procedure. After treatment, your face will be bandaged. Beginning 24 hours post-op, you’ll clean the area and apply ointment (like petroleum jelly) several times a day to prevent scabbing. Healing takes anywhere from 10 to 21 days, depending on the treatment area. 

[Swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) after resurfacing is common. Your doctor may prescribe steroids to keep it in check, especially if you’ve had treatment around the eyes. [Elevating the head](https://aedit.com/aedition/best-pillows-for-plastic-sugery-recovery-healing) (including while sleeping) and icing for the first 48 hours can minimize swelling. Burning or itching in the first few days is common. Expect the skin to peel about a week post-treatment.

[Avoid your usual skincare and makeup](https://aedit.com/aedition/skincare-after-facial-plastic-surgery-procedures) until the wounds heal completely. Instead, look for products specially formulated for sensitive, post-procedure skin, and use only as directed by your doctor. Redness can linger for a few months (maybe even longer, if you’re fair-skinned). Your provider will let you know when it’s safe to use a green-tinted concealer to hide residual redness. [Sunscreen](https://aedit.com/aedition/best-lightweight-non-greasy-sunscreens-to-wear-indoors) and [moisturizer](https://aedit.com/aedition/difference-between-creams-lotions-moisturizers) are critical to keeping your fresh skin hydrated and protected. 

## **Combining Laser Peels with Other Procedures**
Many surgical facial rejuvenation patients (think: facelifts and blepharoplasties) opt to add on ablative laser skin resurfacing while they’re at it. Experts say that cosmetic procedures like these can be [safely combined](https://aedit.com/aedition/best-surgical-and-non-surgical-cosmetic-procedures-to-combine) in the right candidates. A resurfacing laser, he says, can be like the icing on the cake of any anti-aging facial surgery. Patients experience the added bonus of one recovery period.

“Right now, in the time of COVID-19, it’s perfect for treatments that require more downtime because most people are staying home and [wearing masks](https://aedit.com/aedition/influence-of-covid-19-face-masks-on-medical-aesthetics-trends) when they are out and don’t need their faces to be seen,” Dr. Russak notes. “ Chemical peels and strong ablative lasers are [very popular at the moment](https://aedit.com/aedition/aedit-survey-reveals-how-2020-altered-aesthetic-landscape).“

## **Non-Ablative Lasers & IPL**
We promise we’re not purposely trying to confuse you, but there are also erbium YAG lasers (and a whole host of other types) that are non-ablative, meaning they don’t remove the epidermis. Don’t be surprised if a ‘simple’ Google search for laser resurfacing leaves your head spinning. That’s why it’s best to consult with your trusted provider and rely on their expertise to address your particular concerns.

Technically speaking, it’s more accurate to describe [non-ablative lasers](https://aedit.com/procedure/nonablative-laser-skin-resurfacing) and [intense pulsed light (IPL)](https://aedit.com/procedure/ipl) as skin refining rather than skin resurfacing, since they don’t remove the epidermis. Instead, these treatments use light to heat the underlying dermal layer, stimulating collagen and elastin production. Non-ablative lasers treat skin with a single wavelength of light, whereas IPL utilizes multiple wavelengths. The result? A gentler (but also less dramatic) procedure.

Dr. Lombardi’s go-to non-ablative regimen includes non-ablative erbium YAG (M22 ResurFX) and IPL. She uses them alone or in combination, depending on the patient. “Combining a non-ablative laser plus the IPL targets both surface changes as well as wrinkles and scarring and has minimal downtime,” she notes.

### **What It’s Like to Get Non-Ablative Laser & IPL Skin Resurfacing**
As Dr. Lombardi explains, IPL does not require any topical numbing medication. While the flash of light can be startling, the pain is described as similar to a snapping rubber band. Most patients find it tolerable. Non-ablative erbium YAG treatments do require topical anesthetic because the laser is going deeper into the skin and can be more painful. “We typically use a topical numbing product for 30 minutes prior to the procedure and use ice packs during it,” she shares.

Unlike the one-and-done nature of ablative resurfacing, non-ablative and IPL treatments are usually done in series. Dr. Lombardi often recommends three sessions spaced one month apart for best results. Another tip? Consider booking now. “The winter time is ideal as a patient cannot be tan prior to laser treatment,” she adds.

### **Recovering From Non-Ablative Laser & IPL Skin Resurfacing** 
Compared to ablative laser procedures, non-ablative lasers and IPL have a far more truncated recovery process. “Clear + Brilliant really doesn’t have any downtime besides the few hours of redness post laser, whereas IPL will make brown spots appear darker post-treatment and flake off after a few days and you will have swelling for a few days following,” Dr. Russak explains. “With an erbium laser you can have redness and skin peeling for up to one week.”

## **Risks of Laser Skin Resurfacing**
Removing layers of skin — your body’s first line of defense — is a delicate business. Risks of both ablative and non-ablative laser treatments include infection, burns, scarring, and unwanted pigmentation changes (either hyper- or hypopigmentation). Darker skin carries a higher risk of hyperpigmentation. Burning, itching, redness, skin peeling, and milia (tiny white bumps on treated areas) are typical and temporary post-ablative procedure side effects.

Forget everything you think you know about lasers. Here’s the scoop on the lasers capable of actually resurfacing the skin in the most technical sense.

Ablative Laser Skin Resurfacing: Treatment, Benefits, Recovery, Cost

Everything You Need To Know About Laser Skin Resurfacing

nicola-fioravanti-IXs4vNROZTE-unsplash

Even the most skincare savvy among us may be confused by the differences between [dermabrasion](https://aedit.com/procedure/dermabrasion) and [microdermabrasion](https://aedit.com/procedure/microdermabrasion). After all, they practically share the same name and can both be effective [skin resurfacing procedures](https://aedit.com/aedition/ultimate-guide-to-skin-resurfacing-procedures). Here, we’re breaking down the two treatments in terms of invasiveness, technology, and what aesthetic concerns each address to help you understand which might be the best choice for you. 

## **Dermabrasion vs. Microdermabrasion**
Yes, dermabrasion and microdermabrasion are similar in theory, but they are very different in reality. “While both sound similar and are resurfacing procedures that damage the skin in a specialized manner to improve it, they are otherwise pretty dissimilar,” says New York City-based board certified dermatologist [Blair Murphy-Rose, MD](https://www.mdcsnyc.com/provider/blair-murphy-md). Dermabrasion and microdermabrasion differ greatly in their intensity, depth of skin damage and, therefore, in the results, downtime, and associated risks.

In a nutshell, dermabrasion is the mechanical removal of the epidermis and upper layer of the dermis. Microdermabrasion, meanwhile, is a minimally invasive treatment option that exfoliates the surface of the skin. While microdermabrasion is suitable for all skin types, dermabrasion is best for people with lighter skin — usually [Fitzpatrick skin types](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types) I through III, explains [Jennnifer Levine, MD](https://drjenniferlevine.com/), a double board certified facial plastic and reconstructive surgeon in NYC. 

Now that we understand the differences between the two, it’s time to explore the ins and outs of each.

## **Dermabrasion 101**
[Dermabrasion](https://aedit.com/procedure/dermabrasion) is a surgical method that uses a high-speed rotary tool to abrade the skin in order to resurface it, Dr. Murphy-Rose says. She likens the device to a “sanding-like” tool that can penetrate deep into the skin. “Layers of skin are essentially removed down into the upper dermis and then, through the natural healing process, a new layer of healthier, smoother skin replaces them,” she adds.

The procedure typically requires [local or general anesthesia](https://aedit.com/aedition/everything-you-need-to-know-about-anesthesia) and comes with one to two weeks of downtime. High-quality dermabrasion can reduce deeper wrinkles, lines, pigmentation, and other textural abnormalities (like scars), explains [Jessica Weiser, MD](https://www.weiserskin.com/), a board certified dermatologist in NYC. But it’s not without risk. “Dermabrasion carries risk of infection, discoloration, and scarring,” she says. 

### **Popular Types of Dermabrasion** 
Dermabrasion can be performed with a motor-powered diamond fraise, wire brush, or serrated wheel. Alternatively, it can be done manually using a medium-grade drywall sanding screen. “Dermabrasion rapidly planes the skin surface,” Dr. Weiser explains. The tool used will likely depend on what you are trying to treat. “The wire brush is best used for [deeper scars](https://aedit.com/aedition/dermabrasion-might-be-the-scar-treatment-youve-been-looking-for) and irregularities, whereas the fraise and wheel are typically utilized to soften the edges of skin removed by the wire brush,” Dr. Weiser says. 

### **What to expect from dermabrasion** 
Prior to dermabrasion, you’ll be treated with pain medication, local anaesthetic for nerve blocks, and, on occasion, general anesthesia. “Eyes are covered to protect from possible spray, and the skin is sometimes treated with gentian violet stain to monitor how deep the treatment is extended,” Dr. Weiser shares. “The skin is held taut and then abraded, leading to a raw skin surface and some bleeding.”

You can expect significant redness, [swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery), and moderate pain (managed by [pain medication](https://aedit.com/aedition/opioid-crisis-plastic-surgery-recovery-pain-management)). Bleeding may also occur after treatment. “As the area heals, scabbing or crusting will occur and the redness and swelling will eventually subside over one to two weeks,” Dr. Murphy-Rose says. “You will need to follow your doctor’s instructions and take very good care of your skin during the healing process to prevent infection.” You’ll also want to ask your doctor when it’s safe to go into the sun again. “During the healing process, you should avoid all exposure to sunlight on the treated area,” she says. Most doctors will also advise [avoiding strenuous exercise](https://aedit.com/aedition/when-to-start-exercising-again-after-cosmetic-surgery-procedures) for about a month post-procedure. 

## **Microdermabrasion 101**
While dermabrasion lives at the invasive side of the aesthetic procedure spectrum, [microdermabrasion](https://aedit.com/procedure/microdermabrasion) falls at the other end. “Microdermabrasion is a non-invasive procedure that removes the dead skin cells from the epidermis to help exfoliate the skin surface,” Dr. Weiser explains. It does not, however, reach the viable skin cells of the lower epidermis and superficial dermis. Microdermabrasion can improve superficial skin concerns such as fine lines, brown spots, and enlarged pores, Dr. Murphy-Rose says.

Microdermabrasion, which is generally considered painless and involves little to no recovery time, can be done with a [diamond](https://aedit.com/procedure/diamond-tip-microdermabrasion) or [crystal](https://aedit.com/procedure/crystal-microdermabrasion) tip tool. “A handheld device sprays tiny crystals onto the skin causing light skin abrasion or exfoliation to the outermost ‘dead’ skin cells with minimal discomfort, no real downtime, and without the need for anesthesia,” Dr. Murphy-Rose explains. 

There are also over-the-counter skincare devices with microdermabrasion in their names. These are exfoliators designed to mimic the benefits of the in-office procedure at-home — albeit in a less intensive manner.

### **Popular Types of Microdermabrasion?**
Microdermabrasion is best suited for younger skin. It can also be a helpful treatment option for [acne-prone skin types](https://aedit.com/aedition/best-professional-treatments-for-acne-and-acne-scars). The most common forms of microdermabrasion include: 

1. **[Crystal Tip](https://aedit.com/procedure/crystal-microdermabrasion)**: “Crystals are sprayed on the skin surface and a vacuum-based tip suctions up both dead skin cells and loose crystals,” Dr. Weiser says. It’s best for acne because the crystals also have antibacterial properties.
2. **[Diamond Tip](https://aedit.com/procedure/diamond-tip-microdermabrasion)**: This technique involves a tip made from natural or synthetic diamond chips with attached suction. “The diamond abrades the dead skin cells which are removed by the vacuum-based suction,” she notes. 
3. **Dermasweep**: A gentler vacuum pump with a silk, nylon, or polyester bristle-tipped head is used to allow for greater customization.

### **What to expect from microdermabrasion** 
Unlike the seven to 14 days of downtime associated with dermabrasion, there is little to no downtime with microdermabrasion. “There is a mild scratching sensation over the skin surface — sometimes in single or repeated passes — depending on the skin type,” Dr. Weiser says. Post-treatment, your skin may appear pink or red. Dr. Levine likens it how the skin looks after a scrape. “Any procedure or product that causes exfoliation will make you more sensitive to the sun, so excellent [sun protection](https://aedit.com/aedition/best-lightweight-non-greasy-sunscreens-to-wear-indoors) is essential,” Dr. Murphy-Rose advises. She recommends applying mineral sunscreen daily and wearing a hat and sunglasses after microdermabrasion. Other tips? Skip washing your face the day of. In the following days, opt for a gentle cleanser and [moisturize](https://aedit.com/aedition/difference-between-creams-lotions-moisturizers) liberally. “You can otherwise go about your regular routine without limitations,” Dr. Murphy-Rose says. 

## **Which Procedure Is Best for You?**
Generally speaking, microdermabrasion can be an effective treatment option for patients with acne, pore congestion, and oily skin. At lower settings, it can be used for drier skin types as well. “Very sensitive skin does not respond well to microdermabrasion, and treatment should also be avoided in patients on [Accutane](https://aedit.com/procedure/accutane) therapy where the skin surface is very fragile,” Dr. Weiser notes. It is also not a good choice for patients with [rosacea](https://aedit.com/aedition/what-its-like-to-live-with-and-treat-rosacea), [eczema](https://aedit.com/aedition/best-skincare-products-to-treat-eczema-flare-ups-in-the-winter), and lupus because the treatment stimulates blood flow to the skin, which can worsen certain skin conditions.

Dermabrasion, meanwhile, is best suited for those with significant textural abnormalities such as scarring, wrinkles, and sun damage. It can be used to treat small areas with deep wrinkles (think: lines around the mouth). “These wrinkles are hard to treat and need a treatment that will go deep enough to fully address the wrinkle,” Dr. Levine explains. As such, it is also good for scars and [acne scarring](https://aedit.com/aedition/how-to-treat-acne-scars). Additionally, someone who has failed to achieve desired results from [fractional laser resurfacing](https://aedit.com/procedure/nonablative-fractional-lasers) may be a candidate.

But it’s not for everyone. “Because it can go deep, it may lead to the stimulation of melanocytes, causing the cells to produce more or less pigment,” Dr. Levine notes. Therefore, it is not recommended for people with darker skin. “Darker skin types may be more prone to adverse effects like pigmentation changes, and anyone prone to keloid formation should avoid dermabrasion,” Dr. Murphy-Rose explains. “Any underlying medical conditions causing poor wound healing would be a contraindication to treatment.”

Sure, dermabrasion and microdermabrasion sound similar, but they are very different procedures. Here’s what you need to know about the benefits of each.

The AEDITION

AEDUCATION