A woman receives a relaxing facial treatment at a medspa, eyes closed and wrapped in a striped towel. The soothing experience reflects the shift from outdated procedures to more modern, holistic aesthetic treatments in 2025. This image captures the calming, results-driven approach of today’s medspa trends.

Top Outdated Medspa Treatments—and the Modern Aesthetic Procedures Replacing Them in 2025 | Cottonbro | Pexels

Beauty is ever evolving, and if it seems like every few years, popular medspa treatments fall to the wayside only to be replaced with their 2.0 version, it’s because that is exactly what happens. Once deemed “the next best thing” the constant emergence of innovative and science-based aesthetic treatments sends some non-invasive aesthetic procedures to the beauty graveyard to die.  In this article, we break down the most outdated medspa treatments and the new aesthetic treatments that are replacing them while answering all your questions along the way. 

# **FILLERS AND INJECTABLES**

Filler migration and fatigue are changing the world of fillers from a once-overfilled look to a more natural, undetectable one, aka quiet filler.

### *What treatments are replacing traditional dermal fillers?*

Today, more patients opt for non-invasive treatments, like Botox and other neuromodulators, which relax the muscles that contribute to expression lines, over fillers. "While fillers are useful for volume loss, they can sometimes result in an overfilled or unnatural appearance when used indiscriminately," says [AEDIT Founder and board-certified facial plastic and reconstructive surgeon Dr. William Kennedy, MD](https://aedit.com/provider/william-kennedy-md-26292). "Patients favor the subtle, more natural-looking results that neuromodulators provide. The rise of '[baby Botox](https://aedit.com/aedition/baby-botox-pros-cons)' and microtox techniques makes Botox appealing to a younger demographic seeking a refreshed look without dramatic changes." These nonsurgical treatments offer minimal downtime compared to procedures that require surgery, making them a convenient choice for many.

Another medspa innovation that is making headway is microdroplet filler. Rather than adding significant volume, this technique injects tiny amounts of filler superficially into the skin to hydrate it and improve its texture and radiance. Dr. Kennedy says it results in a dewy, plump complexion rather than a sculpted one since the microdroplet method provides more diffuse, skin quality-focused results. Microdroplet filler is an advanced skincare technology that he says is ideal for patients who want improvement without the risk of looking "done." The area treated is carefully selected based on the desired outcome, and proper injection site technique is essential to minimize side effects such as redness, swelling, or bruising.


Regenerative aesthetics is a popular cosmetic procedure in 2025, consisting of treatments like platelet-rich plasma (PRP) and platelet-rich fibrin (PRF). Dr. Kennedy explains that these treatments harness the body’s healing factors to stimulate collagen, elastin, and tissue repair. “They also improve skin texture, under-eye hollows, and even encourage [hair growth](https://aedit.com/aedition/kourtney-kardashian-prp-injections-to-treat-hair-loss) over time for a more natural, holistic approach with fewer synthetic materials.” Since PRP and PRF are derived from your blood, they act as an alternative to fillers without the risk of adverse reactions. 

### *What are the alternatives to traditional lip fillers?*

Lip fillers, done conservatively, are the best way to add volume to the lips for enhanced shape and size, but other [lip-enhancing treatments](https://aedit.com/aedition/when-lip-fillers-are-not-enough) have made their way onto the list of Medspa trends for 2025. Some of the more popular options include:

1. **HydraFacial Perk:** This exfoliating lip service temporarily smooths the lips for a subtle boost in plumpness.
2. **Lip flip:** Harnessing neuromodulators, the popular lip flip minimizes movement of the tiny muscles around the lips, causing the upper lip to curl out for added fullness and definition.
3. **Skin boosters like SkinVive:** These hyaluronic acid injectables work differently from traditional lip fillers. Rather than volumizing, they add hydration to smooth away fine wrinkles.
4. **LipLase:** This laser-based treatment helps smooth the lips and add natural-looking volume by stimulating collagen production, thanks to Nd: YAG and Er: YAG energy.

### *What is the best alternative to Botox?*

Some new aesthetic treatments that work like Botox but offer unique benefits include Daxxify and Xeomin. According to Dr. Kennedy, [Daxxify](https://aedit.com/aedition/everything-you-need-to-know-about-daxxify-r) provides a longer duration of effect of up to six months, while [Xeomin](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) is marketed as a “naked” botulinum toxin, free from accessory proteins, making it less likely to trigger resistance.

If injectables aren’t for you, topical ingredients, such as [peptides](https://aedit.com/aedition/best-peptide-skincare-products), are another route. “Peptides like Argireline offer subtle smoothing for those hesitant to inject although the results are far less dramatic,” Dr. Kennedy says. Another option is a fractional resurfacing laser, which stimulates collagen to improve the appearance of fine lines and wrinkles.

# **FAT MELTERS**

[CoolSculpting](https://aedit.com/procedure/cool-sculpting) was the fat-melting treatment of choice for years, but new technologies have superseded it, making it one of the more outdated medspa treatments.

### *Is CoolSculpting still effective, or are there better alternatives?*

CoolSculpting was one of the original non-invasive fat-reducing treatments, harnessing cryolipolysis (extreme cold) to eliminate stubborn fat. Yet, as new non-invasive treatments come to the forefront, CoolSculpting has lost its luster and has been replaced with more effective and less painful treatments. “As the aesthetic market matures, patients seek faster, more reliable, and safer options,” Dr. Kennedy says.

Dr. Kennedy says devices like Lumenis [NuEra Tight](https://lumenis.com/aesthetics/products/nuera-tight/) and [triLift](https://trilift.me/) are more versatile body-contouring options. “NuEra Tight uses temperature-controlled radiofrequency to target both superficial and deep tissue, helping to reduce stubborn fat while tightening the skin, which is a major advantage over CoolSculpting.” Other new aesthetic treatments that utilize radiofrequency (RF) and high-intensity focused electromagnetic energy (HIFEM) or a combination of the two, such as [TruSculpt](https://aedit.com/procedure/trusculpt) and [EmSculpt NEO](https://aedit.com/aedition/what-its-like-to-get-emsculpt-neo), also target stubborn fat pockets and improve muscle tone and strength.

Dr. Kennedy adds that while triLift is often used for facial rejuvenation, it's dynamic muscle stimulation and RF technology make it suitable for toning and firming areas of the body that have lost definition due to aging or weight loss. "These technologies offer more holistic, customizable, and safer results than traditional cryolipolysis.”

### *Why is CoolSculpting controversial?*

According to Dr. Kennedy, there has been a decline in the treatment's popularity due to mixed results and reports of rare but serious side effects like paradoxical adipose hyperplasia (treated fat cells that grow larger). “Most patients require multiple sessions and may see inconsistent outcomes, especially in smaller or less defined treatment areas.” Since CoolSculpting relies on cold to destroy fat, it can also cause long-term numbness, pain, and a visible delineation in the skin between the treated and surrounding areas.

# **SKIN TIGHTENERS**

The uptick in GLP-1s and weight loss therapies leads to increased sagging and loose skin, leading to non-invasive treatments to tighten things up.

What are the latest treatments for sagging skin due to weight loss?
Several advanced skincare technology devices make achieving smoother, firmer skin easier than ever after losing weight. Ultrasound-based treatments such as [Sofwave](https://aedit.com/aedition/sofwave-for-skin-tightening-collagen-production) tighten slack skin by delivering focused energy below the surface without puncturing the skin. Dr. Kennedy shares that stimulating collagen lifts and firms areas like the stomach or jawline over time. “Non-invasive ultrasound treatments have little to no recovery, although the results may appear more slowly and be less dramatic in cases of significant skin laxity.”

RF microneedling treatments like [Morpheus8](https://offer.inmodemd.com/morpheus8?utm_source=google&utm_medium=cpc&utm_campaign=FFG%20-%20Workstations%20Search%20-%20B2B%20-%200503_Morpheus8%20Ad%20Group&utm_content=734000547587&utm_term=morpheus8&campaignid=17689575343&adgroupid=147635101127&adid=734000547587&gad_source=1&gad_campaignid=17689575343&gbraid=0AAAAADqbadgj6J4675yzcC8TEkbQoazak&gclid=CjwKCAjwo4rCBhAbEiwAxhJlCXSfeSYWcLPHdrKn12gzRk9zuphHey2qgIidAOMkPMHhW9vaBI40UxoCvyEQAvD_BwE), [Profound RF](https://candelamedical.com/press-releases/candela-introduces-the-new-fda-cleared-profound-matrix-system/), [Sylfirm X](https://www.sylfirm-x.com/), and [Genius RF](https://www.lutronic.com/us/provider/product-line/genius-rf/) can also tighten sagging skin. RF microneedling uses tiny needles to deliver radiofrequency energy deep into the skin, triggering collagen production and tightening tissue while improving texture and tone. “It is ideal for addressing both laxity and surface-level concerns, but it may involve some redness or downtime,” Dr. Kennedy adds.

# **FACIAL TREATMENTS**

Some of the most popular facial medspa trends for 2025 may sound far-fetched and employ off-the-cuff ingredients and technologies, but all signs point to them replacing outdated beauty treatments.

### *Are vampire facials still popular? Or is there a new trend?*

The vampire facial, which uses PRP to rejuvenate the skin, is phasing out as exosomes are gaining popularity. Exosomes are more powerful than PRP and can regenerate and rejuvenate the skin, making them one of the most popular cosmetic procedures for 2025. “Exosomes, which are extracellular vesicles rich in growth factors, stem cell-derived proteins, and signaling molecules, offer more dramatic improvement in skin tone, texture, and healing when paired with [microneedling](https://aedit.com/aedition/difference-between-professional-microneedling-at-home-dermarolling), especially in patients with lower platelet quality or age-related changes,” Dr. Kennedy explains. 

Salmon DNA, aka [salmon sperm facials](https://aedit.com/aedition/the-salmon-sperm-facial-what-are-polynucleotides-and-is-this-trending), is also on the up and up. “Salmon DNA is rich in polynucleotides, which are molecules that support skin regeneration and hydration,” says Dr. Kennedy. When used with microneedling, he says they help repair the skin barrier, reduce inflammation, and improve elasticity. “Early results and studies look promising, but there’s also the novelty factor here. While trendy, the science is still catching up compared to more established regenerative treatments.”

### *Is microdermabrasion still effective?*

You’ll be hard-pressed to find a medspa that still offers [microdermabrasion ](https://aedit.com/aedition/difference-between-dermabrasion-microdermabrasion)since the once-popular skin treatment has been replaced by beauty treatments that are more advanced and better for the skin. Microdermabrasion is an older way of exfoliating the skin and has the potential for over-exfoliation, skin tears, and limited depth.

### *What is replacing microdermabrasion in modern skincare?*

Advanced skincare technologies that replace microdermabrasion offer exfoliating benefits with improved strength, potency, and precision, including customized [chemical peels](https://aedit.com/aedition/guide-to-superficial-medium-deep-chemical-peels), [Hydrafacials](https://aedit.com/procedure/hydrafacial), [DiamondGlow](https://www.diamondglow.com/), and carbon laser facials.

Hydrafacial: This non-invasive treatment is like microdermabrasion but far less abrasive on the skin. A specialized wand uses vacuum pressure to extract impurities from the pores while infusing the skin with serums, resulting in better results than microdermabrasion.

1. **Chemical peels:** Depending on their depth, chemical peels offer stronger exfoliation that can be customized to meet the skin's needs. They can also help renew the skin and treat concerns such as acne, acne scars, sun damage, discoloration, fine lines, and dull texture.
2. **DiamondGlow:** DiamondGlow rejuvenates the skin through chemical exfoliation with a diamond-tipped handheld piece, high-powered suction, and an infusion of SkinMedica Pro-Infusion Serums.
3. **Carbon Laser facial:** This relatively new aesthetic treatment starts with a layer of carbon paste and is followed by a pass of a laser to target fine lines, pigment, acne scars, redness, and more. Although it doesn’t exfoliate the skin, it breaks down skin impurities and reaches deeper into the skin for a brighter, smoother complexion.

### *Is microneedling still relevant, or has it been replaced?*

Microneedling is far from being considered an outdated medspa treatment, yet it has evolved from the original devices and machines that put the skin treatment on the map. Gone are the days of treating the skin solely with microneedling and using dermarollers in-office, which Dr. Kennedy shares are inconsistent in needle depth and offer limited collagen stimulation, and in its place comes energy-based, RF microneedling devices. “In the hands of an experienced provider, microneedling still plays a valuable role, especially when paired with regenerative serums or exosomes.”

### *Are LED facials still effective, or are there better options?*

[LED facials](https://aedit.com/aedition/difference-between-professional-at-home-led-therapy) may be considered an outdated medspa treatment since they aren’t performed as commonly as other non-invasive treatments. For the most part, replaced beauty treatments like Intense Pulsed Light (IPL), biohacking facials, which are infused with peptides, growth factors, and NAD to stimulate deep cellular repair, and RF therapies have put LED facials on the back burner. Whereas LED facials target acne, minimal wrinkles, and inflammation and help improve skin texture, IPL and RF firms help tighten the skin.

# **CONCLUSION**

In the fast-paced world of beauty and wellness, staying informed is essential if you want to get the most out of your medspa experience. As outdated treatments make way for newer, more effective, and often more personalized solutions, knowing which trends are rising—and which are fading—is the key to achieving optimal results. The innovations defining 2025’s aesthetic landscape prioritize safety, science-backed efficacy, and natural-looking outcomes. Whether you're a seasoned medspa visitor or just exploring the possibilities, embracing the latest technologies and techniques ensures you won’t just look your best—you’ll feel empowered doing it. So before your next appointment, take a moment to reassess your go-to treatments; the future of beauty is here, and it’s smarter, sleeker, and more sophisticated than ever.


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Discover which medspa treatments are becoming outdated in 2025—and explore the innovative, effective aesthetic procedures taking their place. Learn what’s worth your time and money in the evolving world of beauty.

Outdated Medspa Treatments to Avoid in 2025 — And What to Try Instead

Top Outdated Medspa Treatments—and the Modern Aesthetic Procedures Replacing Them in 2025

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Whether you go by [before and after](https://aedit.com/aedition/importance-of-before-and-after-photos-in-plastic-surgery) photos, online reviews, or recommendations from friends, getting an honest opinion about a product is a crucial part of the decision-making process. In a nutshell, trust is essential – especially when products promise to deliver results that rival in-office procedures. In recent years, body-focused creams have been the buzziest product on the market promising to address crepiness, cellulite, stretch marks, and a plethora of other concerns (that are completely normal) so it’s no wonder that there have been skeptics debunking these claims. 

However, if the skin-firming creams utilize the same ingredients as our favorite face-focused products that address crepiness, loss of laxity, and firmness, shouldn’t they also work? Here’s what you should know.  

## **What Skin-Firming Creams Can And Can’t Do** 

Firming creams can provide just that, a taught appearance by moisturizing and nourishing the skin with good-for-you ingredients. Similar to skincare products, they won’t work the same for all and results vary but the aim is to address collagen and elastin production as it slows down with age. “Rome wasn’t built in a day, and neither was your booty, right? To rebuild skin elasticity, it can take up to 56 days,” explains Jessie Reder, the VP of Product Development and Regulatory for [MAËLYS](https://www.maelyscosmetics.com/). She notes that it’s possible for products to help improve the appearance of certain skin concerns as “technology has unlocked all kinds of powerhouse ingredients that communicate directly with our skin.” 

“You see, our skin loses elasticity but gains in volume over time, and if you don’t have any [ingredients](https://aedit.com/aedition/category/read-the-label) that support your collagen, that’s when you start to see a saggy or droopy look,” explains Reder. The goal of these products is not to transform but rather to give the skin the ingredients it needs to rebuild and strengthen which can manifest as radiant, taught skin. With MAËLYS products, the ingredients are the stars, adds Reder. “They protect the skin from environmental aggressors, bring strength-building treats like amino acids, calm it before it has a meltdown, and encourage collagen to snap back in place.” 

Now it’s also valid to note that creams these creams can’t compete with in-office procedures like [QWO](https://aedit.com/aedition/what-its-like-to-get-qwo-for-cellulite), [EmSculpt](https://aedit.com/aedition/what-its-like-to-get-emsculpt-neo), or [truSculpt](https://aedit.com/aedition/what-its-like-to-get-trusculpt-flex-butt-lift) but can be a bonus add-on. [Sonage](https://sonage.com/) co-founder, Anisha Khanna notes that certain products that utilize proven ingredients and have been clinically tested can be paired with these non-invasive procedures. “Our [Jolie Body Contour Crème]((https://sonage.com/products/jolie-contour-body-firming-cream?_pos=1&_sid=8f69eeeff&_ss=r) is a complementary addition to an -in-office treatment (such as radiofrequency or Emsculpt) to help keep the skin well moisturized, firm, and even-toned.” It’s an affordable option for those looking for modest improvements or “those who aren’t ready for an in-office treatment, or can’t readily access a medispa.” After all, even in-office procedures require time for results to be visible, so it’s important to remember that with these creams as well. 

## **How To Find The Right Skin-Firming Cream For You** 

Searching for a product you can trust is like dating, not every one will be a fit and only time will tell whether it’s working or not. Here’s what you should know about adding skin-firming creams to your routine.  

**Check The Label:**: Potent ingredients and their delivery system are the backbones of skin-firming creams. “We work with active ingredients that were tested in specific areas of the body,” explains Reder. “Then we clinically test the product on the specific area of the body – so in arms, we look at loose, crepey skin, and the circumference of the upper arm.” It may seem that all skin is created equal but it’s not with various areas requiring a methodic approach.
**Do Your Research:** The same way we’d do research on an injectable treatment or a cosmetic procedure, we should be doing for the products we put on our bodies. If a brand is worth its salt, the proof will be there. “Brands that are serious about results will prove it with a clinical study, a self-perception study, or both,” explains Reder. We know that brands often blur the lines with their data so Reder notes that “high-performance ingredients and rigorous testing do come at a cost, so if you’re looking at a prestige brand with a higher price point, make sure that it is because they substantiate their results.” Additionally, she recommends seeing checking reviews from others who have tried the products themselves. “My favorite part about our community is when they share their before and after pictures. This is authentic content from people who are so excited to share their success stories.”
**Use As Instructed:** “Proper application is essential for maximum results,” explains Khanna. After all, you wouldn’t skip your SPF every day, so why would other creams that require daily use be any different? Some require daily use, others can benefit from twice a day and should be used accordngly. Khanna recommends massaging the cream into the skin. “Using the recommended self-massage technique can aid in lymphatic drainage and assist in optimum product application for maximum benefit.”  
**Set Your Expectations:** It’s natural to hear the word ‘firming’ and immediately assume the results will rival those of in-office procedures but set your expectations accordingly. While Reder notes that results can be seen in a relatively short period of time, it’s not a guarantee. “We see clinical results at both 28 and 56-day marks, but everyone is different.”  

## **The Takeaway** 

While we’d all love a miracle cream that has the transformative powers of hours in the gym and a clean diet, the reality is: that there’s no such thing. To put the onus on a single cream to instantly tone and [tighten](https://aedit.com/aedition/toning-stomach-skin-after-weight-loss) the dermis in a matter of days is unrealistic by any standards – even [in-office](https://aedit.com/aedition/best-nonsurgical-skin-tightening-procedures) procedures can’t always deliver those results. What skin-firming creams offer is a boost of potent ingredients targeted to nourish the skin and improve the appearance of crepiness, elasticity, and wrinkles. Though not all creams will provide drastic results, they can have other benefits Khanna adds.”These self-care rituals not only help the body but the mind, as well. Take a few minutes to care for your body with the same commitment to above-neck skincare.” 


Do Skin-Firming Creams Really Work?

Do Skin-Firming Creams Actually Work? 

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Thinking about a [tummy tuck](https://aedit.com/aedition/tummy-tuck-recovery-healing-process) post-pregnancy or weight loss? Or perhaps a sculpting [liposuction](https://aedit.com/aedition/high-definition-liposuction-techniques-for-body-contouring) session? In your research, you may have come across something called a seroma. If you’ve had surgery, maybe you’ve even experienced it first hand. It can be likened to having a puddle inside of you. A seroma is “a build-up of tissue or healing fluid inside the body, which can happen after surgical procedures of any type,” says [Ryan Neinstein, MD](https://neinsteinplasticsurgery.com/), a board certified plastic and reconstructive surgeon in New York City. 

One of the most common [cosmetic surgery complications](https://aedit.com/aedition/guide-to-cosmetic-surgery-complications), a seroma is most likely to occur after [body contouring surgeries](https://aedit.com/procedure/body-contouring-solutions). Here, we’ll talk more about what a seroma is, why it happens, and what you can do to avoid it. 

## **What Causes a Seroma?**
“Seroma is a collection of normal body fluid that accumulates in dead spaces,” says [Elise Min, MD](https://www.drcassileth.com/surgeons/dr-elise-min.html), board certified plastic and reconstructive surgeon at Cassileth Plastic Surgery in Beverly Hills. The clear (i.e. serous) fluid pools under the skin and is usually found near incisions. It can happen soon after surgery or, in some cases, weeks later.

While it’s natural for some amount of body fluid to accumulate at a surgical site, it becomes problematic if it does not subside. “Generally, [the fluids] get reabsorbed by the body in the postoperative period and go away on its own,” Dr. Min explains. “Sometimes, too much fluid can accumulate and form a pocket of fluid collection.” This is most common, she adds, after operations “where a surgical space is created” due to tissue removal. In cosmetic surgery, this can include:

- [Abdominoplasty](https://aedit.com/procedure/abdominoplasty) (a.k.a. tummy tuck) 
- Breast surgery 
- Lifts (such as [arm lift](https://aedit.com/procedure/arm-lift), [butt lift](https://aedit.com/procedure/butt-lift), or [thigh lift](https://aedit.com/procedure/thigh-lift))
- [Liposuction](https://aedit.com/procedure/liposuction) 

As Dr. Neinstein explains, our bodies respond to the inflammation from surgery by creating fluid and scar tissue. “When the healing capacity is overwhelmed, the fluid becomes apparent and a seroma develops,” he shares. “This can happen because surgery was aggressive, too much energy – such as a laser – was applied, no drains were used, or improper garments or aftercare were applied.” Other times, he says, seromas can happen for no reason at all.

## **Symptoms of a Seroma After Cosmetic Surgery**
While they can usually be identified via a physical exam, an ultrasound may be needed to confirm a seroma diagnosis. Most seromas don’t pose a health risk to the patient. They usually look like a swollen lump and feel like a cyst that may or may not be tender to the touch. Clear discharge is common and changes in color may be indicative of an infection that requires medical attention. If the seroma becomes infected, it may look red and feel painful and/or warm to the touch. An infected seromas can lead to the formation of an abscess.

## **How to Treat a Sermona After Cosmetic Surgery** 
How a seroma is treated depends on its size. A small seroma usually goes away on its own with compression, but larger ones may need professional intervention. “Some may require aspiration in the clinic by the physician,” Dr. Mi says. Dr. Neinstein says that seromas can be dealt with in a minor office procedure where the fluid is drained and pressure is applied through dressings and garments to prevent re-accumulation.

If a large or infected seroma is left untreated, it may eventually require a full removal of the seroma and the fibrous [capsule](https://aedit.com/aedition/capsular-contracture-breast-implants) that comes to surround it, Dr. Min cautions. In very rare cases, calcification (read: hardening) of the fluid may occur. “Once in a while, the seroma can harden and form a scar ball inside that may need to be removed surgically,” Dr. Neinstein notes. “Luckily, these are rare.”

## **How to Prevent a Seroma After Cosmetic Surgery**
In the case of seroma, like so many things, the best treatment is prevention. That prevention begins in the operating room. In his textbook chapters and masterclasses on liposuction, Dr. Neinstein shares many strategies to reduce the occurrence of seroma. “It all starts with finesse surgical technique and gentle handling of tissues,” he says. “After this, I discuss an outlet for surgical fluid to get out.” Those outlets can include various forms of drains or leaving small liposuction sites open so that excess fluid can drain. 

Dr. Min adds that surgeons try to prevent seromas by either placing drains in the surgical space or by placing progressive tension sutures in the surgical site internally. “All of the techniques strive to minimize the dead space created during the surgery,” she says. 

After surgery, [lymphatic drainage massages](https://aedit.com/aedition/benefits-of-lymphatic-drainage-massages-after-cosmetic-surgery) can help reduce the risk of seroma by promoting healing, Dr. Neinstein says. Additionally, it’s important to follow your post-op instructions to a T. Beyond healthy eating and [proper rest](https://aedit.com/aedition/sleeping-better-after-cosmetic-surgery-aesthetic-procedures), they will likely include recommendations for elevating the treatment area and wearing compression garments and tell you when to return to your surgeon to have drains removed. If you need help assembling your post-op recovery kit, we’ve got guides to the best [meal plans](https://aedit.com/aedition/meal-plans-diet-before-after-cosmetic-surgery), [pillows](https://aedit.com/aedition/best-pillows-for-plastic-sugery-recovery-healing), and [compression garments](https://aedit.com/aedition/benefits-of-compression-garments-after-cosmetic-surgery) to consider after cosmetic surgery.

It should be noted that, in some cases, seroma is unavoidable – no matter your surgeon's or your own best efforts. If you think you might have a seroma, contact your provider. Early diagnosis and treatment can be key to preventing infection. 

Aesthetics

There is much that can be done to prevent the common complication.

The Risk Of Seroma After Cosmetic Surgery

What To Know About The Risk Of Seroma After Cosmetic Surgery

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Hot right now — literally and figuratively — is radiofrequency (RF)-based aesthetic treatments. Part of the allure? It’s host of benefits, sans surgery. “The final frontier in aesthetic medicine is the non-surgical rejuvenation and tightening of skin along with fat reduction,” says [Ryan Neinstein, MD](https://neinsteinplasticsurgery.com/?gclid=Cj0KCQiAweaNBhDEARIsAJ5hwbeRtsR4ZnReWqZyMJssBYHmW_08Ey3LQTnyi08ZlkwEuG4hj6EUVqkaAtdPEALw_wcB), a board certified plastic and reconstructive surgeon in New York City. What once took multiple modalities, can now be achieved in a single step.
 
In the past, [ultrasound](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy) and [lasers](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing) have been used to induce skin injury as a means to remodel the skin firmer than it was prior to treatment, while [cryolipolysis](https://aedit.com/procedure/cool-sculpting), or forced cooling, of selective tissue has been a go-to for fat reduction. “These modalities, while important in the evolution of what we use today, have fallen out of favor for best-in-class, up-to-date aesthetic medicine,” Dr. Neinstein explains. Our understanding of collagen aging and stretch, he notes, has allowed for the development of new solutions. “Building on pioneering science in the field of fat metabolism, new technologies have allowed more robust non-surgical treatments without the complications of traditional modalities,” he says. 

Here, we’ll cover what radiofrequency is, how it’s used in aesthetic medicine, and some popular treatments top dermatologists and plastic surgeons are offering in-office now. 

## **What Is Radiofrequency?** 
Radiofrequency (RF) energy is part of the electromagnetic spectrum. In daily life, it can be found in WiFi signals, radio and TV waves, and microwave ovens. Because RF energy can be delivered through various types of tissue (i.e. skin, fat, and muscle) to generate thermal energy, it has also been used in just about every medical speciality — [including aesthetics](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7489578/). 
 
Despite all of the recent buzz around RF to address cosmetic concerns, it's nothing new. In 2002, the United States Food and Drug Administration (FDA) approved the ThermaCool™ (a.k.a. [Thermage®](https://www.thermage.com/#home)), the first monopolar RF device for wrinkle reduction. Needless to say, the technology has evolved ever since. During a radiofrequency [skin tightening procedure](https://aedit.com/aedition/best-nonsurgical-skin-tightening-procedures), heat is used to encourage the production of new collagen and elastin. When RF energy is directed to subdermal adipose tissue, meanwhile, it leads to fat necrosis without burning or injuring the epidermis. 
 
Because of the lower frequency of RF, it can safely be used on a wide range of skin tones. “The RF and RF microneedling treatments are usually safe for patients of all skin types as opposed to lasers, which work best for patients with lighter skin types,” says [Jennifer Levine, MD](https://www.drjenniferlevine.com/), a double board certified facial plastic and reconstructive surgeon in NYC. For all these reasons, RF devices have earned a spot in many dermatology and plastic surgery practices. 

## **Types of Radiofrequency Treatments**
As we’ve covered, radiofrequency can be used to tighten the skin, reduce fat, or a combination of the two on both the face and body. Below is a roundup of some of the most popular RF treatments on the market today:
 
### **1. Evoke**
[InMode Evoke](https://aedit.com/aedition/evoke-radio-frequency-for-jawline-neck-skin-tightening) uses RF technology to stimulate collagen and lift and tighten the skin around the cheeks, jawline, and jowls. “It uses artificial intelligence to maintain a constant temperature, which promotes collagen production,” Dr. Levine says. During a session, “radiofrequency energy is delivered to the treatment area, penetrating the layers under the skin’s surface to remodel the tissue and muscle in the area, resulting in smoother skin texture, toned, tighter skin and more defined facial features,” explains [Bruce Katz, MD](https://www.instagram.com/juvaskinandlasercenter/), an NYC-based board certified dermatologist. “It’s great for someone who wants a more youthful appearance, with a quick treatment time and no downtime.”
 
Dr. Levine sees Evoke as a contouring treatment and says it works best for fuller faces with mild to moderate laxity, and Dr. Katz says those who are concerned about their lower face tend to see the best results. “The procedure excels at tightening and defining the [jawline area](https://aedit.com/concern/neck-and-jawline-definition),” he shares. Who isn’t a good candidate? “If a patient needs to lose a significant amount of weight to help shape the face, Evoke is not the ideal procedure for that patient,” he adds. 
 
### **2. EmSculpt Neo®**
The original [Emsculpt®](https://aedit.com/aedition/why-everyone-is-talking-about-emsculpt) employed high-intensity focused electromagnetic (HIFEM) technology to build muscle, and the latest iteration of the device, [Emsculpt Neo®](https://aedit.com/aedition/what-its-like-to-get-emsculpt-neo), combines HIFEM with — you guessed it — RF to simultaneously tone muscles while melting away fat in a manner that board certified dermatologist [Kenneth Mark, MD](https://kennethmarkmd.com/), calls “unparalleled.” 
 
As you may have heard, “the HIFEM aspect of the device causes muscles to contract at an incredibly rapid speed that no one could replicate with an at-home workout for visibly toned muscles — 20,000 in 30 minutes,” says Toronto-based board certified dermatologist [Geeta Yadav, MD](https://skinscience.ca/). “The radiofrequency works in tandem to heat the overlying fat on the muscles, which causes the fat cells to die, making the patient look even more toned.” It is meant to be used on the arms, abdomen, buttocks, and calves, she adds.
 
An initial series of at least four treatments (though up to six may benefit some) are needed to see results. From there, one session every few months will help maintain your toned muscles, Dr. Yadav says. Speaking of results, you will notice some of the strengthening benefits within a few weeks of your final treatment, but it takes three months for the full effect of the fat reduction to present.
 
All of our experts agree that Emsculpt Neo® works best for patients who are already in shape and looking to target a stubborn area. For patients with more than a little pinchable fat, Dr. Neinstein suggests performing liposuction first for maximum results. “If someone is overweight or has a BMI of over 35, Emsculpt Neo® will not deliver the desired results,” Dr. Katz notes. While it’s safe for all skin tones, Dr. Levine says it can not be used on patients who have metal near the area of treatment. 
 
### **3. RF Microneedling**
While radiofrequency alone has skin tightening benefits, [RF microneedling](https://aedit.com/procedure/microneedling-with-radiofrequency) combines the powers of the two minimally invasive collagen-stimulating treatments. “This procedure causes controlled trauma to the skin with microneedling, which stimulates your body's healing response,” Dr. Yadav says, adding that [Infini™ RF](https://aedit.com/procedure/infini-rf) is her technology of choice. 
 
It is ideal for treating [skin texture concerns](https://aedit.com/concern/uneven-skin-texture). “We have multiple radiofrequency platforms, such as Vivace® Microneedling RF, VirtueRF, and Morpheus8,” says [Paul Jarrod Frank, MD](https://pfrankmd.com/), a board certified dermatologist in NYC. “We use them to treat acne scars, enlarged pores, scars, and crepey skin on the face, neck, chest, inner arms, and above the [knees](https://aedit.com/aedition/best-cosmetic-procedures-for-knees).” 
 
Another benefit? “When it comes to skin tone, most radiofrequency devices are color blind and can be used on various skin tones,” Dr. Frank adds. When treating [Fitzpatrick skin types](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types) III and IV (including Asian, Indian, and melasma-prone skin), he and his team adjust the heat to avoid unwanted discoloration. “It is rare for [hyperpigmentation](https://aedit.com/aedition/guide-to-hyperpigmentation-dark-spots-melasma) to happen and most microneedling devices now have insulated needles, which allows consistent distribution of heat and mitigates a lot of the risk,” he explains. 

Dr. Mark, who offers Infini™ RF at his practice, says multiple treatments will be needed to see results. “It stimulates collagen to help tighten the skin to reduce fine lines and wrinkles,” he explains. “When done as a series of three or four sessions spaced roughly a month apart, some lifting can also be accomplished.” 

## **The Takeaway**
At this point you’ve hopefully gleaned that not all radiofrequency treatments are the same. “For example, some go to a different depth, some are a different temperature, some devices combine microneedling or acoustic wave technologies,” Dr. Frank says. RF alone stimulates collagen and firms the skin, but, “when combined with microneedling, it will reduce pores, scars, uneven skin tone, and fine lines,” he adds. 
 
As with any non-surgical treatment, there are limitations. “If someone is severely wrinkled, they will not get near the benefit of a [fractional ablative CO2 laser](https://aedit.com/procedure/ablative-co2-laser), period,” Dr. Mark cautions. With that said, RF still has value. “For the patient who is not that wrinkled and/or cannot afford the downtime of that laser, the radiofrequency, when combined with microneedling, is an awesome compromise,” he says. Consulting with a board dermatologist or plastic surgeon will help determine whether you are a candidate.

Minimally invasive RF treatments can tighten skin and reduce fat without any downtime. Here's what you need to know.

Guide To Radiofrequency Skin Tightening And Fat Reduction

Why Everyone Is Talking About Radiofrequency

shutterstock 1589823085

As we enter 2022, what big trends in aesthetic medicine will the new year bring? “Greater transparency about plastic surgery procedures in general,” says [Jennifer Levine, MD](https://www.drjenniferlevine.com/), a double board certified facial plastic and reconstructive surgeon in New York City. “People are more willing to discuss having it.” Look no further than [Marc Jacobs’ candid chronicling](https://aedit.com/aedition/marc-jacobs-facelift) of his deep plane facelift and subsequent recovery to see that this (very welcome) trend already has roots.  

A more mindful approach is also on the minds of many, says NYC-based board certified plastic and reconstructive surgeon [Ryan Neinstein, MD](https://neinsteinplasticsurgery.com/). “As we enter 2022, we all have a greater sense of the importance of health and wellness highlighted by the pandemic,” he explains. “An extension of wellness is our sense of self” — which leads us to the procedures themselves. Dr. Levine sees continued interest in the more invasive end of the spectrum as our ‘new normal’ takes hold. Between masks and Zoom, “some people just want the best results and are willing to have the downtime to achieve them,” she shares. 

To learn more about what to expect from the aesthetic space in the year ahead, we tapped some of the biggest names in plastic surgery to get their takes on what they foresee to be new and next for face and body in 2022.

## **For Face**
For the most rejuvenating and natural-looking results, expect more patients to opt for clever combinations of surgical and non-surgical procedures that look good on Zoom and in real life. Here’s what 2022 has in store for the face:

### **1. Nasal Rejuvenation Surgery**
Those who wish to address the [aesthetic or function](https://aedit.com/aedition/difference-between-cosmetic-rhinoplasty-vs-functional-rhinoplasty) of their nose often do so earlier in life, but, like any part of the face (and body), the appearance of the nose changes with age. [Dara Liotta, MD](https://www.facialplasticsnyc.com/), a double board certified facial plastic and reconstructive surgeon in NYC, says she’s seeing a rise of patients in their [forties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-40s) and [fifties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-50s-60s-70s) coming in for what she calls “[nasal rejuvenation surgery](https://aedit.com/procedure/rejuvenation-rhinoplasty).” As she explains, the goal is not so much to “change their look” but rather “to get back to the more refined and airbrushed look that they had when they were younger.” 

One possible reason for the trend? Zoom culture, which has people staring at themselves in ways they hadn’t previously. “These aren’t the patients obsessed with their selfies and striving for perfection,” Dr. Liotta notes. “These patients don’t want a rhinoplasty to look different.” As we age, she says two things happen to the nose:

- **Thinning Skin**: The first is that our skin thins, “and this can unearth irregularities that we didn’t see before — such as a bump on the nose, a little twist or asymmetry in the tip of the nose, or a ridge or depression that it seems we didn’t have when we were younger,” she explains.  
- **Relaxing Cartilage**: The second thing is that the cartilage of the nose loses a bit of its structure. “This can cause the midportion of the nose to begin to look a little pinched or asymmetric,” Dr. Liotta shares. Additionally, “the ribbons of cartilage that make up the tip of the nose can relax outward and downward, making the tip of the nose look rounder, wider, and ‘droopier’ than it used to,” she notes. 

This relaxation of cartilage can also cause [breathing difficulties](https://aedit.com/concern/breathing-issues) to emerge or worsen. “Nasal rejuvenation surgery also optimizes the breathing, restoring structure and support not only to improve aesthetics but to improve breathing as well,” Dr. Liotta adds. 

### **2. The Anti-Zoom Boom**
In late-2020 and throughout 2021, we talked a lot about the so-called ‘[Zoom Boom](https://aedit.com/aedition/aedit-survey-reveals-how-2020-altered-aesthetic-landscape)’ in aesthetic medicine. 2022 may prove to be the antidote to that. [Norman Rowe, MD](https://www.normanrowemd.com/), a board certified plastic and reconstructive surgeon with offices in New York and New Jersey, says that the ‘Anti-Zoom Boom’ is related to the return of in-person events. During the pandemic, we could hide behind our computer screens, but, as in-person events, work, and holiday gatherings ramp up, people are flocking to get ‘[tweakments](https://aedit.com/aedition/non-surgical-cosmetic-procedures-to-get-for-the-holidays)’ like lasers, fillers, and neurotoxins to tighten, lift, and smooth features on their face. The goal: To look and feel your best — in real life. 

### **3. Move Over PRP**
At this point, you’ve likely heard of platelet-rich plasma (PRP). The procedure involves taking a blood sample from the patient (usually the arm or some other non-invasive locale) and putting it into a centrifuge to isolate the platelet-rich plasma. The PRP solution can be applied topically or injected into various parts of the body. A few of the most buzzed about? It’s injected into the scalp to [promote hair growth](https://aedit.com/aedition/kourtney-kardashian-prp-injections-to-treat-hair-loss); it’s rubbed on the face [after microneedling](https://aedit.com/procedure/microneedling-with-prp) for a rejuvenating effect; and it can even be injected into the penile shaft ([P-Shot](https://aedit.com/aedition/p-shot-prp-penis-injections-erectile-dysfunction)) or vagina, clitoris, and labia ([O-Shot](https://aedit.com/aedition/o-shot-for-vaginal-rejuvenation)) to improve sexual wellness.

In 2022, expect to hear a lot more about PRP’s cousin, [platelet-rich fibrin (PRF)](https://pubmed.ncbi.nlm.nih.gov/31280847/), Dr. Levine says. PRF contains a higher concentration of white blood cells and fibrin than PRP, and it also includes a small number of stem cells that boost its wound-healing and skin-rejuvenation benefits. Additionally, Dr. Levine says to keep an ear out for more talk of exosomes and collagen-stimulating procedures.

### **4. The Rise of Chin Enhancement**
[Chin enhancement](https://aedit.com/aedition/best-chin-augmentation-enhancement-procedures) procedures gained popularity during the pandemic, and the interest hasn’t waned. “There is increased interest in the chin area and recognition that a bit of increased chin projection can help balance the profile,” Dr. Liotta explains. The chin has long been an underappreciated facial feature, but it’s finally getting its due. In addition to improving overall [facial harmony](https://aedit.com/aedition/facial-harmony-in-aesthetic-medicine), “a strong chin helps make our neck look longer and our submental angle look deeper,” she says. For temporary improvement, [chin filler](https://aedit.com/procedure/chin-augmentation-with-soft-tissue-fillers) is an option. Those looking for permanent prominence, meanwhile, can achieve it with a [chin implant](https://aedit.com/procedure/alloplastic-chin-implant).

### **5. Combination Procedures**
Whether it's minimally invasive treatments or surgeries, there are many reasons to consider combining or stacking procedures. For starters, it allows you to [make the most of your time in the office](https://aedit.com/aedition/best-aesthetic-procedures-to-combine-to-maximize-appointments), consolidate recovery, and maybe even save a bit of money (in the case of surgery, for example, anesthesia will only need to be administered once). “People feel if they are going to have downtime, they may want to add something on,” Dr. Levine says. And, when it comes to results, strategic combinations can yield even better benefits.

On the non-surgical side, Dr. Levine says patients are realizing that it’s probably not enough to just do injectable [neuromodulators](https://aedit.com/aedition/where-to-use-botox-from-head-to-toe) and [fillers](https://aedit.com/aedition/hyaluronic-acid-filler-vs-biostimulatory-injectables). Instead, adding [lasers](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing) or [micro-focused ultrasound](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy) or radiofrequency (or all of the above) may be best. “These are customizable to the individual patient,” Dr. Levine notes. Fat reduction with skin tightening for the body is another popular combination, she adds.

Dr. Liotta says that it’s common to [combine rhinoplasty and chin augmentation](https://aedit.com/aedition/combining-rhinoplasty-and-chin-augmentation), plus or minus [submental liposuction](https://aedit.com/procedure/submental-liposuction). She calls this trio a “profile makeover.” In the right patient, “combining these procedures helps balance the profile, and allows the results of the individual procedures to make the greatest impact,” Dr. Liotta says. It also leads to a more natural aesthetic.  “Combining procedures to achieve a more ideal profile can actually help the results of rhinoplasty look more natural — like your profile was meant to be like that,” she adds.

Combining procedures also minimizes downtime — there’s one anesthesia and one recovery — and usually saves a bit of money.  “Who doesn’t like that?” Dr. Liotta says. We’d have to agree.
 
### **6. The Minimally Invasive Brow Lift**
The last couple of years have seen many add ‘brow lift’ to the list of concerns they are looking to treat with neurotoxins. While the so-called [Botox brow lift](https://aedit.com/procedure/chemical-brow-lift) can have a lifting effect, the results are temporary (think: three to four months) and limited (it’s best for younger patients with minimal sagging). So, what’s the alternative? Enter the minimally invasive surgical brow lift. Gone are the days of cutting from ear to ear to lift the upper face. Instead, an [endoscopic brow lift](https://aedit.com/procedure/endoscopic-brow-lift) can achieve substantial and long-lasting brow elevation that rejuvenates the eye, brow, and forehead area with inconspicuous incisions. “It’s minimally invasive, little downtime, and has almost no scar,” Dr. Rowe says.

### **7. New Injectables on the Horizon**
Last year, we welcomed new hyaluronic acid-based fillers (hi, [Restylane® Contour](https://aedit.com/aedition/restylane-contour-cheek-filler)) to the market. In 2022, Dr. Levine says to expect “hyaluronic acid fillers as skin boosters” (as found abroad in treatments like Juvéderm® Volite and ProfHilo®), CaHA (“combining calcium fillers with HA fillers”), and “hyper-diluted and [biostimulatory fillers](https://aedit.com/aedition/benefits-of-sculptra-injections) to stimulate collagen and elastin” to be big. 
 
As for [neurotoxins](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin), Revance is seeking approval from the United States Food and Drug Administration (FDA) for daxibotulinum toxin (a.k.a. DAXI), which seeks to improve the longevity of neuromodulators from the standard 12 to 16 weeks to an average of six months. On the flip side, Bonti is a new toxin being developed by Allergan (the maker of Botox®) that should have a quicker onset time (within 24 hours!) but a shorter lifespan (just two to four weeks).  
 
## **For Body** 
Our experts expect lots of surgical and non-surgical body contouring requests this year (the COVID 19 is real) — plus, a modern take on the breast lift.
 
### **8. Cellulite Treatments**
When [Qwo™](https://aedit.com/procedure/qwo), the first-of-its-kind injectable that treats moderate to severe cellulite on the buttocks, received FDA approval in the summer of 2020, patients and providers alike rejoiced at the minimally invasive treatment option that was found to be safe *and* effective. After rolling out to doctors’ offices in 2021 ([read about one beauty editor’s experience](https://aedit.com/aedition/qwo-for-cellulite-before-and-after-photos)), Dr. Rowe expects the procedure to get even more popular in 2022. “It is quick and easy and is really the only effective treatment,” he shares. While it may be the best in the business at the moment, Dr. Levine says to stay tuned. “There may be other treatments coming out,” she forecasts. 

### **9. The Lipoabdominoplasty**
A traditional [abdominoplasty](https://aedit.com/procedure/abdominoplasty) (a.k.a. tummy tuck) is known for removing excess skin and tightening the abdominal muscles, but what if fat is your primary concern? Meet the lipoabdominoplasty. “It’s the thinner version of the old tummy tuck,” says [Lisa Cassileth, MD](https://www.drcassileth.com/surgeons/dr-lisa-cassileth.html), a board certified plastic and reconstructive surgeon in Beverly Hills. As she explains, the surgery works well for patients who are looking to remove central fat around the waist in combination with any excess skin. With pandemic-induced weight gain and the continued demise of the American diet, Dr. Cassileth says many patients find that, even with their best efforts, this fat is stubborn and is the new normal for them. The procedure “has the advantage of being able to remove all the fat, whereas tummy tucks focus primarily only on loose skin,” she notes. 
 
### **10. Post-Pandemic Customized Mommy Makeover**
“With the pandemic baby boom, my focus has become the post-pandemic customized [mommy makeover](https://aedit.com/concern/mommy-makeover),” Dr. Neinstein says, adding that a lot of moms come into his office with an ‘if not now when’ mentality since they find themselves unable to achieve their postpartum aesthetic goals with diet and exercise alone. 

To provide better and enhanced care, his practice offers a variety of procedures beyond the traditional tummy tuck and breast augmentation. “With so many fit moms, my common procedures are sculpting of the abdomen and waist or lipo 360 using the powerful energies of Vaser® and Renuvion® along with my innovation of c-section shelf repair and [mini tucks](https://aedit.com/procedure/mini-tummy-tuck),” he explains. In his experience, many women no longer need or want a full tummy tuck. “We can now, with new instruments and techniques, not interfere with the belly button and accomplish their goals,” Dr. Neinstein says. 
 
### **11. The Pocket Lift**
A fresh take on a mastopexy (a.k.a. [breast lift](https://aedit.com/procedure/breast-lift-solutions)), Dr. Cassileth says the so-called pocket lift “holds the breast high” and “looks great” — [sans implant](https://aedit.com/aedition/combining-breast-augmentation-with-breast-lift). “No longer will a patient need an implant to get a great lift,” she shares. During the procedure, the breast tissue is tucked under the pectoral fascia. “This holds the breast up, gives it support, and makes the top of the breast full again,” Dr. Cassileth explains. “Traditionally, breast surgeons used implants for this to work, but the pocket lift gives it a younger, fuller look without the implant.” 
 
The recovery is similar to a traditional lift, about a week of downtime followed by a month of no aerobics or heavy lifting. “The pocket lift is best for those who don’t want a bigger breast, but just want a lift with a great long-term, high result,” Dr. Cassileth notes. It can also be paired with a [breast reduction](https://aedit.com/procedure/breast-reduction-and-revision-solutions). For really ptotic (read: saggy) breasts, a piece of absorbable mesh is used to lock in the lift as the fat is tucked under the breast. “It’s also important to know that this technique, with or without mesh, will not interfere with mammograms,” Dr. Cassileth adds. “The breast tissue is still easily visible through the thin fascia.”
 
### **12. Double Reverse Mini Tuck**
Back to the belly, Dr. Neinstein says the double reverse mini tuck is another take on an abdominoplasty that is increasingly popular. “For women with loose, stubborn skin above the belly button, I can harness the skin-tightening effect of Vaser® and Renuvion® with the hybrid skin removal of a reverse tuck,” he explains. If you’re curious about the incision (and [resulting scar](https://aedit.com/aedition/scarring-after-body-plastic-surgery)), it is well-concealed. “Here, we take the skin out under the breast, hiding the scar in the fold,” he shares. “It typically looks like a scar from a breast augmentation, but it allows me to address their concerns of the abdomen,” he adds. 

### **13. Radiofrequency Skin Tightening**
You are no longer resigned to surgery if you want to treat skin laxity concerns on the body (or face). Dr. Cassileth says that [radiofrequency (RF) skin tightening](https://aedit.com/aedition/best-nonsurgical-skin-tightening-procedures) has continued to improve to the point where she and her team can, in some cases, address loose skin without cutting. Needless to say, not everyone is a candidate, but it can be a great alternative for the right patient. “It works best with thinner skin, like on the arms, which contour easily and lift well with the radiofrequency energy,” she says. 

### **14. ‘Nooks & Crannies’ Surgery**
Patients travel from near and far for Dr. Neinstein’s “nooks and crannies surgery,” as he calls it. Last year, he and his team custom-built instruments and created a safety protocol to perform calf and ankle [liposculpting](https://aedit.com/procedure/liposculpture). “Women are now wearing dresses and shorts for the first time because they have the lean sculpted calves and ankles they have desired but genetically were held back,” he says. “This has been so rewarding.”

Expert Opinion

We tapped the biggest names in plastic surgery to get their take on what’s new and next for face and body this year.

Biggest Medical Aesthetics Trends Of 2022 For Face And Body

The 14 Biggest Medical Aesthetics Trends Of 2022

priscilla-du-preez-Nm69uaNeDbs-unsplash

When it comes to non-surgical [body contouring](https://aedit.com/procedure/body-contouring-solutions) treatments, the lack of downtime is often the draw — and it’s a considerable one! That said, whether you’re heading in for [Emsculpt Neo®](https://aedit.com/aedition/what-its-like-to-get-emsculpt-neo), [CoolSculpting®](https://aedit.com/aedition/what-its-like-to-get-coolsculpting), [Qwo™](https://aedit.com/aedition/qwo-for-cellulite-before-and-after-photos), or any of the other minimally invasive procedures on the market, there are still some post-procedure recommendations that help streamline the recovery process and improve results. 

“Just like surgical procedures, we have extensive information and tips for our patients to better prepare and enjoy the results of these non-surgical procedures,” says [Ryan Neinstein, MD](https://neinsteinplasticsurgery.com/), a board certified plastic and reconstructive surgeon in New York City. While they can be performed alone, he notes that “non-surgical services are the perfect complement to surgical procedures for long-term maintenance and enhancement of results.” 

Here, we caught up with top dermatologists and plastic surgeons to get their best advice on some of the most popular non-surgical body contouring procedures they’re doing of late. 

## **Types of Non-Surgical Body Contouring**
Non-surgical body contouring procedures generally fall into one of the following categories: 

1. Fat freezers via cryolipolysis (think: [CoolSculpting®](https://aedit.com/procedure/cool-sculpting))
2. Fat melters with lasers, radiofrequency (RF), and/or thermal energy (i.e. [SculpSure®](https://aedit.com/procedure/sculpsure), Vanquish™, [TruSculpt®](https://aedit.com/procedure/trusculpt), etc.), 
3. Electromagnetic muscle toners (à la [Emsculpt®](https://aedit.com/procedure/emsculpt)) 
4. Fat-dissolving, cellulite-smoothing, and collagen-building injectables (hi, [Kybella®](https://aedit.com/procedure/kybella), [Qwo™](https://aedit.com/procedure/qwo), hyper-diluted [Radiesse®](https://aedit.com/procedure/radiesse) or [Sculptra®](https://aedit.com/procedure/sculptra))

None of these treatments are for [weight loss](https://aedit.com/aedition/why-you-should-lose-weight-before-plastic-surgery). Instead, they are designed to fine-tune problem areas — like the [stomach](https://aedit.com/procedure/abdominal-slimming-solutions), [thighs](https://aedit.com/procedure/thigh-slimming-solutions), [upper arms](https://aedit.com/procedure/arm-slimming-solutions), or [butt](https://aedit.com/procedure/buttocks-enhancement-solutions) — for a more sculpted appearance. And, while all of these procedures use different technology to destroy unwanted fat, tone muscles, or smooth cellulite, they are all technically considered ‘no downtime’ treatments. Even so, following this advice will help optimize your results:
 
### **1. Hydrate, Hydrate, Hydrate**
The number one piece of post-procedure advice from all of our experts? Drink up. “Stay hydrated during and after the procedure, as it is thought that it may help eliminate fat cells faster,” says [Marie Hayag, MD](https://www.mariehayagmd.com/), a board certified dermatologist in NYC. Water is the beverage of choice, and alcohol should be avoided. 
 
### **2. Skip the Salt**
In the same vein, keep your sodium intake in check. “The body has been placed in a short term inflammatory condition, so we encourage limiting salt intake to essentially zero and refrain from alcohol use for 48 hours,” Dr. Neinstein notes. “Both will contribute to swelling and bloating.” [Paul Jarrod Frank, MD](https://pfrankmd.com/), a NYC-based board certified dermatologist, also emphasizes the importance of avoiding salt, especially in between Emsculpt Neo® treatments.  
 
While you’re at it, lay off sugar and simple carbohydrates that can cause inflammation in favor of a [well-balanced, healing diet](https://aedit.com/aedition/meal-plans-diet-before-after-cosmetic-surgery) that consists of lean protein, plant-based fats, unprocessed carbohydrates, and antioxidant-rich fruits and vegetables (think: vitamins A, C, E).
 
### **3. Avoid the Gym**
While you may be motivated to [hit the gym](https://aedit.com/aedition/when-to-start-exercising-again-after-cosmetic-surgery-procedures) to bolster the results, keep your routine simple (read: restful) for the first day or two. At Dr. Neinstein’s practice, patients are asked to wait 24 hours before exercising in order to allow the metabolic toxins to be flushed out and for muscle recovery. Since the treatment area may be tender, Dr. Hayag says to take it easy and “wear loose, comfortable clothing after the procedure to help minimize any possible soreness.”

### **4. Make Sure to Massage**
Some treatments, including CoolSculpting® and hyper-diluted [biostimulatory injectables](https://aedit.com/aedition/hyaluronic-acid-filler-vs-biostimulatory-injectables) (like the ones found in Dr. Frank's [PFRANKMD BIOSTIM](https://pfrankmd.com/biostimulatory-smoothening-and-tightening/) treatment), require massage during and after treatment to improve the outcome. 
 
For patients who are injected with hyper-diluted Radiesse® and Sculptra®, [Jennifer Levine, MD](https://www.drjenniferlevine.com/), a double board certified facial plastic and reconstructive surgeon in NYC,  preaches the “five-five-five” rule. Massage the treatment area for five minutes, five times a day, for five days. “We generally massage our patients post-treatment,” Dr. Franks adds. But don’t use it as an excuse to go to the spa. “Avoid going to a [masseuse](https://aedit.com/aedition/guide-to-massage-techniques-etiquette) for one to two weeks,” he cautions. 
 
In the case of CoolSculpting®, [studies show](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265298/) that patients who receive post-treatment manual massage enjoy a “consistent and discernible increase” in fat reduction. Data from two and four months later show improved fat destruction of 40 to 70 percent.
 
### **5. Consider Compression**
[Compression garments](https://aedit.com/aedition/benefits-of-compression-garments-after-cosmetic-surgery) are most commonly recommended after surgical body contouring treatments (think: [tummy tucks](https://aedit.com/aedition/tummy-tuck-recovery-healing-process), [arm lifts](https://aedit.com/procedure/arm-lift), [thigh lifts](https://aedit.com/procedure/thigh-lift), and even [liposuction](https://aedit.com/procedure/liposuction)), but certain non-surgical procedures may benefit from it as well. Dr. Levine suggests “some light compression” after Qwo™ injections. Be sure to check with your provider before wearing to ensure it will not interfere with results.
 
### **6. Supplement with Skincare**
You may consider supplementing your body sculpting session with a topical treatment. After Qwo™, for example, Dr. Levine says applying arnica gel to the treatment area can help minimize swelling. She also likes the [Alastin TransForm Body Treatment](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Falastin.com%2Fproducts%2Ftransform-body-treatment), which “has been proven to show improvement in fat reduction” after procedures like EmSculpt Neo®, SculpSure®, and CoolSculpting®.
 
The body cream is also a favorite at Dr. Hayag’s practice. “It enhances and accelerates the results of non-surgical body contouring procedures by supporting the body's natural repair processes,” she says. As she explains, hexapeptide-11 “aids in clearing away fat cells that have been broken down” during treatment, and the formula also helps “improve skin's hydration levels, crepiness, and overall texture.” 
 
*All products featured are independently selected by our editors, however, AEDIT may receive a commission on items purchased through our links.*

These procedures may not carry any downtime, but that doesn’t mean there aren’t steps you can take to maximize the benefits.

What To Do After Non-Surgical Body Contouring Treatments

6 Tips For Optimizing Non-Surgical Body Contouring Results

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Even though [cellulite](https://aedit.com/concern/cellulite) is incredibly common in female bodies (nine in 10, to be specific), I have never been able to accept it as a natural part of mine. The rippling appearance of cellulite generally begins during puberty, and I was no exception to the rule. First noticing it at the age of 13, it continued to be a bother into my early twenties. By the time I hit 30, I was seriously looking into [possible solutions](https://aedit.com/procedure/cellulite-removal-solutions). After having exhausted every at-home avenue to smooth my skin to no avail, I started to think the dimpling was something I would have to live with. That’s when [Qwo™](https://aedit.com/procedure/qwo) came into the picture.  

## **Why I Chose Qwo**
Anyone who has sought out ‘solutions’ for [cellulite](https://aedit.com/aedition/the-complete-guide-to-cellulite) will agree that no amount of dry brushing, foam rolling, coffee scrubs, firming creams, or lifestyle changes will truly change its appearance. Sitting at a size four and standing at 5'5”, I am someone who works out consistently and can attest that your weight, size, and diet can’t naturally change what is in the cards genetically. And, as someone who exercises to feel strong and does not mind having a little jiggle, I knew that my options were limited if I truly wanted the dimples to disappear. 

In-office procedures never interested me due to their inconclusive results, which left me in this limbo waiting for a concern-specific fix that does not require extensive downtime. I first found out about Qwo™ through [an article we published](https://aedit.com/aedition/qwo-cellulite-injectable-treatment-fda-approved) a year ago when it first received approval by the United States Food and Drug Administration (FDA). It appeared to be a miracle cure for one of my biggest insecurities. The [breakthrough injectable](https://aedit.com/aedition/new-injectables-neurotoxins-fillers-for-face-body) is approved by the FDA for use on the buttocks in moderate and more severe cases of cellulite. 

I was excited enough just knowing that a solution was approved and within reach. But, when I was offered the chance to get Qwo™ injections administered by [Bruce E. Katz, MD](https://www.juvaskin.com/about/our-staff/dr-bruce-katz/), a board certified dermatologist and the founder of JUVA Skin and Laser Clinic in New York City who had been a part of the clinical trials for the treatment, I knew the time to tackle my cellulite had arrived. According to Dr. Katz, Qwo™ has been “tested on moderate to severe cellulite” and “can treat all forms of cellulite.” 

<a href="https://youtu.be/yOLeojEnKWM" class="embedly-card" data-card-width="100%" data-card-controls="0">Embedded content: https://youtu.be/yOLeojEnKWM</a>

Because the process requires three sets of injections spaced 21 days apart, I cleared my calendar and hurried to see Dr. Katz for my shot at smoother skin. 

## **Qwo Treatment & Recovery**  
During my first appointment with Dr. Katz, I was assessed and told that I was indeed a candidate for Qwo™ (cue the sigh of relief). He had been a part of the clinical trials for Qwo™ and had glowing reviews from his patients, who, two years post-treatment, were still happy with their results. After getting marked up and having my ‘before’ pictures taken (see below), I laid down for the first set of injections. 

As somebody unphased by needles, the process was seamless, and Dr. Katz went above and beyond to make me feel comfortable. Unlike [Botox®](https://aedit.com/aedition/everything-you-need-to-know-before-getting-botox-for-the-first-time), which is injected into the muscle, Qwo™ requires a different technique. When the needle is inserted, collagenases (the enzyme that breaks down peptide bonds in collagen) are released as the needle is moved around to dissolve the collagen bond. While, from the outside, it appears as though the needle is being moved around, Dr. Katz explained that this is the necessary method to ensure the bands dissolve and release, thereby reducing the dimpling appearance. The overall pain level was no more than that of other injections, and the entire process was done in under 10 minutes. I was instructed to stay on my stomach for another 10 minutes to allow for the injectable to get to work on the fibrous septae. 

<CaptionImg url={https://images.ctfassets.net/zw35sfestf1t/3oq3bwUvuZkYPpWPI1a5rN/08bdfb2c2ec24aab5397df212bce4673/QwoBA-2.jpeg}>
  The writer before (*left*) and seven weeks after (*right*) her last Qwo™ treatment.
</CaptionImg>

Now, although I did my [research on the treatment](https://aedit.com/aedition/what-its-like-to-get-qwo-for-cellulite) — reading up on aesthetics is, after all, my job — I was unaware of the dramatic impact the first round of injectables would have on me. During my initial appointment with Dr. Katz, I was reassured that [bruising](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox) and [swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) were to be expected. In fact, they’re a sign that the treatment is working. “That is indicating that the fibrous bands have been dissolved by the Qwo™,” he explained. I am prone to bruising, so I thought I had a pretty good idea of what the bruises would look like on me. However, I wasn't prepared for what happened a mere 11 hours post-injection. 

As the first day progressed, I started to experience a feeling of soreness as though I’d done a glute-heavy workout, and my skin felt raw as if I had a sunburn. Not knowing what I would experience that day, I wore jeans and soon found myself feeling irritated by the denim fabric. By the end of day one (and after constant inspection of my derriere), the small injection sites had blossomed into deep purple, baseball-sized circles. Nothing could have fully prepared me for the shock factor of the bruising, but having the forewarning from Dr. Katz allowed me to sleep easy — albeit somewhat uncomfortably — the next few nights. By my second set of injections three weeks later, the bruising had disappeared and I was ready to do it all again.    

The following two treatments mirrored my first experience — sans the significant bruising. I went in, got marked up, took progress photos, and felt the same sore-raw hybrid of sensations with limited bruising (compared to what I had come to expect from round one). The entire process, from consultation to completion, lasted less than three months, and I was excited to see a vast improvement. 

## **Qwo Results & Recommendations**
Once the swelling and bruising from the first set of injections went down, I noticed a slight improvement in the appearance of my skin. The real change, however, came at the three-month mark. After the third set of injections, the bruising was barely there — though it did linger for a few weeks (Dr. Katz assured me that this was perfectly normal).  

While my case of cellulite may fall in the ‘moderate’ category, in unflattering light or under constrictive clothing, I still found myself concerned about its appearance. Now that enough time has passed, I find that my skin is much smoother, the thought process behind choosing what to wear is less complicated, and my self-confidence has been restored. 

<CaptionImg url={https://images.ctfassets.net/zw35sfestf1t/2aY5KXamhCqPipbEWWyqdg/ed4445c77d1b9348805da3503a5ddd58/QwoBA-1.jpeg}>
  The writer before (*left*) and seven weeks after (*right*) her last Qwo™ treatment.
</CaptionImg>

As far as the timeline for how long the results should last, there’s no specific answer. Dr. Katz has patients who participated in the trials two and a half years ago and are still happy with their appearance. Even if there is a shelf life to my results, I would gladly go back and do it all again as needed. I would also recommend it to anybody who wants a minimally invasive solution that produces visible results. 

For those considering this treatment option for cellulite, here are a few things I think you should keep in mind when scheduling your Qwo™ injections: 

### **Do**: 
- Schedule treatment for a time when you’re less likely to wear revealing bottoms
- Consider what you will wear the day of injection
- Wear underwear that doesn’t dig into the injection site
- Plan your days following the injections to be light and know that sitting or physical activity may cause discomfort
- Expect bruising, especially if you are prone to it 

### **Don’t**: 
- Schedule any physically demanding activities post-treatment 
- Push yourself physically in the days following 
- Wear anything too compressive or with a rough texture for the first few days
- Feel discouraged by the bruising, swelling, or soreness (trust the process!) 

## **The Takeaway** 
Cellulite is not a reflection of your health, diet, or fitness capabilities — it's a genetically determined structure under your skin that creates a rippled appearance. While it is currently only FDA-approved for use on the buttocks, Qwo™ is being tested for use on the back of the thighs and has shown realistic improvement to a concern that previously was hard to treat. Despite the deep bruising and discomfort for a few days, the process is quick and the results are real!

Patient Perspective

After years of being self-conscious about my cellulite, I was able to treat it with Qwo™, an FDA-approved injectable that promises smoother skin in three sessions. 

What I Look Like Before And After Getting Qwo Injections For Cellulite

I Got Rid Of My Cellulite With Qwo Injections — Here’s Proof

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Whether it’s post-weight loss or a simple matter of wanting to firm up without going under the knife, non-surgical skin tightening treatments can do a lot for [unwanted skin laxity](https://aedit.com/concern/facial-skin-laxity). Instead of surgically removing excess skin, energy-based treatments tone what’s there. “Obviously there is no extraction of any tissue, so we’re using various forms of energy to stimulate natural collagen production and improve elasticity,” explains [Paul Jarrod Frank, MD](https://pfrankmd.com/), a board certified dermatologist in New York City, of non-surgical skin tightening techniques. 

Needless to say, non-surgical skin tightening are not going to be able to offer as a dramatic a result as any of the various surgical ‘lifts’ (think: [facelift](https://aedit.com/procedure/facelift-rhytidectomy), [neck lift](https://aedit.com/procedure/neck-lift-lower-rhytidectomy), [arm lift](https://aedit.com/procedure/arm-lift), [thigh lift](https://aedit.com/procedure/thigh-lift), [body lift](https://aedit.com/aedition/guide-to-surgical-nonsurgical-body-lifts)) would, but, for the right candidate, they can be seriously rejuvenating. Here’s what you need to know.

## **How Non-Surgical Skin Tightening Works**
In the absence of the excision of skin, non-surgical skin tightening devices rely on energy-based technology to firm the skin from within. The two main sources used are ultrasound and radiofrequency. Both produce heat that can be delivered deeper into the skin than laser light, and they have none of the same [skin tone restrictions](https://aedit.com/aedition/best-laser-skin-hair-removal-treatments-for-darker-skin-tones). “[They] have the advantage of being colorblind,” Dr. Frank adds. “Both these forms of energy don’t affect the epidermis, which, in addition to being colorblind, also means very little downtime and no sun sensitivity.”  
 
## **The Ideal Candidate for Non-Surgical Skin Tightening**
It should come as no surprise that the best candidates for any of these non-surgical skin tightening devices are those who have mild to moderate laxity, Dr. Frank notes. Generally speaking, patients for these procedures are somewhere between their [thirties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-30s) and their [fifties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-50s-60s-70s). 
 
While the treatments can be used preventatively to delay (or eliminate) the need for surgery down the line, they can also be employed as maintenance for those who have already gone under the knife. “[They're good for] people who have had surgical treatments in the past and don’t want to have to go through that again,” Dr. Frank says. 

For most, non-surgical skin tightening works best as a part of a larger [prejuvenation](https://aedit.com/aedition/i-was-practicing-prejuvenation-before-it-was-a-trend) or rejuvenation protocol. “These procedures do not replace other non-surgical techniques such as [lasers](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing) and [injectables](https://aedit.com/aedition/best-procedures-to-restore-facial-volume), which are excellent complements to all of these treatments,” he adds. 
 
## **The Best Non-Surgical Skin Tightening Treatments**
The good news about non-surgical skin tightening? There are an array of treatments to choose from. The bad news? It can be hard to differentiate between them. Fortunately, your dermatologist or plastic surgery is here to help. “It’s not about choosing the best product, it’s about choosing the best candidate and we certainly have several varieties to choose from,” Dr. Frank says. From Ultherapy® to Thermage® and everything in between, here is our guide to the best of non-surgical skin tightening. 
 
### **1. Ultherapy®**
A favorite of patients and providers alike, [Ultherapy®](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy) employs microfocused ultrasound imaging to deliver energy to specific layers of tissue. “It uses ultrasound to visualize the patients’ unique anatomy and allows the treatment to be customized for the individual patient,” says [Jennifer Levine, MD](https://www.drjenniferlevine.com/), a double board certified facial plastic and reconstructive surgeon in NYC. In fact, “Ultherapy® is the only treatment that delivers energy to the [SMAS](https://aedit.com/procedure/smas-facelift), which is the layer you would lift, if you were doing a facelift,” she adds. 

Ultherapy® is cleared by the United States Food and Drug Administration (FDA) to lift the neck, chin, and brow and improve the appearance of lines and wrinkles on the upper chest. It uses fractionated energy to create thermocoagulation points (TCPs), which, in turn, cause the body to produce collagen and elastin. “I would say the number one and most powerful non-invasive skin tightening device is Ultherapy®,” Dr. Frank says. “It’s been around for at least a decade and it’s still the standard of care, as it penetrates much deeper than most radiofrequency technologies like Thermage®.” 
 
Safe for all skin types, Ultherapy® has no downtime and isn’t a sun-sensitive treatment. One downside? Dr. Frank says it is “more painful” and “can cause a bit more swelling” than some other energy-based treatments, but, “in the right hands and under the right pain management,” it “really is a far superior technology.” 
 
When it comes to results, they “can be seen sometimes in a couple of months, but may take three to six months for the full effect,” Dr. Levine shares. Since Ultherapy® requires the body to produce collagen and elastin, patients who take certain anti-inflammatory medications are not good candidates for treatment, she adds. Most of Dr. Frank’s patients who like Ultherapy® do it once or twice a year as part of a larger maintenance plan. “It does not replace other treatments,” Dr. Frank emphasizes. “I consider these devices icing on the cake.”
 
### **2. Thermage®**
[Thermage®](https://www.thermage.com/) is a non-invasive skin rejuvenation treatment that is FDA-cleared to smooth, tighten, and contour skin for an overall younger-looking appearance. Like the name suggests, it involves heat. The treatment works by using radiofrequency (RF) energy to bring heat to the skin’s dermis under the surface layer and stimulate collagen production. Thermage® can be used on the eyes and along the jawline, but it can also be used on the backs of the hands, stomach, arms, thighs, knees, and butt. 

Most patients see results after one 30 to 90 minute treatment, and the session is generally considered more comfortable (compared to Ultherapy®) because a cooling mechanism is integrated into the pulsed RF. Localized redness, swelling, and bloating is possible and usually resolves in 24 to 48 hours. Results last one to two years.

### **3. Emsculpt Neo®** 
While most people tout [Emsculpt Neo®](https://aedit.com/procedure/emsculpt) for its muscle toning and fat reduction ([read about one editor’s experience](https://aedit.com/aedition/what-its-like-to-get-emsculpt-neo)), Dr. Frank says that one of the major advancements in skin tightening is the combination of energies. In the case of Emsculpt Neo®, it’s the pairing of high-intensity focused electromagnetic technology (HIFEM) with RF to treat the abdomen, arms, buttocks, and thighs. “The Neo is the second-generation of the Emsculpt® technology with added radiofrequency, which not only adds additional fat reduction to the muscle development but also its traditional skin tightening technique,” Dr. Frank says. 
 
The duo makes an already multitasking technology even more versatile. “We’re able to see examples of these non-invasive energy forms being combined with other purposes to get what is called the synergistic reaction, like an Emsculpt Neo®,” he shares. The initial treatment protocol is four 30-minute treatments over the course of one month, followed by the occasional maintenance session. While the muscle toning benefits show up in a few weeks, the results of the RF fat reduction and skin tightening improve over the course of three months.
 
### **4. Thread Lifting**
We often talk about [thread lifts](https://aedit.com/procedure/pdo-thread-lift) (also known as suture suspension lifts) for their ability to, well, lift, but they can have a tightening effect as well. “This is another non-surgical form of skin tightening people don’t commonly think about,” Dr. Frank notes. 
 
During the minimally invasive procedure, dissolvable, barbed sutures are threaded under the skin to elevate lax tissue *and* stimulate collagen production. “People assume that these just shift and lift tissue, using the various lifting techniques, but the actual main ingredient in the threads, which are absorbable, is PDO,” he explains. [PDO](https://aedit.com/aedition/pdo-thread-lift-for-facial-rejuvenation) (a.k.a. polydioxanone) is an absorbable substance found in sutures, but it’s also a well-known biostimulatory agent. “The PDO in the threads themselves cause non-invasive collagen stimulation and overall skin tightening,” Dr. Frank adds.  
 
The result? Improved firmness and contour in the neck, jawline, cheeks… or just about anyplace else you can think of (hi, [buttocks](https://aedit.com/aedition/butt-thread-lift-vs-bbl-implants-filler) and [knees](https://aedit.com/aedition/best-cosmetic-procedures-for-knees)).
 
### **5. Evoke**
For those looking to treat the lower face and neck, Dr. Levine is a fan of Evoke ([read about one writer’s experience with the treatment](https://aedit.com/aedition/evoke-radio-frequency-for-jawline-neck-skin-tightening)). The device uses sustained bipolar radiofrequency to reduce fat, stimulate collagen, and/or lift and tighten the skin around the cheeks, jawline, and jowls. The and/or is because artificial intelligence allows the device to maintain the correct temperature for either skin tightening or fat destruction. “It can help get rid of fat under the chin but still maintain the fat in the lower face,” Dr. Levine says. 
 
She usually recommends three to six treatments, spaced one week apart. There’s no pain or downtime, and it’s safe for all skin types. “Results are seen fully at 12 weeks,” Dr. Levine notes. “But there is some immediate effect, so it’s great before a big event.”   
 
### **6. Frax 1550**
The only laser of the group, Dr. Levine likes the ability of the [Frax 1550](https://aedit.com/procedure/nonablative-fractional-lasers) from Ellipse to tighten the skin; and there is also a Frax 1940 handpiece to better target pigment, she says. “Unlike traditional [Fraxel®](https://aedit.com/aedition/guide-to-fraxel-laser-skin-resurfacing-treatments), which is an ablative fractionated laser, this is a non-ablative fractionated laser, which means it can have a similar effect with much less downtime,” Dr. Levine explains. 

With that said, the face will be red and a bit swollen — like a sunburn — for a day or so, and she allows her patients to wear makeup after the first 24 hours. It’s safe for [Fitzpatrick skin types I to IV](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types) and, in the hands of an expert, may be used conservatively on type V. “The treatment can also be customized to target skin quality, texture, and tightening and can also be combined with other treatments for pigment and dyschromia,” Dr. Levine says. For best results, she usually recommends two to three treatments spaced one month apart. 
 
## **The Takeaway**
For those with mild to moderate skin laxity who aren’t ready to go under the knife or for those who are looking to maintain skin firmness after surgery, non-surgical skin tightening is a safe and effective solution for most skin types. Consulting with a board certified dermatologist or plastic surgeon will help determine the best treatment protocol for your needs.

Skin laxity solutions sans surgery. Yep, it’s possible.

Best Non-Surgical Skin Tightening Procedures For Face And Body

6 Non-Surgical Skin Tightening Treatments For A Firmer Face And Body

alexander-krivitskiy-v3jlOMgK6V8-unsplash

Linda Evangelista made headlines on social media this week when she candidly opened up about her experience with paradoxical adipose hyperplasia (PAH), which she says she developed after a series of cryolipolysis treatments five years ago. In an emotional [Instagram post](https://www.instagram.com/p/CUJZa40tWXC/), the supermodel alleges the CoolSculpting® procedures “increased, not decreased” her fat cells and left her “permanently deformed even after two painful, unsuccessful, corrective surgeries.”

<CaptionImg url={https://images.contentful.com/zw35sfestf1t/5tUYfh7YSiYd0xHs77qCwi/eb88a5821865ba0aef90405f401b176c/LindaEnvangelistaIG.png}>
  Linda Evangelista's Instagram post about her experience with PAH. (@lindaevangelista/ Instagram)
</CaptionImg>

By sharing her story, Evangelista (who filed a lawsuit against the device’s manufacturer, Zeltiq Aesthetics, which is a subsidiary of Allergan) has paved the way for a renewed conversation around one of the lesser known adverse effects of the popular [fat-freezing procedure](https://aedit.com/aedition/comparing-fat-melting-sculpsure-and-fat-freezing-coolsculpting). So, what is paradoxical adipose hyperplasia and how common is it? Here, a top dermatologist and plastic surgeon break down everything you need to know about PAH — including how to treat it.

## **What Is Paradoxical Adipose Hyperplasia?**
To understand paradoxical adipose hyperplasia (PAH), it’s first important to understand cryolipolysis. Also known as ‘fat freezing’ or by its brand name, [CoolSculpting®](https://aedit.com/procedure/cool-sculpting), the non-invasive body contouring procedure is a controlled cooling technique that works by freezing fat cells at negative 11 degrees Celsius to permanently destroy them. “Cryolipolysis uses cooling to damage and destroy subcutaneous fat cells without damaging the skin to reduce the amount of fat in the treated area,” says [Paul Jarrod Frank, MD](https://pfrankmd.com/), a board certified dermatologist in New York City. 

Most patients experience a 20 to 25 percent reduction of fat in the treatment area, and CoolSculpting® is approved by the United States Food and Drug Administration (FDA) to address visible fat bulges on the back, buttocks, thighs, upper arms, flanks, and abdomen and under the chin and jawline. According to the [CoolSculpting® website](https://www.coolsculpting.com/index.html), post-treatment side effects include “temporary redness, swelling, blanching, bruising, firmness, tingling, stinging, tenderness, cramping, aching, itching, or skin sensitivity, and sensation of fullness in the back of the throat after submental or submandibular area treatment.” 

The site also notes that “rare side effects” may occur: “CoolSculpting® and CoolSculpting® Elite may cause a visible enlargement in the treated area, which may develop [two] to [five] months after treatment and requires surgical intervention for correction.” The paradoxical adipose hyperplasia Evangelista describes was [first reported in 2014](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171727/). “It is a rare, previously unreported adverse effect of cryolipolysis,” Dr. Frank notes.

PAH refers to hardened areas of localized fat that develop after cryolipolysis. “PAH is the unintentional growth of adipose, or fat, after cryolipolysis,” explains [Melissa Doft, MD](https://doftplasticsurgery.com/), a double board certified plastic and reconstructive surgeon in NYC. “Patients complain of a thick layer of hard fat in a similar shape to the applicator used for CoolSculpting®, and it has been described as looking like a stick of butter.”

[Studies show](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171727/) that less than one percent of patients (about 0.05 percent to 0.39 percent) experience the condition after cryolipolysis, though [more recent data](https://www.sciencedaily.com/releases/2018/06/180629182037.htm) indicates the figure may be as high as 0.72 percent. “It is unclear why some patients have the growth of fat cells instead of reduction, but what is known is that the incidence is higher than was previously expected,” Dr. Doft says. “Researchers estimated that it affects one in 138 patients who undergo cryolipolysis and is more common in male patients.”

As such, providers increasingly believe PAH does not get enough attention. “This complication is more common than we think, along the spectrum of mild to severe,” Dr. Frank shares. In her IG post, Evangelista laments that she was “not made aware” of the risk prior to undergoing treatment. 

While it is not life threatening, PAH can be physically and emotionally distressing — and it will not go away without treatment. “I do not have a CoolSculpting® machine, but I have seen several complications unfortunately,” Dr. Doft shares. “It is devastating to the patients.”

## **What Causes Paradoxical Adipose Hyperplasia?**
The tricky thing about paradoxical adipose hyperplasia? We don’t really know exactly what causes it. “We assume the cooling effect has some sort of stimulatory stem cell activation which causes multiplication of fat cells,” Dr. Frank explains, adding that it is “typically a localized phenomenon.” That means most patients who experience PAH do so in the area where the cryolipolysis applicator was placed, and it can happen anywhere on the body. 
 
Additionally, it can happen to anyone. “There is no data on why someone is more susceptible than others,” Dr. Frank says. “That makes it such a problem because it's unpredictable.” One potential factor? “People who get too many repetitive treatments in the same area may be more inclined to have PAH,” he adds. 

For example, there could be situations in which a patient is misdiagnosed after CoolSculpting®. “The most common cause is when a patient says they have a CoolSculpting® cycle, and they start noticing growth in the area,” Dr. Frank explains. Rather than recognize the growth as PAH, an untrained provider may blame it on weight gain and have the patient undergo another session. “It usually happens when you have too many CoolSculpting® treatments in a short period of time to the same area,” he says.

## **How to Treat Paradoxical Adipose Hyperplasia**
The most important thing to know about treating paradoxical adipose hyperplasia is that additional cryolipolysis treatments are not the answer. Instead, [liposuction](https://aedit.com/procedure/tumescent-liposuction) or, in more severe cases, [abdominoplasty](https://aedit.com/procedure/abdominoplasty) (read: tummy tuck) are the most effective ways to improve or completely correct PAH. Be aware that multiple surgeries may be needed.
 
The coldness of cryolipolysis creates inflammation that destroys fat cells, but it can also cause panniculitis, or the inflammation of fat. “That causes a rebound and exacerbation of scar tissue that comes from the inflammation,” Dr. Frank explains. As such, “it is necessary for patients to wait six to nine months after the [cryolipolysis] procedure to confirm that the inflammation and growth has plateaued,” Dr. Doft adds. During that time, “people who are experiencing the active stage of growth soon after CoolSculpting® treatment require systemic steroids,” Dr. Frank notes. 
 
At Dr. Frank’s practice, [vaser liposuction](https://pfrankmd.com/lipo/) is the “gold standard” of treating fat adipose hyperplasia. “[Most patients](https://www.instagram.com/p/CMUeHjRFm46/?utm_medium=copy_link) get enormous improvement after one treatment,” he explains, but many patients “will require two rounds of surgical intervention to really reduce the irregularities.” 
 
Dr. Doft agrees that liposuction often “works well to remove the excess fat tissue,” though it is not always enough. “Some patients not only have excess fat but also significant scar tissue and will need an abdominoplasty to correct the problem,” she says.
 
## **The Takeaway**
Even non-invasive treatments that are generally considered safe and effective, like CoolSculpting®, can have negative outcomes that require costly revision. “[PAH] is a more common than discussed complication, particularly in the hands of unlicensed professionals and med spas,” Dr. Frank cautions. While all aesthetic procedures carry the possibility of side effects and complications, visiting a [board certified provider](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) who specializes in the treatment you are interested in can help mitigate risk and ensure you are in qualified hands should something go wrong.

Cryolipolysis is generally considered a safe and effective form of body contouring, but adverse effects (however rare) are possible. Here’s what you need to know about PAH.