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From Michelle Obama’s toned triceps to Dwayne Johnson’s bulging biceps, the desire for sculpted arms is real. Logging hours in the gym with weights and pushups will certainly build muscle, but it might not be enough to provide the strong silhouette you’re after. “Today’s patients are definitely looking for arm slimness with contouring,” says Thomas Su, MD, a cosmetic surgeon and founder of [Art Lipo Arm Liposuction & Plastic Surgery Center](https://artlipo.com/?utm_source=rcw&utm_medium=press_release&utm_campaign=outreach&utm_content=pr) in Tampa, FL. 

Back in the day, cosmetic procedures that treated the arms would remove excess skin and/or fat, but they didn’t provide the kind of refinement that is now available. From high-definition liposuction and implants that sculpt to a modern twist on the classic arm lift, here are three procedures for toned and taught arms.

## **1. Liposuction**
You may have heard about [‘high-def’ lipo](https://aedit.com/aedition/high-definition-liposuction-techniques-for-body-contouring) for the abdomen to create a more chiseled torso, but what about a liposuction technique that has a similar effect on the arms? While traditional arm liposuction methods tend to focus exclusively on the underside of the upper arm, Dr. Su has pioneered a more comprehensive approach he calls [Celebrity Arms](https://www.youtube.com/c/ArmLiftLiposuctionExpertDrThomasSuArtlipo/featured). “[It] is different from traditional arm lipo because it is a 360-degree, or circumferential, treatment — not just the underarm area,” he explains. 

The water-assisted liposuction procedure reveals the natural muscle contour and can be performed alone or in tandem with other treatments (think: lipo to slim upper back, bra bulges, or forearms; skin tightening with [Renuvion®](https://www.renuvion.com/); or brachioplasty to remove excess skin). “The ideal candidates for this procedure are women 20 to 40 where loose skin is not an issue,” Dr. Su says. “However, we commonly treat women over 40 and usually combine it with an additional skin tightening treatment to address the extra skin issues.” 

Performed under local anesthesia, the procedure takes about three hours and involves five to seven small incisions. Compression garments are needed for the first two weeks post-op, at which point most of the pain and discomfort subsides. Minor swelling may persist for one to three months, but patients can resume most daily activities (including going back to work) after a few days. Results are immediate and long lasting, assuming the patient maintains a healthy weight. 

Since the procedure removes fat to reveal natural musculature, you might be wondering if you need to tone up before treatment. While it’s not required, it doesn’t hurt. “As far as achieving a defined, toned look, it is not necessary to work out, but it does help,” Dr. Su notes. “As with any procedure, lifestyle always helps to enhance the long-term results.”

## **2. Bicep & Tricep Implants**
For those looking to bulk up a little or a lot, bicep and tricep implants may be an option. Not just for bodybuilders (though fitness-focussed men and women are common patients), the ideal candidate has “the desire for larger biceps and/or triceps or may be relatively weak in that body part due to genetics, trauma, muscle rupture, or injury,” says [Ryan Stanton, MD](https://aedit.com/provider/ryan-stanton-md-644), a board certified plastic and reconstructive surgeon in Beverly Hills. 

Performed alone or together, bicep and tricep implants can create arms of all shapes and sizes. As Dr. Stanton explains, he provides custom-molded looks for his patients that range from “slender, tasteful, and proportional results” to “dramatic, massive augmentations.” Each procedure takes about an hour under general anesthesia and requires a single three- to four-centimeter incision (usually in the armpit) to place the silicone implant.

Unlike silicone breast implants that [need to be replaced](https://aedit.com/aedition/guide-to-replacing-breast-implants) every 10 years, bicep and tricep implants are considered permanent because “they cannot rupture and leak,” he notes. After surgery, the results are immediate and the initial recovery period is about a week. Dr. Stanton says patients with “desk job-type work” can return after three days or so, but you must refrain from exercising those muscle groups for six weeks.

As with any implant, there is potential for it to flip or rotate — especially when it is not placed within a muscle — but Dr. Stanton’s surgical technique minimizes the concern. “This risk can be greatly limited by creating the perfect surgical pocket around an anatomically shaped implant,” he explains. Other than avoiding arm workouts for 6 weeks, he allows patients to resume all activities post-op.

## **3. Brachioplasty (a.k.a. Arm Lift)**
If you’re looking to wave goodbye to arm flab, [brachioplasty (a.k.a. arm lift)](https://aedit.com/procedure/arm-lift) is a tried-and-true surgical procedure that removes excess skin and fat for a slimmer, smoother, and firmer appearance. “An arm lift is for anyone with extra skin of the upper arm, with or without excessive fat,” explains [Lauren Chmielewski, MD](https://aedit.com/provider/lauren-chmielewski-md-143), a board certified plastic and reconstructive surgeon in New York City. While individuals who have undergone major weight loss and have excess skin are typical candidates, she says patients with focal areas of fat in the upper arm that are resistant to diet and exercise can also benefit from the procedure.

Brachioplasty is usually performed under general anesthesia and takes one to two hours. Depending on the patient’s needs, liposuction may be done in tandem. When it comes to scarring, Dr. Chmielewski says the degree of the mark is proportional to the amount of skin removed. “The trade-off for removing extra skin is placing a scar on the arm,” she shares. “The scar can be placed posteriorly on the upper arm or on the inner arm under the biceps muscle. Patients with minimal extra skin may be candidates for a shorter scar in the armpit.”  

Swelling, soreness, and limitations on lifting heavy objects are common for several weeks post-op. “The arms are wrapped or kept in a compressive garment to help manage swelling,” Dr. Chmielewski says. “And pain medication is utilized as needed.” Clearance to lift the arms and carry things is gradually increased once the incision is healed around two weeks post-op, she adds. 

The results are permanent, so long as the patient doesn’t gain a significant amount of weight that deposits fat in the arm and stretches out the skin. The scar will fade over the course of the first year, at which point a variety of [scar minimization techniques](https://aedit.com/aedition/minimizing-scars-after-surgery) can be employed to further reduce its appearance.

While brachioplasty is effective at slimming the silhouette of the arm, Dr. Chmielewski notes that it will not affect the appearance of the arm muscles. “To tone the upper arms, I generally recommend working out the biceps, triceps, and shoulders with light weights,” she shares. She suggests [multiple reps a few times a week](https://aedit.com/aedition/best-fitness-classes-workouts-exercises-to-try-at-home) for best results and says the workouts can begin in the lead up to the procedure. “This can be done as ‘prehab’ before the surgery and continued at four to six weeks after surgery — or whenever the incision is healed,” she says.

AEDITION rejuvenators-min

Medical Aesthetics Collection | The AEDITION

Aesthetics

From Michelle Obama’s toned triceps to Dwayne Johnson’s bulging biceps, the desire for strong, sculpted arms is real. Here’s how to get them without a trip to the gym.

How To Get Slimmer Arms With Cosmetic Surgery

3 Procedures That Sculpt And Contour The Arms

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Aromatherapy, a natural way to use scent to cause a physiological response, is no longer just for self-care Sundays. Gaining popularity in the medical field, essential oils are increasingly playing a role in pre- and post-procedure care. When you consider the mind-body connection, it shouldn’t be surprising that it can be an important facet of the recovery process. While doctors might not have focused on the [benefits of aromatherapy](https://aedit.com/aedition/unexpected-things-to-know-about-the-plastic-surgery-operating-room) in medical school, there is a renewed interest in integrating eastern traditions into western medicine — especially as it relates to how patients heal.

## **Aromatherapy in Aesthetic Medicine**
According to a [study published](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5743169/) in Laryngoscope Investigative Otolaryngology, aromatherapy helps combat preoperative anxiety, which can have a negative impact on patient satisfaction and outcomes. “The decision to use essential oils before and after a procedure was actually made in collaboration with one of my anesthesiologists, who had been using them for years for her surgical patients,” says [Gregory Buford, MD](https://aedit.com/provider/gregory-buford-md-1015), a Denver-based board certified plastic surgeon. “She found that patients not only went to sleep more relaxed, but they also awoke more relaxed.”  

At high levels, the stress hormone cortisol can impede healing. Whether it’s elective or not, it’s only natural for anxiety and stress to rise in situations that include surgery. By introducing calming essential oils, providers are effectively modulating stress levels and cortisol to create a more positive outcome for their patients. “An integral part of the overall outcome itself is actually the experience,” Dr. Buford shares. “If we can create a very positive experience for our patients then our outcomes actually improve.”

## **How to Use Essential Oils**
Surgeons like Dr. Buford are applying a small amount of a calming essential oil (think: [lavender](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5743169/)) inside their patients’ masks prior to induction. Post-procedure, [Ixchel Leigh](https://artisanparfums.com/the-collections), aromatherapist and author of *[Aromatic Alchemy: Recipes for Transformation](https://www.amazon.com/Aromatic-Alchemy-Recipes-Transformation-Ixchel/dp/0967594138)*, recommends inhaling your oil of choice by placing one drop onto a clean cloth, bringing it close to your nose, and taking three to five deep breaths. Another way to incorporate calming oils to help reduce your stress levels is to add two to three drops into one ounce of coconut oil or sweet almond oil and massaging the formulation into your hands or feet.

## **How to Choose an Essential Oil**
Not all essential oils are created equal. The quality of the oil you purchase for post-procedure use will make a big impact on your results. In order to find an oil that’s pure, therapeutic, and potent, here’s what you need to look for:

- The Latin binomial should be listed on the label next to the common name. For example: Lavender (*Lavendula augustifolia*)
- The country of origin should be listed on the label or website
- Third party testing should be easy to find and prove that the oil isn’t diluted with other essential oils or synthetic chemicals
- Look for the words ‘wildly crafted,’ ‘organic,’ and ‘ethically sourced’ on the label

Leigh likes [Eden Botanicals](https://www.edenbotanicals.com/products/essential-oils-pure-therapeutic-grade/essential-oils-a-b.html) because they craft smaller batches of essential oils, meet all of the standards above, and are fairly priced. If you are wondering what scent to choose, there are a few essential oils that are known for inducing calm:

- Lavender (*Lavendula augustifolia*)
- Roman Chamomile (*Anthemis nobilis*)
- German Chamomile (*Michelia alba*)

## **The Takeaway**
Incorporating nature’s medicine into western medicine is increasingly common. When it comes to essential oil use pre- and/or post- procedure, make sure to speak to your doctor first. Despite the many benefits, they can be irritating and misuse can be toxic. Once you get the all clear, however, get ready to relax. “Creating this positive environment for surgical patients can literally create a differentiating factor between two surgical practices,” Dr. Buford says. “If both practices have similar outcomes but one proactively creates a more relaxing and positive environment, it only makes sense that a patient would choose the latter.”

AEDITION minimalists-min

Wellness Collection | The AEDITION

Wellness

Could your favorite essential oil be the secret to a better recovery? The AEDITION asks the experts.

Aromatherapy And Essential Oils For Plastic Surgery Recovery

The Benefits Of Aromatherapy Pre- And Post-Procedure

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Approaching double-digit growth and generating nearly one billion dollars a year in the United States alone, [eyelash extensions](https://aedit.com/procedure/eyelash-extensions) have become big business. Between the price point (a full set costs between $175 and $500 for first timers) and maintenance (monthly touchups running $80 and $150), finding the right technician to perfect your lash look is so important. But it’s not just about cost, cleanliness, or comfort level — it’s about connecting with an experienced pro who’s able to evaluate your anatomy and create a design that enhances your unique features.

Developing the ideal lash look is more complicated than it may seem. A lash extension artist must consider everything from eye shape and lid height/depth to natural lash length, texture, curl, and direction. Oh, and then there is the client’s desired result to consider. This is especially true for clients of Asian descent and those with monolid or hooded eyes. To learn more, we talked to Mydygma Nimbueva, a premiere lash specialist and owner of [Beautyful Lashes Salon](https://www.beautyfullashes.com/) in Beverly Hills.

## **The Relationship Between Lash Extensions & Eye Shape**
Eye shape plays a big role in lash extension techniques, and this is particularly true for clients with monolid and hooded eyes. “As an Asian lash artist and educator, who also wears lash extensions, it’s very easy for me to understand our struggles and our needs,” Nimbueva shares. “A lot of Asian women try to find an Asian hairstylist who knows how to work with Asian hair and a makeup artist who specializes in Asian makeup because our faces and our beauty is different.”

Technically, there are a half dozen different classifications for the Asian eyelid, but Nimbueva breaks it down more simply:

- **Monolid**: This is an eyelid without a visible crease. There are variations within this category, Nimbueva explains, with some lids closed along the entire eye, some closed toward the beginning (near the nose) and more open at the outer corner, and some with a combination.
- **Partial Monolid**: Eyelids that show only a portion of the crease are known as half, partial, or demi monolids. “In the majority of cases, these eye shapes are a little bit asymmetric,” Nimbueva says. “We can correct that with different styling on each eye.”
- **Open Eye**: Open eyelids have a distinct crease that visibly separates the lower and upper portions of the eyelids. This can be either genetic (“I have an open eye type,” Nimbueva says.) or obtained via [blepharoplasty](https://aedit.com/aedition/what-its-really-like-to-get-eyelid-surgery-blepharoplasty) — one of the most common cosmetic surgery procedures in Asia.

And then there is the growth pattern of the lashes themselves. Nimbueva explains that having lush locks on the head (“we are blessed with great hair,” she quips) doesn’t necessarily translate to the brows and lashes. Women of Asian descent often have sparse brows and fragile, straight lashes (short or long in length) that grow downward. It’s not hard to understand then why many Asian women turn to lash extensions as a semi-permanent substitute for traditional eye makeup, like [mascara](https://aedit.com/aedition/best-lengthening-curling-volumizing-mascaras), strip lashes, and eyeliner.

## **Lash Extension Techniques**
It’s clear when talking to Nimbueva that applying eyelash extensions is a combination of both art and science. Each look is highly customized to the individual client, but there are some commonalities she’s noticed over the years. “Forty percent of my clients are Asian,” Nimbueva estimates. “Some prefer a really natural, almost flat curl that is a little bit thicker than her natural lashes.” The second group, she explains, is just the opposite. “Those women who aren’t blessed with long, strong, curly lashes and want to feel like they’re maximizing their investment want a very long, very full, almost mega-volume technique.”

<CaptionImg url={https://images.ctfassets.net/zw35sfestf1t/3cTtHDN3LE8acDt73cIqUY/82f089bc7ac09f783afdba918974eb4c/mydygma-nimbueva-beautyful-lashes-tiffany-edit.png}>
  A before and after look at one of Nimbueva's clients.
</CaptionImg>

### **Volume**
- **Classic Technique**: Traditionally, the most subtle, natural looking lash extensions use a 1:1 ratio, where a pro glues one individual lash extension onto each natural lash.
- **Russian Volume/Megavolume Technique**: This ultra-lush look is achieved by creating a “fan” of multiple lashes (anywhere from two to 16) that is paired with one individual natural eyelash. “A megavolume look can be amazing on Asians with monolids,” Nimbueva says. “It can cover the monolid if we choose the right length and can create the illusion of the open eye.” Those with small, round eyes, however, should avoid megavolume, as it can make the eyes appear even smaller.

### **Shape**
- **Doll Eye**: This look focuses the attention on the center of the eye. The longest eyelash extensions are placed at the center of the eye, and the length gradually decreases towards the corners. This shape is best for almond-shaped eyes because “a doll eye look on round eyes makes them look smaller,” Nimbueva notes.
- **Cat Eye**: The longest lashes are placed towards the outer corner of the eye to achieve an elongated appearance, and it’s ideal for those with round and small eyes. 
- **Asian Eyelid Lift**: Nimbueva is uniquely trained in the method developed in Kazakhstan by lash pioneer Malika Nauryzova, which creates a ‘double lid’ look on a monolid, without eyelid surgery. It also works well on slightly hooded and aging eyes, because it gives a little bit of lift. Due to the added complexity, this treatment takes three to four hours.

Anecdotally, Nimbueva notes that she has noticed sensitivities and allergic reactions (most commonly to cyanoacrylate, the main ingredient in lash glue) are less common among her Asian clients.

## **Lash Extension Types**
Because the lash extension industry isn’t regulated, Nimbueva warns that the same false lash type produced by different manufacturers will vary. If you’re aiming for a specific look, it’s best to defer to your lash specialist.

<CaptionImg url={https://images.ctfassets.net/zw35sfestf1t/6aRlEYB2FAfamhR9YCjIaq/c006614140472449a58c987626841288/mydygma-nimbueva-beautyful-lashes-tam-edit.png}>
  A before and after look at one of Nimbueva's clients.
</CaptionImg>

To achieve a natural effect, Nimbueva relies primarily on three lash extension types. “C is the most classic curl in lash extensions, more of a natural curl,” she explains. “J and B curl is a flatter curl.” For clients with open eye types looking for a more dramatic effect (and lots of volume), CC curl and D curl tend to offer the best results. Those with downward-facing lashes, meanwhile, benefit from L+ curl extensions because they have “a longer leg and an extreme curl that goes up,” she says. But that doesn’t mean they are for everyone. L+ lashes may feel heavy and can twist as they grow out.

To avoid weighing down the natural lashes, Nimbueva favors very fine eyelash extensions — those with a thickness of 0.03 millimeters. These lashes, particularly in a CC curl, create a “very natural, wispy, feathery look,” she shares. Her preferred L+ curl lashes are just a fraction thicker at 0.05 millimeters. For perspective, most salons in the U.S. use extensions that range from 0.10 to 0.15 millimeters. The ultra-light lashes tend to be favored by elite pros to create more volume without weight, though you’ll pay a bit more for the service.

## **The Takeaway**
No matter your eye shape and eyelash type, it is important to find a professional who has extensive training treating clients with similar needs. Nimbueva says that any reputable lash artist will ask you about your goals and ideas during your consultation. “I often end up doing a combination that elongates and opens up the eyes at the same time,” she explains. In her experience, clients are extremely loyal once they find a lash pro who really understands their unique anatomy and objectives. “I educate and make it fun for them,” Nimbueva explains. “Each of my clients is her own designer. She can’t stop looking at herself in the mirror afterwards — it gives her a boost of self confidence.”

AEDITION complexion perfection-min

Beauty Collection | The AEDITION

Beauty

When it comes to applying eyelash extensions, there is no such thing as one size fits all. Here, an expert lash stylist breaks down the relationship between eye shape and lash techniques.

Eyelash Extension Techniques For Monolid, Hooded, Asian Eye Types

A Guide To Lash Extensions For Monolid And Hooded Eyes

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It seems there’s a [new injectable](https://aedit.com/aedition/new-injectables-neurotoxins-fillers-for-face-body) every few months that promises to work better and longer and give more natural results. Come January 2021, another will be added to the list: [Renuva®](https://myrenuva.com/). And although it gives the effect of a traditional filler, that’s not quite what it is. Marketed as “an off-the-shelf alternative to autologous fat transfer,” it does its work by triggering the body to create more of its own fat in targeted areas. 

Part of a larger trend in injectables that’s all about stimulating your body to create the anti-aging elements you lose over time rather than replacing them with outside agents, Renuva® promises to be an interesting addition to the ever-growing selection of anti-aging injectables. Here are the basics. 

## **How Renuva® Works**
Renuva® is an adipose allograft matrix composed of collagen, proteins, and growth factors derived from donated and purified fat. Think of it as a scaffolding that triggers your body’s fat production. After it’s injected, “your stem cells divide and grow into new fat cells that populate the new collagen matrix that it creates,” says [Leif Rogers, MD](https://leifrogersmd.com/), a board certified plastic and reconstructive surgeon in Beverly Hills. In other words, the solution gets replaced over time with your own fat.

In addition to resulting in less post-injection swelling, the technology purportedly eliminates that uncanny effect that can happen when filler sits awkwardly on top of moving facial muscles. As Dr. Rogers explains, the new volume “is living cells in the anatomical layer it belongs in. Because of that it will look and animate naturally.” What’s more? He says those new fat cells can live “for at least 10 years, if not longer.”

In line with injectables like Ellansé®, Radisse®, and Sculptra® (all of which trigger the body to boost its collagen production), Renuva® is one more piece of an industry-wide shift. The thinking behind these treatments is to enhance the body's own reparative abilities. “It overlaps with general healing as well as anti-aging and longevity — essentially the doorway to the fountain of youth,” Dr. Rogers says.

Similar to the recent positioning of certain neurotoxins and fillers as [‘clean’ or ‘pure’ injectables](https://aedit.com/aedition/clean-injectable-filler-neurotoxin-trend), West Hollywood-based board certified dermatologist [Jason Emer, MD](https://aedit.com/provider/jason-emer-md-722), sees patient desire driving this turn. “People are wanting ‘regenerative’ procedures that stimulate your own body to improve over time,” he explains. “They like the idea of more ‘natural’ and less ‘synthetic’ injectables.” 

Another selling point? The decade-long results. “People are looking for more long-term improvements since COVID-19 has limited how often someone wants to go into an office to do treatments,” he notes.

## **What Renuva® Is Best For**
The treatment works in areas of the face that naturally have fat cells, including the temples, nasolabial folds, chin, jawline, and cheeks. It can also be used on the hands. And that’s not all. “It's great [to use] post-surgical on patients with small indentations or irregularities on the body, like in the breasts or in cellulite, and those with botched liposuction procedures,” Dr. Emer says. 

Renuva® is recommended for patients who desire mild plumping, but Dr. Emer has seen it used successfully beyond that. “We often will go ‘off label’ by mixing it with Sculptra® to use for buttock and male chest augmentation to build fat volume and collagen at the same time,” he explains. 

It’s important to note that Renuva® is not your best option if speed is your priority. Unlike [hyaluronic acid-based dermal fillers](https://aedit.com/aedition/everything-you-need-to-know-about-dermal-fillers) that offer immediate volume, the fat-building process can take months. So, while the results are long lasting, they can take several months to show up.

Additionally, Renuva® can’t be dissolved like HA-based fillers — but the process it sets off can be halted along the way. “If the volume is undesirable or if there are firm areas that the patient does not tolerate during the process of fat growth, a diluted steroid can be injected into the area to stop the function of the growth factors, as well as the proliferative phase of fat growth,” Dr. Rogers explains. 

## **The Takeaway** 
While it won’t replace the instant gratification of HA-filler, Renuva® will further diversify a growing range of injectables that go beyond filling to stimulate natural volume restoration. The cost of Renuva®, which will be available across the United States early next year, starts at $1,040 for 1.5 cc (though it varies based on practice and size of the treatment area). Dr. Rogers describes the price as “approximately equivalent to the longer-lasting hyaluronic acid injectables like Juvederm® Voluma.”

AEDITION trendsetters-min

Now Trending Collection | The AEDITION

Now Trending

Marketed as an off-the-shelf alternative to autologous fat transfer, Renuva® works by triggering the body to create more of its own fat in targeted areas.

Guide To Renuva: A New Fat-Building Injectable For Volume Loss

What To Know About The New Volumizing Injectable Renuva

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Even with COVID-19 face masks and coverings [concealing our mouths](https://aedit.com/aedition/treat-prevent-mask-mouth-bad-breath-tooth-decay), you’ll be hard pressed to find anyone who doesn’t want a brighter, whiter smile. Professional teeth whitening is the gold standard for illuminating the smile, but there are a host of at-home whitening kits and products ranging from strips and trays to toothpastes and mouthwashes that promise similar benefits. So, what’s the difference between in-office whitening treatments and the ones you can find at the drugstore? We asked the experts.

## **Professional vs. At-Home Teeth Whitening** 
Just like over-the-counter skincare is less concentrated than its prescription counterparts, at-home teeth whitening products are not as potent as professional treatments. “In-office teeth whitening tends to be much stronger,” says [Michael Apa, DDS](https://www.apaaesthetic.com/), a celebrity dentist and founder of [Apa Beauty](https://apabeauty.com/). 

Even so, the active ingredient in all teeth whitening treatments is peroxide, which can come in two forms: hydrogen and carbamide. “Peroxide is a natural occurring compound and safe to use in the mouth,” explains [Stacy Spizuoco, DDS](https://aedit.com/provider/stacy-spizuoco-29347), a New York City-based cosmetic dentist with Onsite Dental and clinical instructor at Columbia University College of Dental Medicine. “The body has peroxidases, which are enzymes that can safely break down peroxide into water and oxygen.” Both types of peroxide offer similar bleaching benefits. 

“Carbamide oxidizes and breaks down to hydrogen peroxide and urea,” she says. “This is a slow and limited reaction.” As a result, it is generally considered safer for at-home use and is found in kits like the [Smile Brilliant Whitening System](https://www.smilebrilliant.com/product/teeth-whitening-trays) and [Apa White Duo](https://www.smilebrilliant.com/product/teeth-whitening-trays). Hydrogen peroxide, meanwhile, acts alone. “In-office teeth whitening is typically 35 percent hydrogen peroxide, whereas at-home is typically 10 percent hydrogen peroxide,” Dr. Apa shares.

## **Professional Teeth Whitening Treatments**
In-office teeth whitening is a non-invasive treatment that uses a professional bleaching agent to whiten the teeth. There are two main types of professional whitening treatments — chairside and take-home trays. “In-office chairside whitening entails the dental professional placing a light setting material on your gums to protect them from the bleach,” Dr. Spizuoco explains. “They then apply the bleach and can leave it on for up to 60 minutes, sometimes using a light to activate the bleach.”

If you think back to old-school teeth whitening lights, you may associate them with tooth sensitivity. “Older lights generated heat, which made teeth more sensitive,” Dr. Apa says. That is less of a concern with newer technologies. “New lights like [Zoom](https://www.usa.philips.com/c-m-pe/teeth-whitening) do not generate heat,” he adds. It should be noted that the light isn’t doing the bleaching. “It is just initiating the bleach,” he explains. “Other systems have liquid initiators that are mixed with the bleach and applied to the teeth.”

The other method is to fabricate take-home trays. “Molds of your teeth are taken to create custom trays that you put the bleach into,” Dr. Spizuoco says of this hybrid professional and at-home option. “These trays can be worn for as short as one hour or as long as overnight while you sleep.” Because dental professionals can use a higher percentage of bleach, teeth may be sensitive. Potassium nitrate and fluoride are often added to soothe the dental nerves, she says.

Professional teeth whitening treatments are efficient (most take less than an hour), and the results typically last six months to a year, depending on the patient. They can cost upwards of $1,000 per session.

To maximize the benefits, Dr. Apa recommends a few healthy lifestyle changes. “If you are really good about not smoking, not eating things that stain your teeth, or not letting things sit on your teeth for long periods of time, your results will have a much longer lifespan,” he says. Additionally, touch-ups are possible without a trip to the office. “Touch-ups are typically done with at-home bleach, where you are using either a custom tray or a strip,” Dr. Apa explains. “If the normal regimen for an at-home bleaching is 10 to 14 days, for example, a touch-up regimen is two to three days.”  

## **At-Home Teeth Whitening Options** 
Speaking of at-home teeth whitening, the process requires a bit more patience. While in-office treatments are done in under an hour, at-home whiteners require a regimen. Over the course of several weeks, patients will see a noticeable difference in the brightness of their smile, but the results are not as dramatic. “The percentage of peroxide is usually lower in over-the-counter systems and, therefore, may not work as well,” Dr. Spizuoco says. “These methods can be messy and the bleach can get on your gums and cause sensitivity.” 

As a reminder, the only active ingredients that bleach teeth are hydrogen peroxide and carbamide peroxide. If the OTC product doesn’t have either of those ingredients, then it is whitening, not bleaching, the teeth. “Whitening is stain removal, while bleaching is actually changing the internal surface of the tooth structure to make it seem whiter,” Dr. Apa clarifies. “Stain removal products are more abrasive and should be used in smaller doses.” (More on that below!)

If you are ready to give at-home teeth whitening a try, here’s what you need to know about three of the most common treatment options: 

### **1. Whitening Strips**
Most whitestrips work by coating the teeth with a gel that contains hydrogen peroxide or carbamide peroxide. The concentration of hydrogen peroxide and carbamide peroxide is, needless to say, much lower than an in-office treatment. Users press the strips against the teeth and leave them for five to 30 minutes, depending on the brand. Most people report seeing initial results after three days and full results in about 21 days. Whitening strips are considered an affordable option — priced between $30 to $50 per kit — and usually include two to three weeks worth of treatments.

### **2. Whitening Trays** 
Similar to whitening strips, whitening trays use a peroxide-based bleaching gel. Instead of applying the gel via strips, you wear a gel-filled, mouthguard-like tray for several hours at a time. Most people see results in seven to 14 treatments, depending on the whitening kit system. Overall, whitening trays deliver the strongest results of the whitening solutions, but they also require the biggest time commitment. 

### **3. Whitening Toothpastes**
Toothpastes with whitening claims usually contain polishing beads and/or whitening agents to remove stains from the teeth. Some over-the-counter toothpastes might also be formulated with a low dose of hydrogen peroxide. While these products may not cause as much tooth or gum sensitivity as strips and trays, those with polishing agents can be overused. “I don’t recommend using them every single day,” Dr. Apa says. “I would use it two or three times a week and alternate with something less abrasive.” Dr. Spizuoco recommends [Sensodyne whitening toothpaste](https://www.sensodyne.com/en-us/products/product-results/teeth-whitening-toothpaste/) because it “has potassium nitrate and fluoride in it to combat sensitivity.”

## **The Takeaway**
Nothing can rival the results of professional teeth whitening, and, at this, point, you probably recognize that there is no such thing as a one-size-fits-all treatment. “It's difficult to give everyone the same treatment, which is why I recommend seeing a dental professional,” Dr. Spizuoco says. “We can customize a treatment plan just for you based on your level of sensitivity.” 

Once you've successfully brightened your teeth, it’s important to preserve the results. “I recommend avoiding coffee, tea, red wine, soy sauce, curry, tomato sauce, smoking, kale, spinach, and basically anything that will stain your white shirt,” she explains. “Using an electric toothbrush with a whitening toothpaste can help remove these stains before they get a chance to set in.” 

AEDITION for men-min

Expert Opinion Collection | The AEDITION

Expert Opinion

Professional teeth whitening is the gold standard, but there are a host of at-home whitening kits and products that promise a brighter, whiter smile. Here’s what you need to know.

Professional Teeth Whitening vs. At-Home Teeth Whitening

Professional vs. At-Home Teeth Whitening: What’s The Difference?

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Like a good fall outfit, skincare should be layered with care. “The order in which you apply your skincare products is important in ensuring that you reap all the benefits of each,” explains [Y. Claire Chang, MD](https://www.unionderm.com/doctors/dr-claire-chang/), a board-certified cosmetic dermatologist at Union Square Laser Dermatology in NYC. The strategy: “In general, apply from lightest to thickest,” she says. “If you apply thicker products first, the lighter or lower molecular weight products will have trouble penetrating through to the skin to deliver its benefits.”

Just as the rules of fashion dictate, it’s all about saving the heavier ‘outerwear’ layers for last. But judging which product is heftier than another just by feel can be tricky — and there are some exceptions to the rule that can make finding your ideal order more difficult. That doesn’t mean you can’t become a skincare recipe master, though. You just need a little know-how. Read on for guidelines of what to apply after that crucial ‘cleanse’ step.

## **Step 1: Prep With Liquids**
Once you’ve [washed your face](https://aedit.com/aedition/dermatologist-tips-for-applying-removing-makeup), if you have anything in your routine that feels like a lot like water, it should get swiped on first. These products are generally meant to prep the skin, either by removing dead skin cells (astringents), balancing your pH or oil level (toners), or adding a light but deeply penetrating level of moisture that ups the magic of ingredients to come later in your routine (essences).

It should be noted that this step is completely voluntary — and some derms would even say unnecessary. That is especially true for toners, one of the more controversial skincare steps. “[They] do not provide any benefit to skin except the possibility of dryness and irritation,” says [Amy Spizuoco, DO](https://true-dermatology.com/about/meet-dr-spizuoco), a board certified dermatologist in New York City. Even so, some do find them beneficial for the right patient. “You do not always need a toner, but it can definitely improve your skin in certain cases,” Dr. Chang says. 

Her advice for those who want to use one: “If your skin is feeling dull, choose a toner with brightening ingredients like niacinamide or [alpha hydroxy acids (AHAs)](https://aedit.com/aedition/guide-to-topical-alpha-hydroxy-acids-in-skincare). If your skin is feeling oily and acne-prone, you can choose a toner with ingredients, like tea tree oil, witch hazel, or [beta hydroxy acids (BHAs)](https://aedit.com/aedition/guide-to-beta-hydroxy-acids-salicylic-acid-in-skincare).” But she says to avoid one ingredient at all costs: alcohol. “[It] can dry out your skin and leave it feeling tight.”

## **Step 2: Treat With Serums, Creams, and Meds**
In the second category, you are applying anything that is of ‘medium’ weight, which tends to be the products with active ingredients (think: serums, treatments, and medications). This is not only because of the consistency of the formulas, but as [Morgan Rabach, MD](https://lmmedicalnyc.com/dr-morgan-rabach/), a board certified dermatologist and co-founder of LM Medical in NYC, explains, putting them on next ensures you’re getting the most out of the glow-inducing, age-defying, and nourishing add-ins inside. “I always put the active ingredients on the skin first and then moisturizers to seal in the active ingredients,” she says.

When it comes to serums and medications, people usually use one or the other in a single session. For instance, you might use a photosensitive [vitamin C](https://aedit.com/aedition/guide-to-topical-vitamin-c-in-skincare) serum at night and an [Rx for acne](https://aedit.com/aedition/best-professional-treatments-for-acne-and-acne-scars) during the day. But if you’re using both at once, Dr. Spizuoco recommends going with the serum first and then the medication on top. Dr. Rabach explains that the key here is to allow each to absorb completely (for a few minutes) before moving on to the next step as not to dilute them.

There are two exceptions to this rule. The first is [retinol](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare) for those with sensitive skin. In such cases, Dr. Chang says that applying moisturizer can help with dryness and irritation. The second case is bleaching cream (like hydroquinone) used for hyperpigmentation. “It's best to apply the moisturizer first and then the bleaching agent to individual spots, as to not spread to unwanted areas on the skin,” Dr. Spizuoco explains.

## **Step 3: Moisturize**
Next up in your routine: Anything that’s main focus is to keep you from feeling parched. This includes leave-on face masks, [eye cream](https://aedit.com/aedition/eye-creams-serums-to-treat-crows-feet-dark-circles-puffiness), moisturizer, and [face oil](https://aedit.com/aedition/benefits-of-face-oil-for-all-skin-types). You don’t necessarily need more than one product in this category, but there can be benefits to combining. Some people find their moisturizer works well enough on its own (oily skin types, for example, may only need a face oil), while dry folks might want to combine a cream and oil. If you’re layering, the general advice is to save the oil for last because it “can help lock in moisture to avoid excess dryness,” Dr. Chang says. Her warning: “If you are acne-prone, avoid facial oils that can clog your pores and worsen your breakouts.”

## **Step 4: Protect**
At night, your routine can stop at moisturizer, but there’s one last thing that needs to cap off every daytime regime: [sunscreen](https://aedit.com/aedition/how-to-apply-sunscreen-and-not-miss-a-spot). Actually, to be clear, it’s sunscreen and then more sunscreen because, as we all know, SPF should be reapplied every few hours to keep your skin protected. Dr. Rabach’s advice: Look for mineral sunscreens that contain titanium and zinc (check out our [roundup of the best sunscreens](https://aedit.com/aedition/best-lightweight-non-greasy-sunscreens-to-wear-indoors)). She explains that, since they act as physical shields from sunlight, they offer more dependable protection — and dependability is exactly what you should be looking for in a sunblock.

Finding the right order for your products can make all the difference.

How To Apply And Layer Skincare Products

How To Layer Skincare Products

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In case ‘[maskne](https://aedit.com/aedition/how-to-treat-prevent-acne-caused-by-covid-19-masks-face-coverings)’ (you know, the breakouts and skin irritation caused by masks and face coverings) wasn’t enough, ‘mask mouth’ is here as another side effect of wearing personal protective equipment (PPE) to slow the spread of COVID-19. Dentists are seeing a rise in patients complaining of bad breath, tooth and gum sensitivity, and even cavities, which can be exacerbated by prolonged periods of mask wearing. 

Good oral health isn’t just about maintaining a bright smile. It actually impacts the body from head to toe. “In recent years there have been hundreds of studies done showing the correlation between systemic diseases and oral health,” says [Brian Harris, DDS](https://drbrianharris.com/), a cosmetic dentist and founder of [Klēn](https://klenproducts.com/). “The mouth is the entry point to the body and it contains 500 to 600 different types of bacteria, and those with poor oral health are going to carry a higher concentration of harmful bacteria.”

With face coverings here to stay (at least for the foreseeable future), it’s time to get serious about your oral health. Here, top dentists break down the ins and outs of treating *and* preventing mask mouth.

## **What Is Mask Mouth?**
As the name suggests, the new oral hygiene disorder is a result of wearing a face mask for extended periods of time. Symptoms of ‘mask mouth’ include:

- Halitosis (a.k.a. bad breath)
- Tooth decay and cavities 
- Gum inflammation (puffy gums, gingivitis, etc.)

Wearing a mask can affect dental health by creating a dry and acidic mouth environment. “This is because we tend to breathe through our mouths while wearing masks and tend to hydrate less,” says [Jennifer Jablow, DDS](https://www.doctorjablow.com/), a New York City-based celebrity dentist and co-founder of [MASKnSIP](https://www.buymasknsip.com/). You might associate wearing a face covering with increased moisture on the skin, but the mouth itself is dry. “We get a dry mouth environment from this and less salivary flow, which is a natural protection to wash away bacteria and keep the mouth pH at an optimal level,” she explains. “When the mouth is dry, it becomes more acidic, which is a perfect environment for plaque and bacteria.” The result? “Gum problems, stinky breath, and even cavities,” she notes.

## **What Causes Mask Mouth?** 
Let’s get one thing straight: The mask itself is not harmful. Face coverings are made of safe materials and allow us to breathe without expelling respiratory droplets. When masks are worn for an extended period of time, however, they can change some conscious and subconscious behaviors that lead to stinky side effects. 

- **Mouth Breathing**: Wearing a mask causes many people to change their breathing habits. We are meant to breathe in and out through the nose. But, once the mask goes on, we often switch to breathing through the mouth, which causes mouth dryness. Dry mouth then leads to a decrease in saliva production. While primarily composed of water, saliva also contains a number of important enzymes, proteins, and minerals that are necessary for fighting disease-causing bacteria, preventing plaque build up, and keeping the mouth clean. If saliva isn’t present to neutralize the mouth, cells decompose and cause bad or sour breath.
- **Dehydration**: Like mouth breathing, dehydration also causes dry mouth and, in turn, bad breath. Most people who are wearing PPE all day are in professions where they are surrounded by a higher volume of people, like healthcare workers. Because of the fear of contracting the virus, a lot of people don’t want to remove their mask to eat or drink.  
- **Acidic Drinks**: Whether you’re on the frontlines or adjusting to a new normal at home, the coronavirus pandemic is stressful. Unsurprisingly, a lot of people have turned to coffee for an energy boost and alcohol for comfort. Both are fine in moderation, but, when consumed regularly, these acidic beverages can have a negative impact on oral health — staining the teeth, causing sensitivity, and eroding enamel. 

## **How to Treat & Prevent Mask Mouth** 
“The main cause of mask mouth is more related to the bacteria and chemistry of the mouth than anything else,” Dr. Harris says. “The best thing you can do is to use the right products to keep things in balance.” With that in mind, below are the products and good habits that will help treat and prevent mask mouth:

### **1. Stay Hydrated**
Steer clear of acidic sodas, iced teas, and sports drinks in favor of a higher pH water, like Essentia or Smartwater Alkaline, Dr. Jablow says. Because hydration is key to good oral health, Dr. Jablow and fashion expert Christina Wilson created the [MASKnSIP](https://www.buymasknsip.com/), the first antibacterial mask designed for drinking. It features a resealable flap and straw hole that allows you to keep hydrated all day long — without removing your mask.

### **2. Brush Regularly**
Brush two times a day, preferably with a sonic toothbrush. For toothpaste, Dr. Jablow recommends using a toothpaste with zinc ions to kill bad breath at its source and xylitol to balance pH. Her pick? The [IntelliWhite Carbon Power Clean Toothpaste and Power Boost Whitening Gel](https://shopintelliwhite.com/products/intelliwhite-carbon-power-clean-toothpaste-and-power-boost-whitening-gel) duo.

### **3. Don’t Forget About Your Tongue** 
“The absolute best fix for mask mouth is the use of a tongue cleanser morning and night, along with a mouth rinse designed to treat halitosis and not just cover it up,” Dr. Harris says. The [Klēn Tongue Cleanser](https://klenproducts.com/collections/all-products/products/tongue-cleanser) is specially designed to remove bacteria from the entire tongue at once, while the [Natural Mint Rinse](https://klenproducts.com/collections/all-products/products/natural-mint-rinse-bundle) is formulated to “neutralize breath odors and hydrate the mouth,” he shares. 

### **4. Try Water Flossing** 
We’ve all heard about the importance of flossing, but Dr. Jablow recommends upping the ante with a water flossing device because it is “much more efficient than string floss.” Her tip? Add a capful of peroxide in the water tank for a deeper clean. “The oxygen from the peroxide will kill the bacteria under the gumline that causes inflammation,” she notes.

### **5. Remove Tartar** 
To complement your brushing, flossing, and tongue scraping routine, Dr. Harris created the [In Between Klen](https://klenproducts.com/products/in-between-klen) kit to help remove plaque and tartar build up and stubborn stains in between professional cleanings. “Tarter is the hardened biofilm of plaque on the teeth and it is loaded with bacteria, which is what causes bad breath,” Dr. Harris explains. “Removing that tarter can improve the smell of the breath, and, at the same time, it improves the look of the teeth.” 

## **The Takeaway**
Bad breath may not necessarily be a primary concern because your mask and social distancing prevents it from wafting over to your friends or peers, but gum inflammation, tooth decay, and bad breath can be your mouth’s way of notifying you of a larger problem.

Previous studies have [found a link](https://www.heart.org/en/news/2018/11/07/bad-tooth-brushing-habits-tied-to-higher-heart-risk#:~:text=Brushing%20your%20teeth%20twice%20a,gum%20inflammation%20and%20tooth%20damage.) between heart disease and periodontal disease (gum infection). Gum disease is believed to increase the risk of heart disease because the inflammation and bacteria in the gums may eventually lead to narrowing of the arteries. “The plaque that builds up and the bacteria that resides inside that plaque can cause chronic low-grade inflammation, which is a cause of many systemic diseases,” Dr. Jablow says. “There is an increased risk for heart problems.” Serious periodontitis is also linked to respiratory disease, chronic kidney disease, rheumatoid arthritis, cognitive impairment, obesity, metabolic syndrome, and possibly cancer.

The bottom line: If you think you have mask mouth, don’t ignore it. 

Move over, maskne! Bad breath, gum inflammation, and tooth decay are also unintended consequences of wearing face coverings for prolonged periods of time. Here, the experts break down how to prevent it.

Mask Mouth: How To Treat Bad Breath, Tooth Decay, Gum Sensitivity From Face Masks

How To Treat And Prevent ‘Mask Mouth’

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High cheekbones. We all want them, but why? Scientific research has found that prominent cheekbones might be linked with [higher levels of estrogen](https://onlinelibrary.wiley.com/doi/full/10.1111/j.1473-2165.2007.00333.x) and may even be an [indication of trustworthiness](https://www.fastcompany.com/3035362/what-your-face-says-about-how-trustworthy-you-are). Regardless of the reason, there’s no doubt that defined cheekbones are ‘in.’ While we may not all be as genetically blessed as Kendall Jenner or Bella Hadid, there are a number of ways we can define our cheekbones. 

## **What Are High Cheekbones?** 
‘High cheekbones’ is a phrase we’ve probably all heard of at some point. In theory, we get it. But do we really *understand* what it means to have defined cheeks? Also referred to as the malar bone or zygomatic bone, the cheekbones are the facial structure that supports the cheeks. When the bones sit closer to the eyes, they are considered to be ‘high’ cheekbones. 

On the other hand, if cheekbones are closer to the tip of the nose, they are considered to be ‘low’ cheekbones. While high cheekbones may be considered a desirable feature, they don’t define beauty. Jennifer Lopez, Salma Hayek, and Kate Moss are just a few insanely gorgeous celebrities who have lower cheekbones. 

## **Best Procedures to Define Your Cheekbones**
While a [good contour kit](https://aedit.com/aedition/contouring-tips-from-celebrity-makeup-artist-patrick-ta) can create the illusion of higher cheekbones, there are a number of in-office procedures that offer temporary and permanent solutions. Below, two board certified plastic surgeons break down the best options.

### **1. Dermal Filler** 
The same filler that you use in your [lips](https://aedit.com/procedure/temporary-lip-fillers) and [under the eyes](https://aedit.com/procedure/under-eye-filler) can also be used in the cheeks. [Cheek fillers](https://aedit.com/procedure/cheek-augmentation-with-fillers) are injected with the goal of lifting and plumping up the area to give them more definition — though a little goes a long way. “Use no more than one cc of filler on each side and check in a mirror,” says [Gerald Imber, MD](https://www.drimber.com/plastic-surgeon-nyc/), a board certified plastic and reconstructive surgeon in New York City. “Overdone cheekbone filler can be dissolved by injection, but it is not a precise process, so overfilling should be avoided.”

To better control the placement of the filler, [Kian Karimi, MD](https://aedit.com/provider/kian-karimi-md-17458), a board certified facial plastic and reconstructive surgeon in Los Angeles, uses a micro-cannula for over 90 percent of his [injectable fillers](https://aedit.com/aedition/everything-you-need-to-know-about-dermal-fillers). “This allows me to get into different compartments of the face precisely and safely for accurate placement of fillers,” he says. “Since the micro-cannula is not sharp, it minimizes the risk of injecting fillers into blood vessels, which can lead to scary complications.”

Filler results are immediate and can last one to two years (or more), depending on the product used. Patients may experience some swelling and bruising for a few days following the treatment. Dr. Imber says filler is the preferred option for patients who are “trying out” the look. “The filler dissipates over the course of a year, and one can then course more permanent fat grafting,” he explains. 

### **2. Fat Grafting**
Speaking of [fat grafting](https://aedit.com/procedure/cheek-augmentation-with-fat-transfer) (a.k.a. fat transfer), the procedure is often considered a natural alternative to cheek implants and a [more permanent solution](https://aedit.com/aedition/comparing-dermal-fillers-vs-fat-grafting-for-facial-rejuvenation-contouring) than dermal filler. “It is, in fact, a totally natural substance,” Dr. Imber shares. Instead of using a foreign substance to augment, the doctor removes the patient’s own fat from another part of the body — usually from the stomach or thighs — and injects it into the cheeks. There is no risk of rejection with the treatment, and it is Dr. Imber’s “first choice” for cosmetically defining the cheekbones thanks to its permanence, natural result, and minimal downtime.

The two-step procedure first involves extracting the fat from the donor site through liposuction. The fat is then purified and injected into the cheek. A percentage of the fat is reabsorbed into the body, so your doctor may ‘overfill’ the area to start. “Using fat can affect a more gradual augmentation of the entire cheek area and a significant portion is permanent,” Dr. Imber explains. It should be noted that weight gain or loss can impact results, so maintenance may be necessary.

After the procedure, most patients experience swelling, bruising, and redness on the face and at the donor site for a few days. Full recovery can take up to six weeks, but most people are able to resume daily life after 48 hours. 

### **3. Thread Lift**
A thread lift procedure involves placing [PDO threads](https://aedit.com/procedure/pdo-thread-lift) subcutaneously to lift the skin. It is commonly used on the midface, jowl, and neck to target aging and is a great option for the cheeks when there is sagging without volume loss.  Dr. Karimi describes the ideal candidate as someone with great cheekbones who is experiencing “smile lines.”

Each thread contains small barbs along the surface, which help it grab and lift the targeted area. When the needles are withdrawn, they cause the tissue to gather over the thread, lifting the skin. New fibrous tissue will soon form around the PDO threads, which help keep them in place and hold the tissue.

“If someone does have volume loss then we recommend a combination of threads and fillers,” Dr. Karimi says. “This allows us to lift the cheek in a natural way and not depend on fillers to try to lift a cheek, which can lead to an overfilled or unnatural appearance.” For the most natural-looking thread lift, Dr. Karimi uses NovaThreads Infinity Threads. They last at least a year. 

### **4. Cheek Implants**
[Cheek implants](https://aedit.com/procedure/cheek-augmentation-with-implant), also known as cheek augmentation, is a permanent augmentation procedure that increases the cheek’s volume and projection. “Cheek implants, when perfectly seated in place, look entirely natural and are permanent,” Dr. Imber says. “They are solid silicone substances added on top of the cheekbone, and their preformed shape mimics the bone.” 

While it is a surgical procedure, most patients are in and out of the surgery room within an hour. After the general or local anesthesia is administered, the plastic surgeon will make a small incision beneath the eyes or in the mouth to create a small pocket for the implant. Once the implant is inserted and secure, the doctor closes the incision and applies a compression or bandage to help reduce the swelling.

While Dr. Imber notes the potential benefits of cheek implants, he prefers other augmentation methods. “The problem is they often slip or aren’t seated properly,” he cautions. “These days, I opt for fat grafting or filler.”

## **The Takeaway**
As with all cosmetic procedures, there is an art to finding the [right proportion](https://aedit.com/aedition/plastic-surgery-results-are-about-proportion-not-perfection) for cheeks. Dr. Karimi likes to follow the “Goldilocks Principle” (i.e. not too much and not too little). “There are practitioners that will pull out rulers and calipers, but I think a good conversation with the patient to understand goals and then augmenting one's own natural cheek and enhancing their beauty is the way to go,” he says. “A great injector will know how to balance this and produce beautiful, natural, and reproducible results.”

From filler and fat grafting to threads and implants, these are the best cosmetic procedures for higher cheekbones.

Cosmetic Procedures For Higher Cheekbones

4 Procedures To Define Your Cheekbones

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Imagine waking up every morning with a perfectly even complexion — the kind that looks like you’ve had a team of pros airbrushing your face overnight. That’s the promise of semi-permanent BB cream (a.k.a. ‘BB Glow’). But is it too good to be true? The AEDITION asks the experts.

## **What Is Semi-Permanent BB Cream?**
BB Glow is essentially a form of [microneedling](https://aedit.com/procedure/microneedling) that has made its way stateside from South Korea. Like typical microneedling, an aesthetician first applies numbing cream to the face. Unlike the traditional treatment, semi-permanent pigments are added to the mix to tint the complexion for about six months to one year. “This procedure is meant to improve the overall appearance of the skin including uneven skin tone, fine lines, wrinkles, hyperpigmentation, age spots, post-acne pigmentation, and large pores,” explains [Sejal Shah, MD](https://smarterskindermatology.com/about-us/sejal-shah-md/), a board certified dermatologist in New York City.

So, what makes semi-permanent BB cream different from a traditional microneedling procedure? “With anti-aging microneedling formulas, the ingredients absorbed through the channels are mostly skin-centric and nutritional raw ingredients,” says permanent makeup pioneer [Dominique Bossavy](https://www.dominiquebossavy.com/). As she explains it, they are usually biodegradable and either work with the lipids or water particles in the cellular makeup of the skin. “They are easily absorbed or carried away and expelled, so their negative effects are either limited and short or there are none,” she continues.

The same cannot necessarily be said of BB Glow pigments. The treatment is not approved or regulated by the United States Food and Drug Administration (FDA). As the FDA notes in its [Tattoos & Permanent Makeup Fact Sheet](https://www.fda.gov/cosmetics/cosmetic-products/tattoos-permanent-makeup-fact-sheet): “Although a number of color additives are approved for use in cosmetics, none is approved for injection into the skin.” The agency continues to investigate the safety of permanent makeup ink with periodic voluntary recalls, including one in 2017 involving inks that were microbially contaminated. While there are reputable providers using quality pigments, Bossavy warns that the lack of regulation makes BB Glow a “buyer beware” procedure.

## **How Semi-Permanent BB Cream Differs from Other Permanent Makeup**
Our experts say that the process of getting [semi-permanent blush or lip color](https://aedit.com/aedition/expert-guide-to-permanent-makeup-cosmetic-tattoo-microblading) is essentially the same as getting a semi-permanent foundation procedure. The difference lies in the amount of surface area being treated. The more skin being injected with pigmented serum, the more potential for complications and side effects.

Like all semi-permanent makeup, there’s really no way to predict exactly how the pigment will hold up over time. “When the pigment starts to fade, it may be more noticeable on the entire face because it is a relatively larger area,” Dr. Shah warns. From microblading mishaps to blundered lip blush, she has treated patients looking to remove their semi-permanent makeup — something that’s harder to do with an all-over treatment like BB cream.

It’s no secret that tattoos can be notoriously [difficult to remove](https://aedit.com/aedition/laser-tattoo-removal-treatment-guide-doctor-patient-perspective), and BB Glow pigments often contain titanium dioxide, which is blended with brown and red pigments to mimic skin tone. It is known to turn blue or black when exposed to lasers, potentially leading to permanent discoloration.

But that’s not the only concern associated with titanium dioxide. “[It’s] one of the largest, most opaque and lasting pigment particles that can remain a lifetime in the skin without fading,” Bossavy explains. “The quantity of non-degradable material deposited over an entire face every few months … can accumulate over time and trigger an immune response that can last longer — creating much uncertainty for the long term.”

BB Glow side effects can range from allergic reactions, contact dermatitis, broken capillaries, infection, and postinflammatory hyperpigmentation (PIH) to granulomas (i.e. the hardening of tissue surrounding the pigment particles), scarring, organ toxicity, and cell damage. Additionally, there is still much research to be done about semi-permanent makeup more generally. For example, some people with permanent eyeliner have reported experiencing burning and swelling from magnetic resonance imaging (MRI) procedures. Though it may be too early to say with certainty, pigment covering the entire face could prove similarly problematic.

## **How to Get Glowing Skin Without BB Glow**
Given the safety concerns of semi-permanent BB cream treatments, what can mimic the, admittedly, alluring effects of a ‘I woke up like this’ flawless face? “There are a number of topical treatments available, as well as chemical peels, lasers, [radiofrequency microneedling](https://aedit.com/procedure/microneedling-with-radiofrequency), and microneedling without pigments,” Dr. Shah says. On the skincare front, she recommends [vitamin C](https://aedit.com/aedition/guide-to-topical-vitamin-c-in-skincare), kojic acid, hydroquinone, arbutin, and [retinoids](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare) for lightening and brightening the skin. Fractional lasers (Fraxel®, CO2, Pico), microneedling, and chemical peels, meanwhile, can “address texture and tone,” she adds.

## **The Takeaway**
Until more research can be done into the long term safety and efficacy, Bossavy suggests steering clear of the ‘beauty’ treatment. “Many things are possible, but that doesn't mean they are safe,” she cautions. “Too often, when beauty is at stake, we are quick to recklessly sacrifice safety for instant beauty gratification. It may look good and feel good now, but we will pay a high price later.”

Imagine waking up every morning with a perfectly even complexion. That’s the promise of BB Glow — but is it too good to be true?