A woman with surgical markings on her face sits in contemplation, symbolizing cosmetic surgery planning. The image highlights the difference between wanting to “look better” and targeting specific facial features, reflecting expert approaches to aesthetic goals.

How Experts Navigate General Cosmetic Goals-unsplash-joeyy-lee

You walk into a Medspa or a plastic surgeon’s office and say, “I just want to look better.” You’re not pointing to a deep wrinkle, a bump on your nose, or a specific feature you want to tweak—you simply want to feel fresher, more confident, and maybe turn a few heads. You’re far from alone. Many patients approach their dermatologist or plastic surgery consults with general beauty goals rather than specific concerns, which can be challenging for professionals to figure out exactly what “better” means for you… and making sure it’s achievable in a way that leaves you satisfied. So, is it a good idea to get injected or go under the knife when you’re not quite sure what’s “off” to you? We interviewed AEDIT founder [Board-certified facial plastic and reconstructive surgeon Dr. William Kennedy](https://aedit.com/provider/william-kennedy-md-26292#google_vignette) to get his opinion on the matter.

# **Can you get plastic surgery just to look better?**

You’re not feeling comfortable in your skin, we totally get it and can relate. But, is plastic surgery the solution? [Board-certified facial plastic and reconstructive surgeon Dr. William Kennedy](https://aedit.com/provider/william-kennedy-md-26292#google_vignette) says, "The first conversation with a patient should be to uncover what ‘attractive’ means to them personally, how they want to feel, and what aligns with their unique features.” Surgeons and aesthetic specialists want to understand your unique vision of beauty. Sometimes that’s rooted in subtle anti-aging goals, while other times it’s about changing harmony and balance. If you don’t come in with specifics, your doctor should put on his or her detective hat, helping interpret your beauty goals while ensuring the procedure plan is realistic and safe.

# **What are the best cosmetic procedures to look more attractive?**

The best cosmetic procedures for general attractiveness depend entirely on your desired outcome. There are a number of non-surgical treatments that you can get at a Medspa like dermal fillers, [Botox](https://aedit.com/procedure/botox), [skin resurfacing](https://aedit.com/procedure/skin-resurfacing-solutions), and [thread lifts](https://aedit.com/procedure/thread-lift) to rejuvenate the face with minimal downtime. Some surgical options might include eyelid surgery to open up the eyes, [lip lifts](https://aedit.com/procedure/lip-lift) for a youthful smile, or [rhinoplasty](https://aedit.com/procedure/rhinoplasty-nose-job) for profile refinement. When it comes to the body, many doctors turn to [liposuction](https://aedit.com/procedure/liposuction), [breast lifts](https://aedit.com/procedure/breast-lift), or [tummy tucks](https://aedit.com/procedure/tummy-tuck-abdominoplasty) to tone and tighten. The most effective approach is personalized; what looks transformative for one person might be unnecessary for another.

# **Do people get surgery without knowing what they want?**

[Dr.  Kennedy](https://aedit.com/provider/william-kennedy-md-26292#google_vignette) shares, “It’s very common for patients to come in with a clear goal in mind, yet be unsure of which procedure will best help them achieve it.” This is where aesthetic consultations play an essential role. The provider’s job is to listen, ask the right questions, and guide you toward options that align with your anatomy, your lifestyle, and your goals. You don’t have to walk in knowing exactly what you want, but you should be open to honest feedback about what will and won’t work for you. 

# **Is it normal to want plastic surgery but not know why?**

If you’ve been feeling like you need to get plastic surgery without a clear idea, we’re here to reassure you that’s completely normal. It often happens when you’ve been feeling “off” about your appearance but can’t pinpoint the reason. Maybe you’ve noticed you look tired in photos or that your reflection doesn’t quite match how youthful you feel inside. These feelings are valid, but they do require exploration. Good providers will help you unpack whether those feelings stem from a specific facial or body feature.

# **What does “facial balancing” mean in cosmetic treatments?**

Facial balancing treatments are designed to create harmony among your facial features. Instead of zeroing in on one small area, providers look at proportions; how the chin relates to the jawline, or how the cheeks support the under-eye area. Balancing can be achieved with fillers, implants, or surgical adjustments, and the goal is to create an overall effect where no single feature overpowers the others. This approach is especially common when patients come in with general requests to “look better” rather than to fix one thing. From [Dr. Kennedy's](https://aedit.com/provider/william-kennedy-md-26292#google_vignette) experience he shares, “True enhancement isn’t about changing a single feature but rather creating harmony among all the features so that no one element overpowers the others. This might mean using fillers, implants, or surgery, but the end goal is always the same: a natural, proportionate look that feels like the best version of themselves.”

# **What do plastic surgeons recommend if I want to look prettier?**

If you tell your provider you simply want to look prettier, they’ll likely recommend a combination of Medspa treatments to look younger, volume restoration in areas that have hollowed over time, or subtle adjustments to enhance symmetry. The advice will always be based on your individual features, and the goal is to keep the results natural so you still look like yourself—just refreshed and more confident.

# **What procedures make your face more symmetrical?**

Facial symmetry can be improved through a variety of approaches, depending on the underlying cause of imbalance. [Dermal fillers](https://aedit.com/procedure/dermal-filler-and-injectable-solutions) can even out minor volume differences while surgical procedures like [rhinoplasty](https://aedit.com/procedure/rhinoplasty-nose-job) or [chin augmentation](https://aedit.com/concern/chin-augmentation) can address structural asymmetries. In some cases, dental work or orthodontics play a role in balancing the lower face. 

# **What should I ask during a cosmetic consultation?**

When going in for an aesthetic consultation, it’s important to have an open conversation with your doctor. Ask how they would approach your goals, what procedures they recommend, what results are realistic, and what recovery will look like. Additionally, you’ll want to ask to see before-and-after photos of patients with similar procedures and discuss any risks associated. This is also the time to talk openly about your budget, your timeline, and whether you’re looking for a one-time transformation or a longer-term maintenance plan.

# **Can plastic surgery make you more attractive?**

Plastic surgery can enhance your attractiveness when it’s done by an experienced board-certified plastic surgeon. When improvements are subtle and in harmony with your overall look, they can boost your confidence and help you feel more comfortable in your own skin. However, it’s important to keep in mind that attractiveness is subjective, which is why it’s so important to ensure that you and your surgeon are on the same page about your desired outcome.

# **What’s the difference between fixing a feature and enhancing overall beauty?**

Fixing a feature focuses on one specific area, like minimizing a bump on the nose, lifting droopy eyelids, or augmenting the jaw. Enhancing overall beauty takes a holistic view, considering how all your features work together. Many providers find that addressing the face as a whole, rather than in isolated parts, leads to results that feel more natural and long-lasting.

# **Is wanting to “look better” a red flag for plastic surgery?**

We’ll keep it honest: it can be. Vague plastic surgery goals could be a sign that a patient hasn’t fully thought through their expectations. In some cases, wanting to “look better” is perfectly healthy and simply means the patient is open to expert guidance. In other cases, it might indicate a deeper insecurity or external pressure. Since plastic surgery is permanent, a responsible provider will help patients explore this before moving forward.

# **Can vague beauty goals lead to regret after cosmetic procedures?**

Yes, vague requests can sometimes result in plastic surgery regrets, especially if the plastic surgeon didn’t have a good understanding of the patient’s idea of beauty. That being said, sometimes patients are disappointed with their outcomes even when they were treating a specific feature. This is why thorough consultations and realistic goal-setting are so critical. 

# **Is it bad to get cosmetic treatments because of social media trends?**

Trends come and go. Social media also tends to highlight extremes and heavily edited results that aren’t realistic for most people. The safest approach is to choose treatments that align with your personal style and natural features, not just what’s trending online.

# **How do experts handle patients who are chasing beauty trends?**

When providers identify that a patient is chasing a fleeting look, they may steer the conversation toward more timeless and individualized options. This might involve explaining why certain beauty trend procedures won’t age well or showing examples of subtle changes that will still look good years from now. The goal is to help you avoid decisions that could lead to regret down the road. "When patients come in with goals influenced by the latest trend, I encourage them to opt for procedures that will balance and highlight their individuality in a way that feels authentic and stands the test of time,” shares [Dr. Kennedy](https://aedit.com/provider/william-kennedy-md-26292#google_vignette).

# **Do aesthetic procedures impact self-esteem and confidence?**

For many people, the right procedure can boost self-esteem and improve confidence. Feeling good about how you look can have a ripple effect, encouraging you to engage more fully in life. However, if deeper emotional issues are driving your desire for change, surgery alone won’t solve them. That’s why good providers take time to understand the whole picture.


Expert Opinion

Explore how experts help patients navigate their cosmetic journey from vague beauty goals to specific procedures by defining attractiveness, setting realistic expectations, and creating safe, personalized treatment plans.

Navigating Your Cosmetic Journey: Expert Insights on Vague Beauty Goals, Specific Procedures & Personalized Plastic Surgery Guidance | AEDIT

Wanting to “Look Better” vs. Fixing a Feature: How Experts Navigate Patients' Cosmetic Goals

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It goes without saying that looking at a photograph is not the same as seeing something in real life. A two-dimensional snapshot simply cannot capture the nuance of a three-dimensional world, yet selfie and [social media culture](https://aedit.com/aedition/march-2020-study-shows-relationship-between-social-media-cosmetic-surgery) too often fails to respect that important distinction. Whether it’s through makeup, lighting, or face tuning apps, the photos that fill our feeds are not necessarily indicative of reality. But, increasingly, people are turning to cosmetic treatments to recreate a specific aesthetic that might look great in a picture but doesn’t translate to a natural-looking appearance in person because it lacks the movement and expression we expect to see. This is where an additional dimension of beauty – one that accounts for life in 2D *and* 3D – comes into play.

Recently, we hosted an Instagram Live with [Julius Few, MD](https://aedit.com/provider/julius-few-md-15580), a board certified plastic and reconstructive surgeon in Chicago and creator of [Aforé Beauty](https://www.aforebeauty.com/), to learn more about his concept of “four-dimensional beauty” and how it influences his approach to aesthetic medicine to achieve the most natural and holistic results for his patients. Watch the entire conversation below or read on for a breakdown of five key takeaways.

<a href="https://www.youtube.com/watch?v=6QcFwi8ptxQ" class="embedly-card" data-card-width="100%" data-card-controls="0">Embedded content: https://www.youtube.com/watch?v=6QcFwi8ptxQ</a>

## **1. Defining Four-Dimensional Beauty**
Dr. Few has been in practice for over two decades. While the original outpost of [The Few Institute](https://www.fewinstitute.com/) is in Chicago, he has a satellite office in Los Angeles where he tends to some very famous faces. As he explains, treating public figures has taught him a lot about our understanding and perception of attractiveness. “One of the things that struck me was how I could see a household-name celebrity, who, in a photograph or in a movie, looked a certain way and by all accounts was attractive,” he shares. “But you saw them in person and they went to even a more dramatic and more appealing level.” 

It’s that dichotomy between what he calls the “in-person encounter” and the “print version” that led him to formalize the idea of four-dimensional beauty. “What that represents is the concept that we deal with the three dimensions we all know – length, width, and distance – and the fourth dimension is time and moments in time,” he explains. “We're not talking about days, hours, minutes – we're talking about microseconds of movement and what is communicated both in terms of verbal and non-verbal communication.” 

While there are extreme examples of people overdoing it, even just a little too much filler or neurotoxin can look off if it impacts the natural movement of the face, he says. “That really is what four-dimensional beauty represents – that transition from moment to moment in interpersonal interaction that can either make or break a moment,” he shares. 

## **2. Photo vs. Video**
Even if your in-person schedule is not quite back to pre-pandemic strength, days spent in Zoom meetings, scrolling through TikTok, or rolling your eyes at Instagram’s ever-conspicuous push for video content are a reminder that we do, in fact, live in a three-dimensional world. The best way to look your best IRL is to consider how the result of whatever you are having done is going to impact your features and expressions. 

Dr. Few says the onus is on the provider to properly assess the patient. “Probably the most important thing that any cosmetic plastic surgeon, dermatologist, or provider of any kind really needs to hone in on is the idea that you have to look at animation during that in-office visit,” he shares. One way to educate the patient and further drive home the point is by supplementing traditional [before and after photos](https://aedit.com/aedition/importance-of-before-and-after-photos-in-plastic-surgery) with video. “I've started to incorporate more and more videography into the assessment, so I can show people,” he says. “I do believe that's going to become the norm in many ways.” 

With the ability to put a smartphone with a 4K camera into the palm of anyone’s hand, all providers need to do is standardize their lighting setup and positioning (à la traditional B&A photos). Dr. Few and his team recently [published a study](https://academic.oup.com/asjopenforum/article/doi/10.1093/asjof/ojac002/6515787?login=false) in the *Aesthetic Society Journal* based on the clinical results of using the [Aforé Beauty CR Emulsion](https://www.aforebeauty.com/products/cr-emulsion) – a serum that blends 0.2 percent retinol, [cannabidiol (CBD)](https://aedit.com/aedition/cbd-beauty-skincare-wellness-benefits), peptides, and hyaluronic acid to improve skin tone, texture, and hydration – that included a dynamic video component. “It gave us a platform to develop the videography assessment tool, which is in its infancy,” he says. “We're still working on it in terms of validating and putting it together, but we're well on our way.”

Long term, Dr. Few sees video as “a great equalizer” that will foster transparency. “There will be more and more of a demand for influencers and the like on social media to have videography versus a static picture,” he notes. “What different people got away with just because they had a great 2D picture, that's not going to be good enough.”

## **3. The Rise of Prejuvenation**
It’s usually easier to prevent something than correct it, and that is certainly true of age-related skin and aesthetic concerns. There is a lot to be said about rejuvenating procedures, but, in the last decade, the conversation has expanded to include the idea of ‘[prejuvenation](https://aedit.com/aedition/i-was-practicing-prejuvenation-before-it-was-a-trend)’ (i.e. preventative treatment). “I kind of came up with that term ‘prejuvenation’ at a multi-specialty meeting probably 10 or 11 years ago,” Dr. Few shares. “The whole concept came up during a panel because, at that time, I was just starting to really kick into taking care of a lot of models and actors, and that group really was keen on the idea of avoiding the knife.” Instead, they were interested in less invasive solutions that they could start earlier in life to potentially delay or eliminate the need for more invasive measures down the line. 

But it’s not just celebrities who want to get ahead. Dr. Few says he has long had patients who are predisposed to deeper frown lines or have a family history of jowling and want to address them as early as possible. “You can preempt that whole phenomenon just by simply targeting that area when it first starts to form, and then you hold it in suspended animation,” he explains, adding that it’s not about stopping the clock or dramatically altering someone’s appearance. “I believe if you try to take that given point where things are transitioning in maybe not the most positive way and hold it, well then that’s mission accomplished,” he says. “You've now made somebody achieve their goal of looking naturally beautiful and aging in the most graceful way, which, in my opinion, is the way to go.” 

Returning to those four dimensions of beauty, it’s all about enhancing what is already there in the most natural way. “It's not about aging ungracefully or in any artificial way or even not aging at all,” Dr. Few explains. “To me, where the artistry of cosmetic medicine and surgery comes through is in creating subtle contrast.” For example, “you have somebody who maybe has gray hair but, at the same time, has a youthful kind of very subtle cuteness that shines through,” he says. “That's their own individual expression.”

## **4. Blending Surgical & Non-Surgical Solutions**
Just because Dr. Few is a plastic surgeon doesn’t mean that every patient of his is going under the knife. “I am somebody who's kind of formed an expertise in both the surgical and non-surgical space – especially for facial rejuvenation and prejuvenation,” he says. In his view, it’s not so much surgical versus non-surgical but rather a continuum. “I try to position things in a way so that if somebody is not sure which direction they want to go, it's easier to do something that's a bit more temporary – that's non-surgical – that then can lead into a surgical option if that's what they want,” he explains.

Generally speaking, prospective patients fall into three categories: 

1. I definitely want surgery.
2. I definitely don’t want surgery – regardless of what I need.
3. I’m undecided and want to know my options.

After determining which bucket someone falls into, there are a trio of factors Dr. Few considers during a consultation to formulate a treatment plan: skin quality, volume loss, and facial laxity. “When you look at those three components, then I get to go into my toolbox and decide what are the options that work for it,” he shares. “For the skin, it may be different forms of resurfacing lasers, peels, etc., and then you look at non-surgical versus surgical lifting.” Seeing as he remembers the days when [Restylane®](https://aedit.com/procedure/restylane) was only one hyaluronic acid-based filler on the market, today’s innovation – especially in the non-surgical space – means there are now “more options than you could even hope to use.” As such, “it becomes much like picking the right paint brush for the component of the canvas you're painting on,” he says.

Finding the right balance between surgical and non-surgical has actually spurred hybrid solutions over the years. Dr. Few cites the evolution of the so-called [Nefertiti neck lift](https://aedit.com/aedition/where-to-use-botox-from-head-to-toe) as one such example. While injecting neurotoxin into neck bands can have a dramatic impact on texture and contour, the effect is temporary. For a longer-lasting result, Dr. Few developed a slightly more invasive neck band procedure. “That's where I can use a special needle that's called a no cord needle to actually go in and break up the bands of the muscle – much like the [Xeomin®](https://aedit.com/procedure/xeomin), [Dysport®](https://aedit.com/procedure/dysportr), or [Botox®](https://aedit.com/procedure/botox) would do – but it does it in a more permanent way,” he says. “You can marry these concepts, which is what makes it fun.”

## **5. The Benefit of ‘Stackable’ Treatments**
Long before the pandemic made the idea of [maximizing in-office time](https://aedit.com/aedition/best-aesthetic-procedures-to-combine-to-maximize-appointments) with your provider a must, Dr. Few was honing the technique of what he calls “stackable treatments.” “When I first came up with ‘stackable treatments’ as a concept, it was the combination of [Ulthera®](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy) and lasers and fillers – doing that all in one setting,” he shares. As he explains, the combination approach was, initially, “purely out of necessity.” “When I first started seeing patients in New York, I didn't have the luxury of trying to space it out over six months,” he notes. But then he realized the multimodal nature of the appointment was more than just convenient. “There's synergy in it,” he shares, that actually improves the results that would be possible with each treatment individually. 

But not all stacks need to happen at once. Lately, one of the popular pairings at his practice involves combining Dr. Few’s signature [thread lift](https://aedit.com/aedition/pdo-thread-lift-for-facial-rejuvenation) with [Sofwave™](https://aedit.com/aedition/sofwave-for-skin-tightening-collagen-production), a new non-surgical skin-tightening treatment that uses ultrasound waves to firm the skin, and [Kybella®](https://aedit.com/procedure/kybella) to address an array of age-related concerns in the lower face. “I'll do thread lifting, get a result, and then we can come back and do Sofwave™ to further enhance,” he explains. “It seems to really play on that matrix that has been created by the thread lifting.” But that’s not all. “If they still have a little bit of jowl fat, I can do a bit of off-label Kybella® injection to shrink it down,” he adds. “All of a sudden we're creating this approach that can deliver a progressive result.”  

Perhaps most importantly, this trio is not designed to create a trendy, overly snatched jawline. “Always bearing in mind four-dimensional beauty, we’re not trying to do anything just for the sake of a photograph on social media,” Dr. Few says. Instead, the procedures subtly-yet-substantially sculpt the lower face and neck for a more youthful countenance. The result: You’ll look like a rejuvenated version of yourself.

Board certified plastic and reconstructive surgeon Julius Few, MD, breaks down the concept.

A Guide To Four Dimensional Beauty For Natural-Looking Results

Why You Need A Four-Dimensional Approach To Beauty

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Injectables are constantly evolving, and what was considered the gold standard yesterday may be passé by tomorrow’s standards. One class of injectables that has largely proven to be trend-proof: [Neuromodulators](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) and their ability to limit muscle contraction and soften the look of fine lines, wrinkles, and other age-related concerns. In fact, [Botox® Cosmetic](https://aedit.com/procedure/botox) is celebrating the twentieth anniversary of its approval by the United States Food and Drug Administration (FDA) for the temporary improvement of the appearance of moderate to severe frown lines in adults. It was the first of its kind when it entered the market, and it’s since been joined by [Dysport®](https://aedit.com/procedure/dysportr), [Jeuveau®](https://aedit.com/procedure/jeuveau), and [Xeomin®](https://aedit.com/procedure/xeomin). 

Since no two faces are the same, no two dosages of these products are necessarily the same to achieve a desired result. That’s where so-called ‘Botox sprinkles’ – also known as ‘baby Botox’ – come into play. Not to be confused with [microbotox](https://aedit.com/aedition/aquagold-botox-microdosing-facial), the sprinkle technique is essentially just a smaller dose of a neuromodulator. A modest amount of Botox® and the like may produce a more natural result for younger patients or newbies who are just dipping their toe into the wrinkle-relaxing pool and concerned about appearing frozen.

So, what are the pros and cons of Botox sprinkles, and how can you tell if you are a candidate? We tapped top dermatologists and plastic surgeons for the scoop.

## **What Are Botox Sprinkles?**
A tongue-in-cheek reference for a smaller dose of a neuromodulator, the term ‘Botox sprinkles’ are injections of Botox®, Dysport®, Jeuveau®, or Xeomin® into a specific part of the face to soften the look of fine lines and wrinkles without eliminating all movement. “Botox sprinkles are great for smoothing fine lines and wrinkles on the face without completely removing muscle movement,” says [Michele Green, MD](https://aedit.com/provider/michele-green-md-34642), a NYC-based board certified dermatologist.

The trend of less-is-more shows no signs of slowing down, and some injectors and patients are preferring to use minimal amounts of neuromodulator to preserve expression. At his Arlington, VA, practice, double board certified facial plastic and reconstructive surgeon [Jonathan Cabin, MD](https://aedit.com/provider/jonathan-cabin-md-956), says a large percentage of his patients opt for these treatments to soften facial wrinkles and prevent traditional aging-related wrinkles while preserving natural movement. “It is the ideal option for [first-time Botox patients](https://aedit.com/aedition/everything-you-need-to-know-before-getting-botox-for-the-first-time) who are a bit nervous, younger patients interested in prevention, and patients who depend on powerful emotive facial expressions for their work,” he explains.

Like traditional injections of neuromodulators, the ultra-light dose version still requires a medical professional to inject botulinum toxin type A under the skin to temporarily relax the underlying muscle. A sprinkling of a neuromodulator within a particular area may provide a reduction of wrinkles and lines and their formation but not to the same degree as a standard treatment, says [Brendan Camp, MD](https://aedit.com/provider/brendan-camp-md-34645), a board certified dermatologist in New York City. Striking this balance is dependent on the [skill of the provider](https://aedit.com/aedition/botox-neuromodulator-safety). “An experienced injector will be able to determine the right amount of Botox to inject based on how strong your facial muscles are and how deep the wrinkles are,” Dr. Green says. 

The just-right amount of product will soften the visible appearance of wrinkles while limiting – but not paralyzing – the movement that causes them in the first place. Botox sprinkles aren't the best route if you want very little to no movement in the treatment areas. Using less Botox is less likely to completely paralyze the muscle and, therefore, results in more expression, says [Marisa Garshick, MD](https://aedit.com/provider/marisa-garshick-md-313), a board certified dermatologist in NYC. “Ultimately, with Botox sprinkles, you retain some movement and some wrinkles but soften the overall appearance,” she notes. Most injectable patients eschew the fully frozen look (though some want it) and the overarched eyebrows and difficulty moving that accompany it. If you specifically request baby Botox, you are less likely to have that frozen appearance since your doctor injects smaller amounts of the product.

Even though the name ‘sprinkle’ implies injecting a dusting or smidgen of neuromodulator into any one area, it's a little more precise than that. While there is no set requirement for what a sprinkle treatment consists of since each patient requires a different dose, expect about half the unit use compared to complete treatment. “For Botox sprinkles, I use as little as five units of Botox in the forehead and glabella, whereas the official dosing is 20 units for each,” Dr. Cabin says. “For the crow's feet, I use about 2.5 units per side, whereas the official dosing is 12 units per side.” Again, a consultation with your injector will dictate the best approach for you.

It should be noted that a full dosage doesn’t necessarily mean an unnatural or immobile result. If your doctor recommends using the standard dose of a neuromodulator, it still can provide a refreshed look that allows for facial movement. “However, if a patient is interested in maintaining a lot of movement, a lighter treatment with neurotoxin can be a great option,” Dr. Camp says.

## **Where to ‘Sprinkle’**
It's safe to ‘sprinkle’ the same areas of the face that providers commonly treat with larger amounts of neuromodulators – like the glabellar lines (a.k.a. the elevens), [crow's feet](https://aedit.com/procedure/periorbital-botox), and even the horizontal lines on the forehead. For the most part, smaller areas don't require as much product to begin with to erase wrinkles and lines seamlessly. Dr. Green prefers to use the sprinkle technique on areas of the face with lighter lines or where the skin is just starting to develop them. “It also works wonders in reducing mild to moderate wrinkles while still looking natural, but it often fails to yield the desired results for deeper lines etched in the skin,” she says.

## **Who’s the Best Candidate for Botox Sprinkles?**
Botox sprinkles are suitable for anyone who doesn't have many lines yet or has lines that aren't very deep but wants to prevent further wrinkles, Dr. Garshick says. “It's also good for someone who prefers a very natural look with minimal correction but still wants a refreshed appearance,” she explains. “And it can be helpful for older patients with a low-set brow or those who rely on the muscle movement to keep the eyelids and brows open to soften the movement without causing the brow to drop.”

Not everyone will benefit from a smaller dose of neuromodulator injections. While Dr. Camp says it may be a “good option” for those with minimal wrinkling who don’t require a full dose, others may find that a smaller amount of neuromodulator does not produce their desired result. Dr. Green says some patients come in expecting to get baby Botox, but, upon consultation, find out they have strong facial muscles and need more product to achieve optimal cosmetic effects. “The key to getting the best results from a neuromodulator is to go to an experienced injector, like a board certified dermatologist, who can give you natural-looking results,” she notes.

Generally speaking, the deeper the line, the stronger the muscle, and the more product needed to create smoother skin. Dr. Green explains that, with baby Botox, such small quantities of Botox are added to the muscle that it is not entirely relaxed. For deep wrinkles that are the result of overly active or strong facial muscles that repeatedly crease in the same spot for years, too little of an amount won't effectively smooth the area. “It's difficult to undo years of wrinkles with small quantities of Botox, so a regular amount is better for deep lines,” Dr Green shares. “But always ask your doctor what is best for you.”

That’s not all. As Dr. Garshick explains, Botox improves dynamic wrinkles or wrinkles that form with expression as opposed to lines at rest. Regardless of the amount of neuromodulator used, if a line is deeply etched in while at rest, it may not go away with Botox alone. “For these types of deeply etched lines, it can be helpful to also use [laser resurfacing](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing) or [microneedling](https://aedit.com/procedure/microneedling) treatments, which can be helpful to improve the appearance of lines at rest,” she adds.

Skin health may also play a role in who Botox sprinkles do and do not work well for. As Dr. Cabin shares, patients with mild-to-moderately etched-in wrinkles but otherwise elastic skin with healthy levels of collagen can eliminate and prevent deepening with consistent sprinkles. “But, in people with poorer skin or those that have significantly deep etched-in lines, this treatment may improve their lines a bit but will not be powerful enough for significant improvement or reversal,” he notes.

## **Does Less Botox Mean Less of a Result?**
In a single word: no. Just because you choose to go lighter on the amount of neuromodulator that is injected doesn’t mean the results are suboptimal. “Botox sprinkles can help the forehead look smoother, the wrinkles around the eyes less pronounced, and the lines between the eyebrows less deep,” Dr. Camp says. “However, the results are more subtle than standard treatments.”

Generally speaking, Dr. Green says baby Botox will yield a similar result to regular Botox, just on a smaller scale. “It is great for younger patients in their [twenties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-20s) and [thirties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-30s) who are looking to prevent fine lines and wrinkles from developing and subtly reducing the appearance of mild to moderate frown lines,” she shares.

Patient response to neuromodulators varies, and what may equate to a ‘lesser dosage’ for one person may be the standard treatment for someone else. “A ‘sprinkle’ for one could significantly decrease muscular movement for another patient,” Dr. Cabin notes. This is why first-timers are usually encouraged to come back for a follow up. “This is why I recommend two appointments with every new Botox patient,” he explains. “The first appointment is a conservative treatment, and the second appointment – two weeks later – is to see the response and if touch-ups are needed for undertreated areas.”

Certain features, like the forehead, actually respond better to smaller amounts of product versus larger quantities. For example, too much neuromodulator in the forehead can weaken the muscle in the area and force the brows to drop. “Injecting too many units can give the impression of a heavy brow,” Dr. Camp cautions.
 
As far as longevity goes, the lesser dose holds just as much weight in terms of results. It shouldn't wear away any faster or slower, so you can expect, on average, to stay wrinkle-free for about three to four months. In some patients, however, fewer units may equate to a shorter duration of results. This is especially true if the muscles are strong. But, “if the muscles are weaker, you will still notice some benefits for the same duration as expected with a full course of treatment,” Dr. Garshick says.

## **The Takeaway**
Whether it’s a preventative treatment, gateway procedure, or aesthetic preference, Botox sprinkles can serve many purposes. By using less neurotoxin, the muscle will retain more movement than a standard dosage, which can lead to a more natural-looking result. Depending on the depth of your lines, the quality of your skin, and/or your goals for treatment, baby Botox may be all you need to enjoy a more refreshed appearance. Consulting with a board certified dermatologist or plastic surgeon is the best way to determine how much neurotoxin you’ll need to achieve your desired outcome.

Aesthetics

Dermatologists and plastic surgeons weigh in on whether using a smaller dose of neurotoxin can still be effective.

The Pros And Cons Of Baby Botox (a.k.a. Botox Spinkles) For Fine Lines And Wrinkles

Are Botox Sprinkles The Way To Go?

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The [non-surgical aesthetics sector](https://aedit.com/aedition/biggest-non-surgical-aesthetics-trends-of-2022) continues to grow with no signs of slowing down. Patients and providers alike love minimally invasive procedures for their scarless results, in-and-out nature, and often downtime-free convenience. The flipside is the rate at which technology advances. While cosmetic surgery techniques evolve over time, it’s nowhere near as quickly as how fast non-surgical procedures wax and wane. Treatments that were once popular go-tos basically become obsolete as cutting-edge, of-the-moment tech that works faster, better, and more comfortably than before replaces those former favorites.

This can also make it tough to keep up with what’s new and next in non-surgical aesthetic medicine, which is why we’re doing the homework for you. The following up-and-coming non-invasive and minimally invasive procedures for face, skin, and body are headed for star status, and we’ve tapped top experts to learn more about why they are gaining buzz. Perhaps you'll discover a new favorite treatment that you've been waiting years to arrive.

## **1. For Next-Level Skin Tightening & Lifting**
- **The Treatment**: [Emface](https://bodybybtl.com/)
- **The Technology**: Muscle contraction & skin tissue heating
- **Best For**: Non-invasive skin tightening & lifting

**How It Works**: The BTL Aesthetics family of noninvasive technologies — you may recognize the brand by it's award-winning high-intensity focused electromagnetic muscle (HIFEM)-building treatments like [Emsculpt Neo®](https://aedit.com/aedition/what-its-like-to-get-emsculpt-neo) and Emsella® — has a new face-focused treatment to add to the group. Enter Emface. Although details about the procedure are still very much under wraps, we know that the device uses proprietary energy to tighten and lift facial muscles. 

Injectables and fillers have their place, but there's also only so much they can do to lift the face. With filler comes the tendency for [over injecting](https://aedit.com/aedition/how-to-correct-overfilled-facial-features), starting them too young, and aesthetic and [medical complications](https://aedit.com/aedition/risk-of-vascular-occlusion-after-dermal-filler), says [Paul Jarrod Frank, MD](https://www.instagram.com/drpauljarrodfrank/?hl=en), a board certified cosmetic dermatologist and founder of [PFRANKMD](https://pfrankmd.com/) in New York City. “The technology will target non-invasive [skin tightening](https://aedit.com/aedition/best-nonsurgical-skin-tightening-procedures) to help people limit the amount of injectables they get,” he shares.

The goal is to create the lift that patients desire without being as dependent on filler or needing it as frequently. “Emface is an answer to the demand that the market is calling for right now and the reason why non-invasive treatments – like [microneedling](https://aedit.com/procedure/microneedling), energy-based devices, and [lasers](https://aedit.com/procedure/nonablative-fractional-lasers) – are increasingly popular,” Dr. Frank explains. “I think Emface will add to that ethos of what technologies have done for the body in terms of being able to affect several aspects of the skin to minimize the need for other types of more invasive procedures.” For now, that’s all we know, so stay tuned for more.

## **2. For More Even Skin Tone**
- **The Treatment**: [Glacial® RX](https://glacialskin.com/)
- **The Technology**: Cryomodulation
- **Best For**: Improving melasma, rosacea, acne, uneven skin tone

**How It Works**: Cold temperatures have been used in body contouring for the past decade (think: [CoolSculpting®](https://aedit.com/procedure/cool-sculpting)), so the concept of harnessing the cold to improve a specific concern or condition is nothing new. However, what is innovative is the idea of cryomodulation – a proprietary cooling technology that normalizes melanin production while reducing inflammation. Glacial® RX is the first device to use the method, which temporarily freezes melanocytes to suspend melanin production and treat pigmented lesions, redness, and inflammation, says Bruce Katz, MD, a board certified dermatologist and the founder of [JUVA Skin and Laser Center](https://www.juvaskin.com/) in NYC. “It is also the first to use a cold probe to treat the skin,” he adds. 

If you are wondering how cryomodulation differs from a procedure like CoolSculpting®, they are targeting different things. CoolSculpting® freezes fat cells to permanently destroy them and reduce stubborn fatty areas like the stomach, thighs, and buttocks. Glacial® Rx, meanwhile “temporarily freezes melanocytes to suspend melanin production,” Dr. Katz shares. “When melanin production pauses, new cells form without new pigment, resulting in a [more evenly toned appearance](https://aedit.com/procedure/even-skin-tone-solutions) on the skin's surface.”

The downtime-free Glacial® Rx treatment takes 10 minutes or less and feels akin to a cooling facial, though it provides a long-term, anti-pigmentation effect that can last upwards of one year (with diligent sun protection). During treatment, a cold plate is manually applied to each area that needs to be addressed. The chill also takes down any puffiness and redness in the skin. Some minor side effects include erythema (redness), micro-crusting, and temporary darkening, all of which resolve independently. However, after two to three treatments over a few months, the full results are seen.

Speaking of results, Dr. Katz says the cooling technology immediately clears up congestion and skin dullness anywhere on the body. Over time, the benefits become more pronounced. “This new technology is the first FDA-approved dermatologic treatment to use cryomodulation to treat [dark spots](https://aedit.com/aedition/guide-to-hyperpigmentation-dark-spots-melasma),” he explains. “According to studies, physicians saw an improvement in 92 percent of patients at one-month follow-up.”

So far, patients receiving Glacial® Rx like the results they see. “The feedback is positive, and the results are pretty quick,” he says. Plus, because there's no downtime, he reports that those who have experienced the treatment like that they don't have to take time off of work or interrupt their lives to recover.

## **3. For Smoothing Out Dimples & Puckers**
- **The Treatment**: [Endosphères® Therapy](https://www.endospheres.com/)
- **The Technology**: Compressive microvibration 
- **Best For**: Tackling cellulite

**How It Works**: With the exception of [Qwo™](https://aedit.com/procedure/qwo) injections, cellulite treatment often calls for the septae bands that fat bulges out of to be severed or cut in some fashion. Now, there is another technology on the scene to offer an alternative. Instead of clipping said bands, the Italian-developed Endosphères® Therapy relies on stimulating blood flow while providing oxygenation and improving lymphatic drainage to smooth [cellulite](https://aedit.com/concern/cellulite).
 
This 100 percent non-invasive procedure tackles the underlying cause of cellulite dimples below the skin (rather than just the surface) via a so-called compressive microvibration method, which involves a roller device containing 55 silicon spheres that generate low-frequency mechanical vibrations. Pressure is a key component of the treatment, which helps to eliminate toxins and activate the lymphatic system. Together, the combination equates to longer-lasting smoothness.
 
But it's not just microvibration that targets cellulite. The technology simultaneously addresses organ function to treat the root cause of the issue. According to the company, a clinical observation of 656 patients improved cellulite by 39 percent – though there is a time commitment involved. One dozen 45-minute treatments are recommended to get smoother, dimple-free skin.

## **4. For a Snatched Jawline**
- **The Treatment**: [MyEllevate®](https://myellevate.com/)
- **The Technology**: ICLED® Surgical Suture System
- **Best For**: Defining & enhancing the jawline

**How It Works**: If a tauter neck and jawline are what you're after, then MyEllevate® – a minimally invasive treatment that targets a poorly defined jaw due to sagging skin and tissue  – may be for you. Created by board certified plastic and reconstructive surgeon [Gregory Mueller, MD](https://drgregmueller.com/), the hour-long procedure is different from other non-surgical under-the-chin solutions because it targets more than fat. Instead, MyEllevate® addresses platysmal banding *and* all of the fat under the chin (not a portion).

Historically, plastic surgeons have to ‘open the neck’ to address the bands surgically, says [Olivia MaDan, MD](https://aedit.com/provider/olivia-madan-md-34660), a board eligible plastic and reconstructive surgeon in Nashville. “With MyEllevate®, these bands can be released or cut without opening the neck since we suspend the skin and muscle as a composite around the mastoid fascia behind the ears,” she explains. While the treatment may sound somewhat similar to a [mini-facelift](https://aedit.com/procedure/minifacelift), it's not. Unlike a mini-facelift or any variation, MyEllevate® – which is best for patients in their forties with visible platysmal banding and skin laxity around the [neck and jawline](https://aedit.com/procedure/neck-and-jawline-definition-solutions) – does not require incisions or cuts on the skin, so there's no scarring. 

A fiber optic illuminated blunt probe is used via a small entry and exit point to pass a permanent suture at the precise depth below the skin to restore a youthful jawline and lower face and improve the profile. “This technology allows for the permanent percutaneous placement of sutures using a light guide to transilluminate beneath the skin,” Dr. MaDan explains. “The color of the light-guide shows the surgeon the plane which the suture passes.” For example, red indicates if the suture is too deep, while amber specifies that the sutures are in the correct placement plane. 

[Local anesthesia](https://aedit.com/aedition/awake-surgeries-without-general-anesthesia) is administered before the treatment to make it as comfortable as possible for the patient. “Eight one-millimeter incisions are made at key points through which the suspension suture passes to address the skin and platysma muscle," Dr. MaDan shares. “However, none of the access incisions require a closure, so there is normal scarring after the procedure just like other minimally invasive procedures like liposuction or skin tightening.” Speaking of lipo, it’s used to remove unwanted fat and facilitate suture placement. “It's much like drawing blood, which requires a small poke but not an incision,” says [Philip J. Miller, MD](https://www.drphilipmiller.com/), a double board certified facial plastic and reconstructive surgeon in NYC.
 
After the procedure, there may be a feeling of tightness around the neck that settles over time. “There is also a [compressive dressing](https://aedit.com/aedition/benefits-of-compression-garments-after-cosmetic-surgery) we apply after the procedure, and we request patients to wear a soft cervical collar to dissuade them from looking down,” Dr. Miller says. “The dressing is removed on day three and the collar after 10 days.” Bruising and [swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) are also typical.

As far as maintenance goes, it's pretty much the same guidelines as most other rejuvenation procedures: take good care of the skin, stay out of the sun, maintain a healthy weight, and refrain from stretching the skin. “Supplementing the original MyEllevate® procedure with a skin-tightening procedure can also prolong the results,” Dr. Miller shares. The results from MyEllevate® should last about five years. “Of course, no procedure can stop natural aging and effects of gravity, and this procedure does not exclude someone from needing a [facelift](https://aedit.com/procedure/facelift-rhytidectomy) or [neck lift](https://aedit.com/procedure/neck-lift-lower-rhytidectomy) in the future,” Dr. MaDan says. 

## **5. For Breaking Up With Your Breakouts**
- **The Treatment**: [Plason](https://artemis.co/aesthetic-devices/plason)
- **The Technology**: Plasma energy & ultrasound 
- **Best For**: Treating acne-prone & oily skin

**How It Works**: We haven't seen a new in-office device that treats [acne](https://aedit.com/procedure/acne-solutions) in a minute, so this one brings lots of excitement. Plason by Artemis is an FDA-registered device that relies on an advanced version of [plasma technology](https://aedit.com/procedure/plasma-skin-resurfacing) to combat breakouts. 

Plason sterilizes the skin to eliminate acne-causing bacteria and germs while stimulating the skin's collagen-producing capabilities for firmer, clearer skin. It uses two different technologies – one is plasma energy (atmospheric low-temperature plasma) and the other is ultrasound technology, says Delaney Allen-Mills, director of partner training and quality at Artemis Distribution. “The real differentiation is the plasma,” she says. The device harvests plasma and then releases plasma radicals and ions into the skin, which attach to bacteria to kill it and create cleaner skin.
 
The quick five-minute, downtime-free treatment is most effective on [acne-prone skin](https://aedit.com/aedition/difference-between-oily-and-acne-prone-skin) and requires a series of treatments. It is also ideal for oily skin types who want less oil production and fewer breakouts. One to two treatments (on average) is all it takes to improve the skin.
 
The treatment also significantly increases skin absorption rate, so you'll absorb 60 to 120 times more transdermal product to the depth of the dermis than you would from topical application alone, Allen-Mills says. Plus, it's safe to use Plason in conjunction with oral medications. While acne is the device's primary target, the treatment is also helpful for [wrinkles](https://aedit.com/concern/fine-lineswrinkles), [scars](https://aedit.com/procedure/acne-scar-solutions), and [pigmentation](https://aedit.com/aedition/guide-to-hyperpigmentation-dark-spots-melasma).
 
## **6. For Removing Loose Skin – Sans Surgery**
- **The Treatment**: [Ellacor™](https://www.ellacor.com/)
- **The Technology**: Micro-coring
- **Best For**: Minor skin laxity in the lower face

**How It Works**: Yes, it is now possible to remove unwanted skin sans surgery. The Ellacor™ procedure uses the proprietary technology of [micro-coring](https://aedit.com/aedition/dermal-micro-coring-benefits) to remove loose skin via hollow needles to improve wrinkles without evidence of scarring and with faster healing time than many energy-based treatments, says [Siamak Agha, MD](https://aedit.com/provider/siamak-agha-md-34668), a board certified plastic and reconstructive surgeon in Newport Beach, CA. 

While micro-coring sounds like it could produce results similar to a facelift, Dr. Agha says that what you'll see afterward is much subtler. “Each session (three in total are needed) removes a small amount of skin – about eight percent,” he explains. “So, even though we are removing less skin than a facelift, that skin removal can be increased substantially without any scars.” Additionally, micro-coring doesn't address the underlying muscles or fat like a surgical facelift. 

To date, the procedure has not been validated on darker skin types. It is currently only FDA cleared for patients who have minimal sagging and are [Fitzpatrick skin types](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types) I to IV. “Ellacor™ is designed for smaller areas of skin removal,” Dr. Agha shares. “But, with more research and development, we may extend this technology to larger areas in the future.”

## **7. For a Brighter, Tighter Face & Body**
- **The Treatment**: [Zaffiro](https://neauvia.com/product/zaffiro/)
- **The Technology**: Hydroexfoliation & near-infrared thermo-lifting
- **Best For**: Improving skin texture & firmness

**How It Works**: Energy-based tightening is nothing new and neither is the widely beloved [HydraFacial®](https://aedit.com/procedure/hydrafacial). But a device that combines the technology of [near-infrared (NIR) energy](https://aedit.com/procedure/infrared-skin-tightening) and hydroexfoliation into a single treatment is one for the books. Enter Zaffiro, which is a the first of its kind to incorporate thermal energy for skin tightening with hydroexfoliation (a.k.a. water peeling). “The hydro technology hydrates and exfoliates to blast the skin and give it a luminosity that improves tone and texture, which my patients love — they say their skin feels more rejuvenated from using it,” says [Jeanine Downie, MD](https://www.imagedermatology.com/), a board certified dermatologist in Montclair, NJ. “And near-infrared technology helps for skin tightening.” Suitable for all skin tones and types, a single session of Zaffiro is relatively comfortable and not too hot.

One of the most effective areas to treat with Zaffiro are the tiny lines around the mouth that appear when smiling and smokers' lines. But providers are already finding additional benefits. “Although I tend to use it more on the face, it can also be used off the face,” Dr. Downie says. This includes on the “soft part of the underarms” and for “tightening on the stomach, thighs, above the knees,” she notes. On the face, a series of four treatments are necessary for optimal results. Six sessions are recommended for the body, with regular maintenance for each.

By delivering a steady dose of gradual heating to the deeper layers of skin, the downtime-free treatment works to thicken collagen fibers, which encourages a tightening and lifting effect while improving skin elasticity and texture. In addition, dead skin cells are instantly removed for better penetration of topical ingredients, providing an immediate improvement in skin texture, clarity, hydration, and glow.

Coming soon to a doctor’s office near you.

Best New Non-Surgical Procedures In Aesthetic Medicine For Face, Body, Skin

7 New Non-Surgical Treatments You Need To Know About

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The idea of a perfectly round, smooth, and sculpted backside has propelled significant demand for the [Brazilian butt lift (BBL)](https://aedit.com/procedure/brazilian-butt-lift). Despite the fact that the infamous procedure has had its time in the spotlight for a myriad of reasons — celebrities who embrace the bigger-is-better booty push the surgery to the top of many women's surgery wishlists, while the dangerous links to embolisms and even death make the BBL front-page chatter — its popularity has hardly waned. New and improved versions, as well as plenty of [safety regulations](https://aedit.com/aedition/brazilian-butt-lift-procedure-safety), keep the butt-boosting surgery in the public eye.

Aesthetic trends and beauty ideals are ever-changing. For some, a larger-than-life posterior remains the goal. But that level of curvaceousness isn't on everyone's agenda. If a tweak is more your speed, then you'll be happy to meet the so-called skinny BBL. The traditional BBL isn't going anywhere (it's still a much-requested option for those with enough fat to achieve the voluminous look), but the toned-down skinny BBL is better suited for those with a limited amount of donor fat who are desiring a subtler enhancement. 

This time around, it's less about volume and more about contour, says [Alexander Earle, MD](https://www.pureplasticsurgery.com/about-us/dr-earle/), a board certified plastic and reconstructive surgeon in Miami. “Typically, the skinny BBL patient wants a curvier look – not an exaggerated one – that from the front has more of an hourglass shape and looks like an upside-down heart from the back," he says. So, who is a candidate for this slimmed down version and how does it differ from the original? We’re breaking down everything you need to know about the skinny BBL.

## **The BBL Basics**
The popular BBL brings to life the notion of taking fat from where it's unwanted and putting it where it is. First, your plastic surgeon performs [liposuction](https://aedit.com/procedure/liposuction) to remove unwanted fat from the lower back, waist, stomach, or other areas. Then, the donor fat is purified and transferred to the hips and butt to create a [lifted, shapelier buttocks](https://aedit.com/procedure/buttocks-enhancement-solutions) with a dramatic difference between the waist and hips.

In order to achieve this result, a decent amount of fat is needed. As such, “it is not uncommon for traditional BBL patients to be a little overweight by medical standards,” says [Zachary Filip, MD](https://www.aiplasticsurgery.com/zachary-filip-md/), a board certified plastic and reconstructive surgeon in Temecula, CA. This usually means there is enough excess fat for harvesting purposes, especially when a significant increase in volume is the ultimate desire.

## **The Skinny on the Skinny**
A skinny BBL is a modified version of its big sister, the traditional BBL. Its name stems from the lesser amount of fat used and that the procedure accommodates leaner and smaller-framed patients who may not have as much donor fat. The skinny BBL is similar to a traditional BBL in just about every way except for the outcome. It is designed for those who want a more natural, athletic-looking result. 

Another key difference between the two BBLs is the amount of fat harvested and injected, says [Kevin Tehrani, MD](https://aedit.com/provider/kevin-tehrani-md-91), a board certified plastic and reconstructive surgeon in New York City. Less fat leads to more emphasis on shape rather than size. “Similarly to patients who [pick smaller breast implants](https://aedit.com/aedition/how-to-choose-the-right-breast-implants), those who choose skinny BBL are interested in minor buttock enhancement,” he shares. Rather than completely overhauling the backside and taking it from small and flat to large and voluptuous, the skinny BBL creates more of a ‘booty pop,’ similar to the results of a diligent yet intense workout routine. It also corrects stubborn hip dips.

A standard BBL removes up to 5,000 cubic centimeters (CCs) of fat via liposuction and places 1,000 to 2,000 CCs into each butt cheek. The remaining fat can be used elsewhere, like under the eyes, or discarded. Since there's less fat removal with the modified technique (think 500 to 1,000 CCs), about 500 to 700 CCs or slightly more per cheek is put into the butt to create its new shape. Keep in mind that, in either case, a percentage of this fat will be reabsorbed by the body (more on that below).

Another plus to the skinny BBL is that the added fat addresses [hip dips](https://aedit.com/aedition/cosmetic-procedures-for-hip-dips) (a.k.a. trochanteric depressions). These indentations or inward-facing curves are hard to correct with exercise and diet. In fact, Dr. Earle says that the more you work out, the worse they can get. One thing to note: this area does not ‘hold’ fat like the buttocks, so there is a chance that the hip dips may return at some point.

## **Who Is the Skinny BBL Best For?**
A skinny BBL makes the BBL a viable option for leaner patients who do not necessarily have stubborn or problem areas of extra fat but want to improve the shape of their butt. “Patients usually weigh in the lower half of ‘normal’ for their height,” Dr. Filip says. Most patients have a BMI of about 20 to 24. In the past, plastic surgeons often rejected these patients for BBLs because they were ‘too skinny’ with too little fat for harvesting purposes. However, the procedure is now safe and effective for lower-BMI patients thanks to improved fat harvesting techniques and [cannulas](https://aedit.com/aedition/guide-to-injectable-techniques-needles-for-botox-filler).
 
So, can someone be too thin for even the skinny version? It is possible (particularly if a patient has a BMI under 20), but plastic surgeons can perform a skinny BBL on thinner patients because the fat removal is from more unconventional areas like the inner knees, arms, calves, and back of the armpits. “We are almost always able to harvest enough fat,” Dr. Tehrani says. “[Water-assisted liposuction](https://aedit.com/procedure/water-jet-assisted-liposuction) is a great option since studies show that the technique allows us to harvest more fat compared to other liposuction techniques.” Another benefit? “There is also better take of the fat, so more of it survives," he adds.
 
Besides fat, other options for thinner patients who want to enhance their rear end are biostimulatory [Sculptra®](https://aedit.com/procedure/sculptra) injections. The downside is that these injections last two years (at most) and require a lot of product, so it gets expensive quickly. There are also [silicone buttock implants](https://aedit.com/procedure/butt-augmentation-with-implants), which work well in thinner patients but are less common today due to their high complication rate. “For these reasons, the best option is to gain weight and reach the appropriate BMI before skinny BBL surgery,” Dr. Earle says. Anyone who is medically underweight for any reason will not be cleared to undergo cosmetic surgery (of any kind) until they can maintain a healthy weight.
 
## **Skinny BBL Recovery**
In terms of [recovery](https://aedit.com/procedure/brazilian-butt-lift-fat-grafting/recovery), the surgery is considered one of the more difficult procedures to recoup from due to the extent of [commitment, protocol, and length](https://aedit.com/aedition/brazilian-butt-lift-bbl-recovery-healing-process). And there's not much difference between the two types of BBLs. “Patients still need to avoid pressure to the buttocks and hips for six weeks, use [compression garments](https://aedit.com/aedition/benefits-of-compression-garments-after-cosmetic-surgery) for at least three months, and undergo post-liposuction lymphatic massages,” Dr. Earle says. “The biggest difference is that skinny BBL patients require more [post-surgery lymphatic massages](https://aedit.com/aedition/benefits-of-lymphatic-drainage-massages-after-cosmetic-surgery) — about 25 to optimize the results — than the traditional BBL patient.” 

In addition, your plastic surgeon may also place a surgical drain to assist in emptying any [tumescent](https://aedit.com/procedure/tumescent-liposuction) solution used during liposuction, says [Martin Benjamin, MD](https://aedit.com/provider/martin-benjamin-md-34666), a board certified plastic and reconstructive surgeon in Scottsdale, AZ. And, of course, all patients should maintain a [healthy diet](https://aedit.com/aedition/meal-plans-diet-before-after-cosmetic-surgery) and [exercise program](https://aedit.com/aedition/when-to-start-exercising-again-after-cosmetic-surgery-procedures) (when given the all-clear to do so) post-op to keep up their results.
 
## **Less Fat Does Not Equal Lesser Results**
Just because there's less volume added to the butt during a skinny BBL doesn't mean the results are less striking or short-lived by any stretch of the imagination. Still, there are some nuances to be aware of. According to Dr. Tehrani, the survival rate of a typical fat transfer is about 60 percent. “That means if we inject 1,000 CCs per side, 600 CCs, on average, will survive,” he explains. Fat absorption is one reason why plastic surgeons prefer to over-inject fat. “However, this approach is not always an option for skinny patients, as they may not have enough fat for overcorrection,” he says. “So, we use ACell MicroMatrix®, which contains stem cells that have special growth factors that improve fat survival by 20 to 30 percent.”
 
Regardless of how much fat your plastic surgeon transfers, the outcome should ultimately be permanent. As Dr. Filip shares, “once a patient heals, the results should be stable and long-lasting if they maintain a healthy weight.”

This slimmed down version of the infamous butt enhancement surgery is making the BBL a viable option for patients who previously weren't candidates.

Skinny Brazilian Butt Lift (BBL): Procedure, Ideal Candidate, Recovery, Results

The Popular BBL Is Getting A Major Makeover

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There are plenty of non-surgical procedures that get billed as facelift alternatives. And, while some have the ability to firm and smooth the skin sans scalpel, none have been able *remove* skin without surgery – until now. Since it received clearance from the United States Food and Drug Administration (FDA) last year, there has been a lot of buzz around [Cytrellis’s Ellacor™](https://www.cytrellis.com/technology/) and its micro-coring technology. 

Since we all know that trendy treatments have a tendency to come and go, you may be wondering if this one lives up to the hype. The short answer is that, in many ways, it does – though it’s not exactly a substitute for a [facelift](https://aedit.com/procedure/facelift-rhytidectomy). To break down everything you need to know about Ellacor™ and micro-coring, we tapped top dermatologists and plastic surgeons for their honest assessment. Here’s the scoop.

## **What Is Micro-Coring?**
Although some may be calling micro-coring the next best thing to a facelift, it's significantly different. For starters, it isn't surgery at all. Instead, micro-coring or fractional micro-coring is a new category of cosmetic treatment that involves the excisional removal of tiny columns of skin over a larger surface without cutting, thermal energy, or scarring.

Micro-injuries are made in the skin using a tiny, hollow needle while simultaneously removing small tissue areas to address mild laxity. “During a facelift, surgeons trim the skin from the sides,” says [Paul Jarrod Frank, MD](https://www.instagram.com/drpauljarrodfrank/?hl=en), a board certified celebrity cosmetic dermatologist in New York City. “With micro-coring, we inject local anesthesia and remove eight to 10 percent of the total skin surface.” As he explains, the idea of micro-coring originally came from the concept of skin tightening and wrinkle removal in studies showing [follicular unit extraction (FUE)](https://aedit.com/procedure/follicular-unit-extraction-fue), which involves removing individual hair follicles from the scalp before transplant. “When the tissue heals, the skin is much tighter,” he notes. 

To date, there’s only one micro-coring device on the market, Ellacor™, which has positioned itself as a minimally invasive facelift alternative thanks to its ability to remove skin without surgery. The first-of-its-kind treatment is [cleared by the FDA](https://www.prnewswire.com/news-releases/cytrellis-announces-fda-clearance-for-breakthrough-ellacor-micro-coring-technology-301341572.html) to treat moderate to severe wrinkles in the mid- to lower-face in patients with Fitzpatrick skin types I to IV. 

Ellacor™ removes micro-portions of excess skin improve the appearance of wrinkles, says [Jill Waibel, MD](https://www.miamidermlaser.com/dermatologist-miami-dr-jill-s-waibel/), a board certified dermatologist in Miami. “Whereas other skin revitalization devices use heat generated by a [laser](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing), [radiofrequency](https://aedit.com/aedition/radiofrequency-skin-tighening-fat-reduction), or [ultrasound](https://aedit.com/aedition/sofwave-for-skin-tightening-collagen-production) energy to induce intentional thermal injury to the skin, Ellacor™ uses patented micro-coring technology to reduce wrinkles,” she says.

## **Who Is an Ideal Candidate for Micro-Coring?**
Not everyone is an ideal candidate for micro-coring. “It's for someone who wants to take a more minimally invasive and natural-looking route to obtain tighter, younger-looking skin,” says [Dendy Engelman, MD](https://aedit.com/provider/dendy-engelman-md-312), a board certified dermatologist in New York City. This can appeal to people at [different stages of life](https://aedit.com/aedition/can-you-be-too-young-for-a-facelift) (and aging). “I sometimes recommend micro-coring to younger patients who are starting to notice changes in their skin and want to nip it in the bud,” she shares. And she also suggests it to “patients with more mature skin who do not want to undergo a full facelift and the [associated recovery](https://aedit.com/procedure/facelift-rhytidectomy/recovery).”

To see success with Ellacor™, the degree of [skin laxity](https://aedit.com/concern/facial-skin-laxity) – which should be on the mild to moderate side – is imperative. “Someone with excessive hanging skin is going to do better with a more invasive surgery,” Dr. Frank notes. In addition, the treatment works best on the [cheeks](https://aedit.com/concern/cheek-volume), around the mouth, and [under the chin](https://aedit.com/concern/neck-and-jawline-definition), since these areas are where loose skin tends to accumulate. 

As we mentioned, the procedure is currently only FDA cleared for [Fitzpatrick skin types I to IV](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types). “A separate clinical study is needed to evaluate the proper protocols for using Ellacor™ on darker skin types,” Dr. Waibel notes.

## **How Micro-Coring Works**
It may seem unfathomable, but, in 2022, we are at the point where doctors can remove minimal amounts of loose skin without the need to cut with a scalpel. 

Before an Ellacor™ treatment starts, [local anesthesia](https://aedit.com/aedition/everything-you-need-to-know-about-anesthesia) is injected into the area (topical anesthetic may also be used) to make the procedure more comfortable. Next, a small handpiece is placed over the desired location, creating cores in a grid formation (similar to energy-based treatments). The hollow needles within the handpiece quickly go to work and pierce out microscopic amounts of skin (less than half a millimeter). “With each excision, the tissue is removed from the needles through an integrated suction system, treating a 10 millimeter square area in less than three seconds,” Dr. Waibel says. 

Your doctor can adjust the depth of the treatment depending on your needs. There is pinpoint bleeding at each core site, which quickly resolves. Not all skin that falls within the coring square is removed. “After removing the excess skin, the body's natural healing response goes into effect as the dermal tissue quickly realigns to close the cores, resulting in improved skin architecture,” Dr. Waibel shares. As Dr. Engelman explains, removing the skin in this controlled fashion stimulates the wound-healing response that increases collagen production, ultimately promoting younger, healthier-looking skin.

## **Micro-Coring Recovery & Results**
A series of three 30-minute treatments are usually recommended to achieve optimal results, though many patients report seeing benefits after the first appointment. “Micro-coring results are more subtle than facelift surgery since each session of Ellacor™ only removes up to eight percent of the treated skin area,” says [Siamak Agha, MD](https://aedit.com/provider/siamak-agha-md-34668), a board certified plastic and reconstructive surgeon in Newport Beach, CA. “Less skin is removed than what a facelift can offer, but, with Ellacor™, that skin removal can be increased substantially without any scars.”

According to the clinical trials, each column of skin is selectively targeted and heals within an average of three days. But, of course, expect some scabbing, redness, slight [bruising](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox), and mild [swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery). “The redness of the treated areas may last 30 days or more, signifying deeper tissue healing and tightening,” Dr. Agha says. Because the skin is sensitive and somewhat compromised after treatment, [a simple, bland skincare routine](https://aedit.com/aedition/post-procedure-skincare-makeup-product-guide) (similar to what is used post-laser or surgery) is often best. Once the skin is fully healed and the resulting holes from the cores are closed up, you should be safe to resume wearing makeup and following your regular skincare regimen.
 
One of the significant advantages of a micro-coring treatment over something like a facelift is the low risk of [scarring](https://aedit.com/aedition/how-to-treat-every-type-of-scar). “Due to the tiny needle used in micro-coring (22 gauge), the scars are microscopic and therefore not visible to the naked eye,” Dr. Engelman says. For reference, [needles](https://aedit.com/aedition/guide-to-needles-used-for-cosmetic-injectables-botox-filler) used to administer neurotoxins (read: Botox®) are usually 30 or 32 gauge. A [filler syringe](https://aedit.com/aedition/guide-to-injectable-techniques-needles-for-botox-filler) is 27 or 30 gauge. Higher numbers indicate smaller needles.  

## **FAQs: Micro-Coring Edition**
Now that you have a better understanding of how micro-coring technology and Ellacor™ treatments work, it’s time to get to some of the questions you no doubt have about what it’s truly capable of. We answer a few of the most common below:

### **1. Is Micro-Coring Anything Like Microneedling?**
We’d understand if, at this point, you are wondering what (if any) relation micro-coring has to microneedling. As it turns out, the only similarity between the two is that both modalities have the prefix ‘micro’ in their names, and both employ needles to some degree. As Dr. Waibel explains, [microneedling](https://aedit.com/procedure/microneedling) uses tiny needles to injure the skin, and there's no tissue removal — the tissue is only temporarily displaced — during the procedure.

The needle depth of a professional microneedling treatment is anywhere from 0.25 millimeters to 2.5 millimeters. The hollow needles used for micro-coring can penetrate up to 4 millimeters to remove the microscopic columns of skin. While microneedling safely creates micro-injuries in the skin to incite collagen production and decrease the appearance of acne scars, fine lines and wrinkles, and sun damage, it does not excise any tissue.

### **2. Is Micro-Coring a Replacement for a Facelift?**
A [traditional facelift](https://aedit.com/aedition/popularity-of-facelift-cosmetic-surgery-for-aging-sagging-neck) does more than just remove loose skin. It also addresses the underlying muscles and repositions fat and tissue for more significant support and a fully rejuvenated yet (hopefully) natural look. Every doctor we spoke to for this story agreed that micro-coring is not a substitute for a facelift, though it may be a suitable alternative for those who are not ready for surgery but desire some skin tightening and wrinkle reduction on the lower face.

Micro-coring acts on the skin alone. So, while the results of the minimally invasive procedure can be significant, it does not address the fundamental structure of the face and cannot provide a facelift-like result. But that’s not to say it doesn’t have value. “I think micro-coring is going to offer a lot more than other minimally to non-invasive treatments like [Ultherapy®](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy), Thermage®, and other forms of [energy-based microneedling](https://aedit.com/procedure/microneedling-with-radiofrequency),” Dr. Frank says. “With micro-coring, we are going to fill that niche between non-invasive and invasive plastic surgery.”

### **THE SIMILARITIES**
- **Skin Removal**: Both a facelift and micro-coring can remove loose skin, however, the amount of skin laxity addressed through a non-surgical treatment is less than surgery.
- **Smoothing**: Micro-coring and facelifts improve wrinkling on the lower part of the face. Of course, what can be achieved with surgery is always greater than less invasive options.
- **Patience**: The results can take time to settle and fully reveal themselves after both a facelift and micro-coring, though there's more of a noticeable improvement right away post-facelift. 

### **THE DIFFERENCES**
- **Comprehensiveness**: Micro-coring does not correct or address anything below the skin like fat, tissue, and muscle. Only a facelift can target those underlying structures of the face.
- **Lift**: Whereas a facelift physically lifts the skin and requires tension, micro-coring induces collagen remodeling and firming through micro-injuries. The chances of having an unnatural result are lessened.
- **Scarring**: The tradeoff for a facelift is the [scarring](https://aedit.com/aedition/scarring-after-facial-plastic-surgery), though board certified plastic surgeons are trained to conceal the incision. There are no cuts, incisions, stitches, or scars with micro-coring.
- **Timing**: Two to three sessions of micro-coring are necessary to achieve full results. Dr. Engelman says patients typically start to see results of 60 to 90 days after the procedure, and there is usually significant improvement after just one treatment. A facelift is one and done, with results lasting a decade or more. 

Micro-coring is far less invasive than a sugical facial rejuvenation procedure such as a facelift. But, just because it's less invasive, doesn't mean it is fool-proof. As with all aesthetic procedures, a full consultation before the treatment is necessary and there is always the [risk of adverse effects](https://aedit.com/aedition/guide-to-cosmetic-surgery-complications).

### 3. **Micro-Coring vs. Facelift: Which One Is Better?**
There's no right or wrong treatment here. What checks of all your [skin-tightening](https://aedit.com/aedition/best-nonsurgical-skin-tightening-procedures) and rejuvenating boxes may not do the same for someone else. For patients who don't have the time – or, should we say, downtime – for surgery or don’t want it (for whatever reasons), micro-coring is perhaps one of the most promising alternatives available. 

With that said, Dr. Engelman reminds us that no procedure (surgical or non-surgical) is without strings. There is still anesthesia involved, your skin will require a few days to recuperate, and there is no instant gratification. “Downtime is minimal, but it will take some time for the results to be visible,” she shares. And be sure to keep your expectations in check. The results “will be more subtle,” she adds.

### **4. Can Micro-Coring Delay the Need for Surgery?**
Given the array of non-surgical modalities available today, it may be possible to delay the need for facial surgery with the right combination of treatments. But will Ellacor™ alone allow you to sidestep a facelift in the future? Probably not. “Micro-coring does not offer the same results as more invasive techniques, like facelifts,” Dr. Engleman says. “So, in that regard, it cannot replace these more dramatic techniques.” That’s not to say it doesn’t have it’s place though. “It is a great alternative for people seeking more natural-looking results with less invasive methods,” she shares.

## **The Takeaway**
Micro-coring is a new skin-eliminating treatment that is the first of its kind, which means there is still a lot to learn. Will it replace the standard facelift? Probably not – at least not right now – but it gives both patients and providers a lot to be excited about. “There is absolutely no doubt that it is going to offer a new category of treatment in between totally non-invasive and totally invasive procedures,” Dr. Frank says. “It will help fulfill that growing niche of patients that want to do something significant in terms of wrinkling and skin tightening but are not yet ready or willing to go through more invasive techniques.”

Everything you need to know about the minimally invasive procedure that removes skin – sans scalpel.

Dermal Micro-Coring: A Non-Surgical Facelift Alternative For Skin Laxity

Does Non-Surgical Micro-Coring Rival A Surgical Facelift?

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Ask anyone who has ever done even a single treatment of [platelet-rich plasma](https://aedit.com/aedition/prp-and-stem-cells-are-changing-the-face-of-the-cosmetics-industry) (a.k.a. PRP) to [regrow their hair](https://aedit.com/procedure/plateletrich-plasma-prp-for-hair-loss), [rejuvenate the skin](https://aedit.com/procedure/vampire-facelift), or help heal an injury about their results, and you'll almost always be greeted with a resounding, ‘It's a game-changer!’ The standard PRP method has been around for years across medical specialties and involves drawing a sample of blood and separating the plasma from the rest. Just like everything else in the world of aesthetics, there are always new advancements that make way for bigger and better treatments and results – and PRP is no exception. Enter: so-called ‘supercharged’ PRP. Here’s what you need to know.

## **PRP Basics**
PRP has gained a significant following in the last few years and quickly rose to aesthetic stardom. Initially, it was an adjunct for wound healing. But, once skin-rejuvenating vampire facials (i.e. [microneedling with PRP](https://aedit.com/procedure/microneedling-with-prp)) made their way into our living rooms — you can thank Kim Kardashian for that — and onto social media feeds, they started to be an in-demand, top-performer in doctor's offices from coast to coast. And then Kim’s sister Kourtney let us all in on her [PRP for hair loss treatments](https://aedit.com/aedition/kourtney-kardashian-prp-injections-to-treat-hair-loss) after a too taut ponytail caused a bald spot, officially mainstreaming one of PRP’s most effective use cases.  

Platelet-rich plasma is a blood plasma-based protein solution packed with platelets and some white blood cells and growth factors. Extracting the PRP from blood allows the growth factors to assist in healing and rejuvenating purposes. Originally, PRP was used in orthopedics to speed recovery from injuries and then made its way to skin and hair applications, says [Macrene Alexiades, MD](https://www.nyderm.org/), a board certified dermatologist in New York City. Now, almost every surgical and pain specialty utilizes PRP to help heal injuries (especially joint and spine), rejuvenate tissue, speed healing, and reduce surgical pain and scarring, notes [William Yates, MD](https://www.dryateshairscience.com/dr-yates-hair-transplant-surgeon-chicago), a board certified surgeon and hair restoration specialist in Chicago. 

In aesthetic medicine, its fandom stems from the fact that it offers non-surgical rejuvenation. “Minimally invasive PRP has become increasingly popular in recent years since it is a natural way of addressing signs of aging,” says [Samuel Lin, MD](https://www.linplasticsurgery.com/about/dr-samuel-lin/), a board certified plastic and reconstructive surgeon in Boston. While fillers and neurotoxins are great (don't get us wrong, we love them), for those who aren’t too keen on the idea of injecting a foreign substance into their skin or are simply looking for additional options, PRP offers a natural alternative since it uses your own blood. Beyond the skin-boosting benefits, PRP injections are also a godsend for anyone [experiencing hair loss](https://aedit.com/procedure/nonsurgical-hair-restoration-solutions), thinning, and impeded growth. 

### **PRP Treatments**
Regardless of the treatment area, the basic principles of a PRP procedure are relatively the same from one to the next. First, blood is drawn from the patient's arm and put into a centrifuge where it spins out and separates the platelets from everything else in the blood. The centrifuge portion of the treatment is as significant as administering the solution itself because the concentration of platelets can vary greatly and impact efficacy (more on that in a minute).

For PRP to become activated and put healing into action, there must be an injury of some kind. For example, Dr. Yates explains that injecting PRP with a needle into the scalp puts the wheels in motion for the powerful growth factors to do their thing. The growth factors contained within the PRP are the secret sauce since the platelets quickly and effectively regenerate the skin and heal injured tissues. The platelets are a rich reservoir of growth factors that have many benefits, including combating hair loss, restoring the synovial fluid in the joints, and stimulating collagen in the skin, says [Michelle Henry, MD](https://www.skinaestheticsurgery.com/), a board certified dermatologist in NYC. “Traditional PRP is less concentrated than the supercharged version in terms of the platelets and, in theory, it has fewer growth factors,” she notes. 

## **All About Supercharged PRP**
Not all PRP is created equally. PRP versions vary based on the concentration of platelets within the solution, says [Miguel Mascaró, MD](https://www.instagram.com/drmascaro/), a double board certified facial plastic and reconstructive surgeon in Delray Beach, FL. “That means that in order to see an effect, there needs to be a concentration that is four times over baseline,” he explains. The potency obtained in standard centrifuge machines average a PRP solution with about five to six times platelet concentration. Its more powerful cousins — the so-called ‘supercharged’ versions of PRP — can feature 10 times the platelets or more. The more concentrated form of PRP provides additional benefits due to its higher levels of growth factors, which signal the body's cells to swarm to the area and speed up the healing process, says [Audrey Kunin, MD](https://www.instagram.com/draudreykunin/), a board certified dermatologist in Kansas City, MO. 

But it’s not just the processing that supercharges the PRP. It’s also what’s added into the solution. “Traditional PRP contains mainly platelets and plasma, with some residual white and red blood cells left over from the PRP preparation process,” Dr. Lin explains. “The ‘supercharged’ version of PRP – which may mean that the PRP has undergone more processing than traditional PRP to be more concentrated and contain less white and red blood cells – refers to the addition of stem cells, often taken from fat, to the PRP mixture.” As Dr. Alexiades shares, the fat is “mechanically broken down and the stromal cells are obtained and then mixed with the PRP for a highly concentrated mixture.”

Patients need not worry about how rich the platelet count is within the concentration — your provider will take care of that. Dr. Yates says there are hundreds of devices on the market that claim to deliver PRP. “The truth is that most only deliver PPP (platelet poor plasma) versus platelet rich plasma,” he cautions. “The difference is the concentration of platelets and other cells derived from the centrifuge — the system concentrates the platelets at least four to six times the normal blood count.” Systems that only concentrate one to two times the average blood count are less effective. “Plus, they don't deliver the same healing results, requiring more frequent treatments,” he adds.

### **Supercharged PRP Treatments**
To create a more potent version of PRP, a sample of blood is taken (just like in traditional treatments). “This blood is processed using a centrifuge to isolate the PRP, and, in the case of supercharged PRP, the PRP is processed further to concentrate it and remove any residual blood cells,” Dr. Lin explains. This is where the extras are mixed in. “Surgeons may add a patient's stem cells to the PRP,” he notes. [Stem cells](https://aedit.com/procedure/microneedling-with-prp-and-stem-cells) and [nano-fat](https://aedit.com/procedure/nanofat-and-prp-injections-for-hair-loss) are retrieved from a separate liposuction procedure. Finally, the PRP is administered through targeted injections or topically as part of a microneedling session.
 
So, how are doctors going about pulling the most out of a single blood draw and putting it to good use? It all comes down to the technology used, of course. “There are currently two companies, [Regen®](https://www.regenlabusa.com/), which is my favorite, and [Eclipse®](https://www.eclipsemed.com/prp/) that have perfected their tubes that ‘pull out’ the PRP fraction and have demonstrated, through diligent science, that their PRP is very high quality,” Dr. Alexiades says. Because of the healing properties, some providers are using supercharged PRP for regenerative medicine, too. [Scientific data](https://pubmed.ncbi.nlm.nih.gov/33525977/) shows a connection in animal studies between PRP and fat survival after [fat transfer](https://aedit.com/procedure/facial-fat-grafting).

## **Is More Powerful Always More Desirable?**
Before you cast aside traditional PRP procedures and disregard devices that have less power than their ‘supercharged’ counterparts, we’re here to tell you that all methods can be effective. It really comes down to what your doctor offers, the concerns at hand, and the inherent quality of the blood and its plasma. Dr. Mascaró, for example, prefers to use higher concentrations over baseline for most patients when doing hair restoration or anything that requires more cellular turnover and growth factors. “This may also be the case in laser resurfacing and during facial fat grafting and facelift surgery,” he says. But, during most microneedling sessions, he sticks with “more traditional PRP concentrations.” 

The science is still evolving on exactly what potency is best for what purposes. “There is ongoing research regarding the optimal concentration of PRP,” Dr. Lin shares. “For some musculoskeletal uses, a higher concentration of platelets in PRP is preferred and … in a study of 10 patients, supercharged PRP [shows](https://academic.oup.com/asj/article/40/4/NP177/5492510?login=true) to be effective for improving [male pattern baldness](https://aedit.com/aedition/common-causes-of-hair-loss-balding-thinning-in-men).” But, in other cases, lower platelet concentration may be effective enough.
 
For cosmetic applications — particularly hair growth — there may not be enough evidence to make everyone a ‘supercharged’ believer. Dr. Lin says that while there are few studies on supercharged PRP, its applications and benefits are likely similar to standard PRP. What's still up for debate is the longevity of the results and if a more potent concentration of PRP, plus the presence of fat-derived stem cells, leads to longer-lasting results. Only time will tell.

Is this version better than the standard?

The Benefits Of Supercharged PRP With Stem Cells For Hair Loss, Skincare

Why Everyone Is Talking About ‘Supercharged’ PRP

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Aesthetics trends come and go at a rate that can be hard to keep up with (don't worry, we’ve got you covered on [what to expect in 2022](https://aedit.com/aedition/biggest-medical-aesthetics-trends-of-2022-for-face-body)). While there are no signs of interest in perennial favorites like [Botox and fillers](https://aedit.com/procedure/dermal-filler-and-injectable-solutions) slowing down now or, really, ever, there are some newer modalities – especially in the [non-surgical space](https://aedit.com/aedition/biggest-non-surgical-aesthetics-trends-of-2022) – that are rising up the ranks. So, what are these treatments and what do their emergence mean for your next trip to the dermatologist or plastic surgeon? We asked top aesthetic providers to weigh in on what procedures are worth investing in this year.

## **What’s Trending – and Why?**
We don’t need to tell you that the COVID-19 pandemic [dramatically changed](https://aedit.com/aedition/aedit-survey-reveals-how-2020-altered-aesthetic-landscape) the way we lived, worked, and socialized in 2020 and 2021. More time at home and more time dissecting our faces on Zoom, led many who had been contemplating surgery to finally opt to go under the knife (a [new report](https://aedit.com/aedition/2021-aafprs-facial-plastic-surgery-trends) shows a 40 percent increase in facial plastic surgery last year). After all, you could recover discreetly without missing a beat. And, if you did venture out, there was plenty that could be concealed behind a face covering.

But, as we increasingly return to in-person living, working, and gathering, the pendulum is swinging back the other way. “My patients are most interested in the non-invasive procedures – what they can do that is a quick treatment, with little downtime, that still delivers results,” says Bruce Katz, MD, board certified dermatologist and founder of [JUVA Skin and Laser Center](https://www.juvaskin.com/) in New York City. The same is true on the West Coast. “I’m also seeing fewer patients interested in facelifts and eyelid surgeries,” says Neda Mehr, MD, a board certified dermatologist and founder of [Pure Dermatology Cosmetic and Hair Center](https://puredermoc.com/) in Newport Beach, CA. “Instead, they’re opting for minimal-downtime procedures that can achieve desirable results without the risks of surgery.”

But it’s not just surgical versus non-surgical. Even among minimally invasive procedures, there are other factors at play. Chief among them? Pain. “Some of the older non-invasive treatments, like [Ultherapy®](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy), are declining in popularity,” says [Stafford Broumand, MD](https://plasticsurgeonsnyc.com/plastic-surgeon/dr-broumand/), a board certified plastic and reconstructive surgeon and founder of 740 Park Plastic Surgery in NYC. “We have treatments that render better outcomes with less pain available now.” Dr. Mehr agrees. “I have seen a huge shift in my practice away from painful procedures like Ultherapy® to the less invasive procedures like Thermage®,” she notes. 

And then there is the very important topic of [side effects and complications](https://aedit.com/aedition/guide-to-cosmetic-surgery-complications). No matter the level of invasiveness, no procedure is without risk. Last year, Linda Evangelista opened up about her experience with [paradoxical adipose hyperplasia (PAH)](https://aedit.com/aedition/paradoxical-adipose-hyperplasia-after-cryolipolysis) after a series of cryolipolysis (read: CoolSculpting®) treatments. Since then, Dr. Broumand says the fat-freezing treatment has become a less popular request among patients. “It has also declined due to a rare side effect and negative press on the treatment,” he shares.

## **Popular Procedure Swaps**
Now that we’ve covered what’s driving patients and providers alike to opt for some of these newer, non-surgical and less invasive alternatives, it’s time to talk about exactly what some of these updated treatment protocols involve. Here are five our experts are most excited about:

### **1. New Uses For Neuromodulators**
While it’s important to talk about [neurotoxin safety](https://aedit.com/aedition/botox-neuromodulator-safety) and how necessary it is to visit a highly skilled provider, interest in the wrinkle-reducing injectables is higher than ever. “We are seeing more filler and Botox® in our practice, as patients are interested in non-invasive quick fixes to correct their facial asymmetry,” Dr. Mehr shares. For some, this may be the first time they are seeking treatment. “Since they see themselves on Zoom all day long, [they] are noticing a lot of discrepancies that may not have bothered them before,” she adds. 

One such area is the [nose](https://aedit.com/procedure/muscle-paralysis-rhinoplasty). Dr. Mehr performs what she calls a “non-surgical nose lift” using strategic placement of neuromodulators. “We use Botox® on the nasal ala (nostrils), the upper sides of the nasal wall, the nasal dorsum area (between the eyes), and the columella (base of the nose) to relax the muscle so it lifts the tip of the nose,” she explains. This can act as a minimally invasive alternative to [rejuvenation rhinoplasty](https://aedit.com/procedure/rejuvenation-rhinoplasty).

And that’s not all. Dr. Mehr and her team are also using botulinum toxin type A injections [to treat](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7424364/) patients with androgenetic alopecia or genetic forms of [hair loss](https://aedit.com/concern/hair-loss). “For patients with androgenetic alopecia, histopathology specimens show that the blood vessels are in the deeper muscular plane,” she explains. “When you soften or relax those muscles with [neuromodulators], the diameter of the blood vessels increases.” Treatment requires 150 units, and, for that reason, Dr. Mehr says she usually chooses [Dysport®](https://aedit.com/procedure/dysportr), [Jeuveau®](https://aedit.com/procedure/jeuveau), or [Xeomin®](https://aedit.com/procedure/xeomin) (rather than Botox®). “When you use beyond 100 units of Botox®, people can start to [develop antibodies to it](https://aedit.com/aedition/botox-immunity-neurotoxin-resistance), and it becomes less effective over time,” she notes. “The science is the same: If it’s a neurotoxin, it relaxes muscles.” 

When it comes to results, she says patients will start to notice an increase in the diameter of the hair follicles after about three months. By six months, there is increased hair growth. “The treatment frequency is every six months,” Dr. Mehr shears. “And ideal candidates are those with temporal thinning and vertex scalp thinning.” 

### **2. Facial Rejuvenation – Sans Surgery**
At the end of the day, nothing can fully compare to the lifting powers of a surgical facelift – but combining the forces of new skin tightening treatments with biostimulatory injectables can have a seriously rejuvenating effect. For starters, our experts all extoll the virtues of [radiofrequency (RF)](https://aedit.com/aedition/radiofrequency-skin-tighening-fat-reduction) for firming the skin. Dr. Broumand likes Morpheus8 because it marries the benefits of [RF with microneedling](https://aedit.com/procedure/microneedling-with-radiofrequency), while Dr. Mehr is a fan of Thermage®. “[It] addresses visible signs of aging in just minutes and can be used on the face or body,” she explains. “There is little to no downtime, so my patients can return to their regular activities almost immediately.” 

These energy-based [skin tightening procedures](https://aedit.com/aedition/best-nonsurgical-skin-tightening-procedures) can be used alone or coupled up as part of a larger, multimodal treatment plan. “Instead of complete facelifts, patients are opting for filler to define certain areas, like the jawline,” Dr. Mehr says. “Over time, as collagen depletes, the face begins to look more ‘boney,’ and placing filler in these areas can help patients achieve a younger-looking appearance.” She often uses [Radiesse®](https://aedit.com/procedure/radiesse) because the calcium hydroxylapatite (CAHA)-based injectable stimulates collagen production.

### **3. Lunchtime Lasers**
Lasers are pretty multifunctional in terms of the aesthetic concerns they can treat, and there are classes of them that won’t require you to hide out for an extended period of time. If you’re looking to treat facial redness (including [rosacea](https://aedit.com/concern/rosacea)), Dr. Mehr recommends the [Excel® V](https://aedit.com/procedure/excel-v) laser. For pigmentation and pore size, consider [Clear + Brilliant®](https://aedit.com/procedure/clear-brilliant). “Each of these has little to no downtime, so patients are able to get back to their Zoom meetings the next morning looking more refreshed,” she says.

[RevLite®](https://www.cynosure.com/product/revlite-si/), meanwhile, is a non-ablative Q-switched laser that can be used to treat pigmentation and [uneven skin tone](https://aedit.com/concern/uneven-skin-tone). “Before RevLite® came out to treat brown spots, we used cryotherapy – or liquid nitrogen – to remove the lesions,” Dr. Katz shares. “You would apply liquid nitrogen to a swab and apply it to the brown spot, and then the liquid nitrogen would destroy the extra pigment, leaving skin more [even-toned](https://aedit.com/procedure/even-skin-tone-solutions).”

As he explains, the RevLite® procedure is “much more efficient” and allows for “more precise” results. “You can do both cheeks with RevLite® in less than five minutes and see great results, whereas you’d only be finished with a portion of a cheek using cryotherapy in the same time,” he says. After treatment, expect your dark spots to turn from brown to white and exfoliate away over the course of a few days.

### **4. A Neck Lift Alternative**
The concept of ‘[tech neck](https://aedit.com/aedition/how-to-treat-prevent-tech-neck)’ took on a whole new meaning during the pandemic, with people examining their [neck and jawline](https://aedit.com/concern/neck-and-jawline-definition) in a whole new way on video calls. Even so, many are not interested in or ready to go under the knife. “A lot of patients don’t want surgery, so they either walked away without treatment or eventually came back for surgery,” Dr. Katz explains. “Now, we can offer those patients something easy and accessible to address their neck concerns.”

What is that “easy and accessible” option you may ask? Enter [MyEllevate®](https://myellevate.com/). The minimally invasive treatment involves percutaneous suture suspension to treat the platysma bands in the neck to tighten skin. “Prior to MyEllevate®, there wasn’t anything available to treat neck bands and sagging skin in that area,” he says. “The only option was surgery – either [neck surgery](https://aedit.com/procedure/neck-lift-lower-rhytidectomy) or a lower [facelift](https://aedit.com/procedure/facelift-rhytidectomy).”

Performed under local anesthesia, surgical sutures are inserted via a lighted needle underneath the skin. A series of needle puncture sites are the only wounds, and there is about a week of recovery time. Depending on the patient, MyEllevate® can be paired with energy-based tightening procedures (as discussed above) and/or [submental liposuction](https://aedit.com/procedure/submental-liposuction).
 
### **5. Lesion Removal**
A blend of medical and cosmetic dermatology, Dr. Katz has been using CellFX® – a new technology that delivers nano-second pulses of electrical energy – to remove [benign lesions and growths](https://aedit.com/concern/birthmarks-and-moles) (think: moles, flesh-colored bumps, warts, and even acne). “Prior to using [CellFX®](https://www.cellfx.com/en-us/) to remove benign lesions, we would do electrodesiccation, which is where an electric current is delivered via a needle-shaped electrode to superheat the skin and essentially ‘burn off’ the lesions,” he explains. 

The pulses alter the cells in the treatment zone, resulting in a gradual clearing of the cells that caused the lesion without damaging healthy collagen or nearby tissue. “CellFX® is more efficient and less invasive,” Dr. Katz shares. “It not only targets the lesion on the skin’s surface, but treats the cause of the lesion at the cellular level, while leaving the surrounding skin tissue unharmed.” 

## **The Takeaway**
Regardless of what the trend reports may say, the right treatment for you is the one that delivers the best results for your aesthetic concern(s) in the most safe and effective way. With that said, it can be helpful to know how technology and techniques have evolved because, in some cases, it means that quicker, easier, and less invasive alternatives exist. Consulting with a board certified dermatologist or plastic surgeon is the best way to learn exactly what you’re options are.

From energy-based skin tightening to an incision-free neck lift, these are the procedures to watch this year.

Up-And-Coming Cosmetic Procedures To Consider In 2022

The Procedures Experts Want You To Reconsider This Year

brooke-cagle-w475s9ZhD4I-unsplash

Much like 2020 before it, we don’t need to tell you that 2021 was a unique year. Even so, new data from the [American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS)](https://www.aafprs.org/) –  the world’s largest association of facial plastic surgeons – finds that lingering pandemic-related concerns couldn’t thwart the demand for aesthetic procedures. “After lockdowns ended and vaccinations rolled out, our patients who had been postponing reconstructive work, upkeep, maintenance, or surgery were eager to schedule treatments to help them feel refreshed, confident, and ready to take on work, events, playdates,” says [Corey S. Maas, MD](https://www.maasclinic.com/), a double board certified facial plastic and reconstructive surgeon and president of the AAFPRS. 

Based on reporting from some 2,200 AAFPRS members, the total number of facial plastic surgery treatments was up substantially, with an estimated 1.4 million [surgical](https://aedit.com/aedition/biggest-medical-aesthetics-trends-of-2022-for-face-body) and [non-surgical](https://aedit.com/aedition/biggest-non-surgical-aesthetics-trends-of-2022) procedures completed. On average, facial plastic surgeons performed about 600 more procedures in 2021 than they did in 2020. That amounts to a 40 percent increase. So, what did the uptick in bookings mean for treatment trends and patient motivations? Below are some of the key takeaways from the [2021 AAFPRS Annual Survey](https://www.aafprs.org/Media/Press_Releases/2021%20Survey%20Results.aspx). 

## **Surgery Reigns Supreme**
While there was a return to in-person gatherings at certain points of 2021, the hybrid nature of the year had patients opting for surgical intervention at a higher rate. Of those AAFPRS members who experienced an increase in appointments, 92 percent indicated it was because people had more time and flexibility to [recover](https://aedit.com/aedition/best-plastic-surgery-recovery-nurses-centers-products). “With more time still being spent at home, there was less concern about the recovery time for surgical treatments,” Dr. Maas notes. Similarly telling: 83 percent of AAFPRS members say 75 percent or more of their work is facial plastic surgery – up from 75 percent in 2020. 

But that doesn’t mean everyone was going under the knife. More patients than ever were interested in ‘tweakments.’ [Neurotoxins](https://aedit.com/aedition/where-to-use-botox-from-head-to-toe) (63 percent) and [fillers](https://aedit.com/aedition/hyaluronic-acid-filler-vs-biostimulatory-injectables) (57 percent) were among the top procedures performed most often on women in 2021. Rounding out the top three? [Rhinoplasty](https://aedit.com/aedition/reinventing-rhinoplasty-whats-different-about-modern-nose-jobs) at 62 percent, which is also the top surgery for patients under the age of 34.

The top procedures for male patients were rhinoplasty (79 percent), neurotoxins (58 percent), and [blepharoplasty](https://aedit.com/procedure/blepharoplasty-eyelid-surgery) (42 percent). While women still make up the large majority of aesthetics patients, [more men than ever](https://aedit.com/aedition/what-you-need-to-know-about-male-plastic-surgery-trends) are seeking treatment. [Hair transplants](https://aedit.com/procedure/surgical-hair-restoration-solutions) may be the only procedure for which men far surpass women as patients, but it is part of a larger development. Blepharoplasty and neuromodulators are trending towards more balance, with a lower percentage of surgeons indicating these procedures are performed on “mostly females.” 

## **Patient Perspective**
In 2020, an [AEDIT survey found](https://aedit.com/aedition/aedit-survey-reveals-how-2020-altered-aesthetic-landscape) that millennials and gen Z accounted for the largest age group interested in aesthetic procedures. The AAFPRS survey continues to bear this out. Patients age 56 or older represented a lower percentage of overall procedures in 2021 than previous years (the organization notes that this may be because of COVID-19 concerns). 

[Social media](https://aedit.com/aedition/march-2020-study-shows-relationship-between-social-media-cosmetic-surgery) and our continued reliance on video conferencing remain key motivators for patients seeking treatment. In fact, 79 percent of facial plastic surgeons identify patients seeking procedures for an improved appearance on video conferencing as a rising trend, compared to only 16 percent the previous year. “The use of video for business, social media, and self-promotion is now so ingrained in society that it provides an easy and ever-present lens for self-scrutiny,” Dr. Maas explains. “We’ve slowly moved from static image filters to ‘Zoom dysmorphia’ being the major patient motivator as the pressures of a virtual lifestyle continue to impact the way we view ourselves and the way we present to peers.”

And then there is the ongoing influence of face coverings. We deemed ‘[eyes the new lips](https://aedit.com/aedition/popularity-of-eyelid-surgery-cosmetic-eye-procedures-during-covid-19)’ back in June 2020, and the upper third of the face continues to take center stage. More than 70 percent of AAFPRS members indicated that more and more patients were asking for eyelid procedures to [look less tired](https://aedit.com/procedure/eye-rejuvenation-solutions) (up 17 percent from 2020). Interest in [brow lifts](https://aedit.com/aedition/guide-to-surgical-and-non-invasive-brow-lift-procedures) also saw a jump, as did [face and neck lifts](https://aedit.com/aedition/pairing-facelift-neck-lift-procedures).

A newer but notable lift trend: The rise of [lip lifts](https://aedit.com/aedition/lip-lift-procedure-instead-of-lip-filler) (i.e. the surgical procedure that addresses the distance between the base of the nose and top of the lip for a fuller, more youthful effect). A new category for the 2021 survey, 70 percent of surgeons report that they performed the pout-enhancing procedure last year. It serves as a longer-lasting and more natural-looking alternative to the overly augmented look that recently dominated patient requests. Curious to see what you would look like after a [lip lift](https://aedit.com/procedure/subnasal-bull-horn-lip-lift)? You can ‘try on’ the procedure and instantly visualize results with The AEDITOR. [Download the AEDIT iOS app now](https://aedit.onelink.me/E6Rw/7f228807).

## **All About Expertise**
Perhaps one of the most encouraging findings is the emphasis on expertise. The 2021 survey indicates that patients’ primary concern is finding a surgeon they can trust (36 percent), followed by worries about an unnatural result (30 percent). While no procedure is [without risk](https://aedit.com/aedition/guide-to-cosmetic-surgery-complications), the likelihood of a safe and successful outcome is greatly influenced by the qualifications (think: [board certification](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology)) and specialty of the provider. Increasingly, patients seem to be valuing and prioritizing this. “For most procedures, effective communication between surgeon and patient is the number one key to a successful outcome,” Dr. Maas notes. “This includes a mutually agreed upon, [reasonable expectation](https://aedit.com/aedition/how-plastic-surgeons-balance-patients-cosmetic-surgery-desires-and-safety) for improvement and what is realistically possible for individual patients and their goals.”

Now Trending

Surgical procedures are up, as are the number of men looking to address aesthetic concerns.

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AEDIT

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Plastic Surgery Trends