shutterstock 1637496319

Nowadays, in-person doctors’ appointments have more considerations than ever. With abundant [telehealth offerings](https://aedit.com/aedition/virtual-consultations-telemedicine-plastic-surgery-dermatology-cosmetic-dentistry) and stay-at-home orders encouraging patients to remain inside, it’s easy to access healthcare from the couch. But when patients *do* decide to opt for an [in-office appointment](https://aedit.com/aedition/plastic-surgery-dermatology-cosmetic-dentistry-practices-reopening-during-covid-19), it’s a good idea to make every moment with your provider count. “No one has time to go to their plastic surgeon [or dermatologist] multiple times,” says [Roxanne Grawe, MD](https://www.roxyplasticsurgery.com/about/meet-dr-grawe/), a board certified plastic surgeon in Powell, OH. “With kid’s activities, work, and running errands, it is impossible to make multiple visits — and that was before coronavirus pandemic precautions.” 

To help you make the most of your time in the office, we asked the experts how to safely stack skin, face, and body treatments for maximum results in minimum time. In addition to saving you another trip to the office, opting for multiple treatments at once also concentrates downtime. Here are some of the most popular combos of the moment.

### **1. Skincare Treatment + Botox + Filler**
The “burger, fries, and a shake” of cosmetic treatments, this combination is one of the most common — and one you may have already tried. “Many patients stack their skincare treatments with [Botox®](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) and [fillers](https://aedit.com/aedition/everything-you-need-to-know-about-dermal-fillers),” Dr. Grawe explains. Her Ohio office schedules patients with an aesthetician first for treatments such as [Hydrafacial®](https://aedit.com/procedure/hydrafacial) or [dermaplaning](https://aedit.com/procedure/dermaplaning), then sends them to a doctor’s procedure room for injectables like Botox® that tackle upper facial wrinkles. “Then, if they decide to get their lips plumped, we can do that too,” she says. “We have seen an increase in these types of facial balancing treatments during the pandemic, since you can don your mask during your [swelling or bruising](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox) phase.”

### **2. Liquid Facelift**
In Dr. Grawe’s office, she often combines a variety of injectable neurotoxins and fillers for a non-surgical facial makeover known as the [liquid facelift](https://aedit.com/procedure/liquid-facelift). Aimed at creating better [facial balance](https://aedit.com/aedition/plastic-surgery-results-are-about-proportion-not-perfection), the patient and doctor will sit together in front of a mirror as the patient describes their concerns. “It may be that the lower eyelids appear hollow and they want to look well rested, or that they don’t like their forehead wrinkles,” Dr. Grawe says. “We look at the entire picture — how the nose fits with the chin, how the cheek bones project, or if their upper lip and bottom lip are balanced — then the treatment plan takes shape.” Depending on the patient’s desired results, each combination of neuromodulator and filler will be different, but the goal is typically to create a more youthful and refreshed look, without looking “fake” or overfilled. 

### **3. Chemical Peels + Ultherapy**
“Now, patients will bundle additional treatments into their routine Botox® and filler appointments,” says [Lesley Rabach, MD](https://lmmedicalnyc.com/), a double board certified facial plastic and reconstructive surgeon in New York City. Before the injections, Dr. Rabach’s patients often stack [chemical peels](https://aedit.com/procedure/superficial-chemical-peels) or [Ultherapy®](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy) in one appointment, instead of coming back for these toning and tightening services later. With all these treatments at once, a patient can leave the office with skin that’s deeply exfoliated, plumped, and tightened. 

### **4. Laser Skin Treatment + Laser Hair Removal + Kybella**
Once the numbing cream is on, might as well make the most of it, right? Dr. Grawe’s patients often opt for laser skin treatments and [laser hair removal](https://aedit.com/procedure/laser-hair-removal) in one fell swoop. “We can do BroadBand Light treatments for brown spots, which are very popular during these wintery months when our tans have faded, then do laser hair removal with the same laser,” she says. On top of the laser work, patients can also add on facial fillers or [Kybella®](https://aedit.com/procedure/kybella) injections to melt excess fat around the chin, neck, and jaw.

### **5. EmSculpt + EmTone**
“For patients seeking body contouring, a common combination therapy we use in our office is EmSculpt and EmTone™,” says [Dendy Engelman, MD](https://aedit.com/provider/dendy-engelman-md-312), a board certified dermatologist in NYC. [EmSculpt](https://aedit.com/aedition/why-everyone-is-talking-about-emsculpt), she explains, is a non-invasive toning and strengthening treatment that uses electromagnetic energy to stimulate the muscles, causing 20,000 muscle contractions in 30 minutes — far more than possible in a typical exercise routine. That’s easy to combine with EmTone™, which uses targeted thermal and mechanical energy to smooth [cellulite](https://aedit.com/aedition/qwo-cellulite-injectable-treatment-fda-approved). “Combining these therapies maximizes the results in the areas treated by addressing the underlying muscles with EmSculpt and the overlying tissue with EmTone™,” she says. Since both tackle the body, it’s also easy to stack them on top of any facial treatments, making for a head-to-toe appointment. 

### **6. PRP + Microneedling**
“There are treatments that I combine for patients because they will actually see better results with the combination,” Dr. Engelman notes. One such combo is platelet-rich plasma (PRP) and microneedling. [PRP treatments](https://aedit.com/aedition/prp-and-stem-cells-are-changing-the-face-of-the-cosmetics-industry) utilize plasma from your own blood, spun in a centrifuge to concentrate the platelets, and then injected back into the treatment area (which can include face and [scalp](https://aedit.com/aedition/kourtney-kardashian-prp-injections-to-treat-hair-loss)) to trigger the body’s natural healing process and boost collagen production. [Microneedling](https://aedit.com/aedition/difference-between-professional-microneedling-at-home-dermarolling), meanwhile, uses a device made up of fine needles to create micro-wounds in the skin, which also stimulates collagen growth and can improve the appearance of scars and wrinkles. [PRP and microneedling](https://aedit.com/procedure/microneedling-with-prp) work well together, she says, because “the micro-injuries to the skin from microneedling heal will more quickly thanks to the growth factors in our own PRP.”

### **7. Eye & Lip Surgery + Jawline Contouring**
“There has been a surge of patients who are opting for more than one surgical procedure at once, so as to have the same surgical downtime and healing process,” Dr. Rabach shares. She routinely performs [blepharoplasty](https://aedit.com/aedition/what-its-really-like-to-get-eyelid-surgery-blepharoplasty) on the upper *and* lower lids to address drooping eyelids. “Many patients who once would opt for either upper or lower blepharoplasties are now having both done at the same time,” she says. She’s also had patients combine eyelid surgery with [lip lifts](https://aedit.com/aedition/lip-lift-procedure-instead-of-lip-filler) and [jawline contouring](https://aedit.com/aedition/8-ways-to-get-a-more-defined-jawline), all of which require [local anesthesia](https://aedit.com/aedition/everything-you-need-to-know-about-anesthesia). 

## **The Takeaway**
As you can see, some of these combinations work together for one desired result, others tackle different areas of the body, and some put numbing cream to good use. While our experts have seen high levels of patient satisfaction with the pairings above, think of your appointment as a chance to choose your own adventure. Talk to your own doctor about how to stack and combine treatments to best serve your aesthetic goals and needs.

AEDITION rejuvenators-min

Medical Aesthetics Collection | The AEDITION

Aesthetics

To help you make the most of your time with your aesthetic provider, we asked the experts how to safely stack skin, face, and body treatments for maximum results in minimum time.

The Best Aesthetic Procedures To Combine During COVID-19 Pandemic

7 Ways To Maximize Your In-Office Treatment Appointment Right Now

shutterstock 328775612

In the early twentieth century, unsuccessful federal court cases and continued adverse consequences of unsafe food, drugs, and cosmetics quickly illustrated the inadequacies of the [Pure Food and Drug Act of 1906](https://www.fda.gov/about-fda/fdas-evolving-regulatory-powers/part-i-1906-food-and-drugs-act-and-its-enforcement). As we discussed in [part I of this series](https://aedit.com/aedition/early-history-of-us-food-drug-cosmetic-regulation-fda), the law did provide some safety standards and labeling accuracy, but it also required that the government prove a manufacturer intended to defraud with its labeling — a nearly impossible burden to meet.

The law also had no power to regulate cosmetics, medical devices, or advertising, nor did it create any standards for food safety. Among the tricks and bad practices used by manufacturers: 

- Glass bottles that only appeared to be full
- False-bottomed boxes
- Misleading and fraudulent advertising claims
- Inadequate record keeping for prescription drugs
- A lack of safety testing for new drugs and cosmetics

Consumer advocacy groups and the publication of books like Arthur Kallet and F.J. Schlink's *100,000,000 Guinea Pigs: Dangers of Everyday Food, Drugs and Cosmetics* (1933) raised awareness of the law’s shortcomings, but the offenses continued.

## **The American Chamber of Horrors**
In 1933, the chief education officer (Ruth deForest Lamb) and chief inspector (George Larrick) of the [United States Food and Drug Administration (FDA)](https://www.fda.gov/home) assembled a collection of misleading and dangerous products to illustrate the inadequacies of the current laws and to advocate for broadened regulatory powers. The exhibit gained notoriety when Eleanor Roosevelt toured it with a reporter, who dubbed the collection the “Chamber of Horrors.”

Included in the exhibit (which was a sensation at the Chicago World’s Fair) were a variety of packaging tricks, advertising swindles, and products that didn’t work or, worse, were hazardous and toxic. Some of the highlights:

- **Lash Lure**: The toxic aniline eyebrow and eyelash dye that caused serious infections, blindness, even death among salon-goers.
- **Banbar**: A blend of alcohol, water, and horsetail (a weed) flavored with peppermint purported to treat diabetes that actually killed those who relied on it instead of insulin.
- **Bred-Spred**: A line of enticingly packaged ‘jams’ that contained artificial colors and flavors, pectin, and hayseeds but no fruit.
- **Koremlu**: Billed as a harmless hair removal cream, this toxic concoction contained thallium acetate and caused systemic hair loss and neurological damage.

## **The Elixir of Sulfanilamide Disaster**
As a result of mounting evidence and pressure, a bill to revise and expand the Pure Food and Drug Act of 1906 was introduced before Congress in 1933. But passage of the bill was stalled for years as politicians, advocacy groups, and lobbyists debated. In 1937, a Tennessee manufacturer created what was believed to be a red raspberry-flavored liquid version of sulfanilamide, a true ‘wonder drug’ that had proven to be safe and effective (in powder form) to treat strep infections. After the elixir was tested for flavor, appearance, and fragrance, it was shipped to doctors and pharmacies across the country.

[Elixir Sulfanilamide](https://www.fda.gov/files/about%20fda/published/The-Sulfanilamide-Disaster.pdf) killed 107 people, many of them children, because the sweet liquid was, in fact, a solution of the powdered drug and diethylene glycol — a chemical commonly used as antifreeze and documented at the time to be a deadly poison, though the manufacturer hadn’t bothered to check.

The combined efforts of the FDA, physicians, and media saved countless more deaths. But, due to the limitations of the 1906 law, the FDA was only able to prosecute the S.E. Massengill Co. because it had mislabeled its product an “elixir” (which must contain alcohol) instead of a “solution.” The fact that the formula contained a deadly poison was not legally actionable. 

## **Finally: The Food, Drug & Cosmetics Act of 1938**
The Elixir Sulfanilamide disaster provided the final incentive Congress needed to act. In 1938, the [Food, Drug, and Cosmetics Act](https://www.fda.gov/about-fda/fdas-evolving-regulatory-powers/part-ii-1938-food-drug-cosmetic-act#:~:text=FDR%20signed%20the%20Food%2C%20Drug,adequate%20directions%20for%20safe%20use.) was passed, making it illegal to market unsafe drugs, cosmetics, and devices, establishing food safety standards, and requiring that a drug be proven safe prior to marketing. Factory inspections and court injunctions were also added to the FDA's arsenal. 

In the ensuing decades, court cases and congressional acts bolstered the original FD&C Act. The highlights:

- **Wheeler-Lea Act (1938)**: Empowered the Federal Trade Commission (FTC) to regulate drug, device, and cosmetic advertising.
- **“The Black Book” (1949)**: A guide to evaluate the safety of chemical food additives that was updated in 1982 to include color additives and is now known as “The Red Book.”
- **Durham-Humphrey Amendment (1951)**: Defined what drugs require a prescription from a licensed practitioner
- **Miller Pesticide Amendment (1954)**: Established procedures for setting safe pesticide limits on agricultural products (this is now handled by the Environmental Protection Agency).
- **Food Additives Amendment (1958)**: Prohibited use of cancer-causing substances and required new food additives to be proven safe prior to marketing.
- **Color Additive Amendment (1960)**: Prohibited use of cancer-causing color chemicals in food, drugs, and cosmetics, and required manufacturers to first establish safety before use.
- **Kefauver-Harris Drug Amendments (1962)**: Required manufacturers of new drugs to prove effectiveness to the FDA.
- **Federal Anti-Tampering Act (1983)**: Passed in response to cyanide poisoning from tainted Tylenol, it made it a crime to tamper with packaged consumer goods.
- **Nutrition Labeling and Education Act (1990)**: Required all foods to have standardized labeling.
- **Family Smoking Prevention and Tobacco Control Act (2009)**: Gave the FDA authority to regulate tobacco products.
- **Drug Quality and Security Act (2013)**: Passed in response to a deadly meningitis outbreak in 2012 originating from a compounding pharmacy, it required greater oversight and electronic prescription drug tracing.

## **Drugs vs. Cosmetics, According to the FDA**
After generations of federal oversight, most people today are familiar with the FDA. From lettuce recalls to Botox® approval, the agency affects our lives on a daily basis. But, in spite of its notoriety, many Americans aren’t clear about how the FDA regulates cosmetics and beauty products in this country. “If you ask 10 different people, then you will get 10 different answers,” says cosmetic chemist [Ni’Kita Wilson](https://www.nikitawilsonbeauty.com/).

Here’s where the definitions spelled out in the FD&C Act become important:

- **Drugs**: “Articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease” and “articles (other than food) intended to affect the structure or any function of the body of man or other animals.” (e.g. oral contraceptives and the active ingredients in [sunscreen](https://aedit.com/aedition/how-to-apply-sunscreen-and-not-miss-a-spot))
- **Cosmetics**: “Articles intended to be rubbed, poured, sprinkled, or sprayed on, introduced into, or otherwise applied to the human body… for cleansing, beautifying, promoting attractiveness, or altering the appearance.” (e.g. moisturizer, lipstick, hair color)

Some products meet the definition of both a drug and a cosmetic. These include things like [dandruff shampoo](https://aedit.com/aedition/best-hair-care-products-by-texture-color) (shampoo is a cosmetic but controlling dandruff alters bodily function like a drug) and most [toothpaste](https://aedit.com/aedition/best-natural-oral-care-toothpaste-mouthwash-brands) (tooth cleanser is a cosmetic but added fluoride is a drug).

So, how does the FDA influence the creation of skincare and makeup? “When we're developing [acne](https://aedit.com/aedition/best-skincare-ingredients-to-treat-acne-blackheads-whiteheads), sunscreen, or other over-the-counter products, we have to adhere to the ‘rules of engagement’ outlined in the monograph ‘rule book’ for that category,” Wilson explains. “I have to be careful with the benefit claims of each product that I develop to ensure that I am not misleading the consumer to think that my cosmetic product has drug benefits.” For example, there are certain colorants that she can’t use on the lip or eye area as per the FDA. “They definitely have a say in how things are done,” she notes.

## **The Difference Between FDA Approval & FDA Regulation**
The FD&C Act and ensuing laws gave the FDA the power to regulate food, drugs, cosmetics, and medical devices. 

- **FDA Regulation**: Implies the agency legally oversees those industries — setting rules, guidelines, and standards and enforcing compliance with relevant laws. 
- **FDA Approval**: Signifies a product has been proven safe and effective through research and clinical trials prior to its market release.

Drugs (both prescription and over-the-counter) must either obtain FDA approval or meet strict standards called ‘monographs’ prior to being marketed. With the exception of color additives, cosmetic products and ingredients do not need FDA approval, nor do they need to be registered with the FDA like drugs and drug manufacturers do.

Falsely claiming that a product is “FDA approved” may be a federal offense. Here’s a rundown of what the U.S. Food and Drug Administration does and does not approve:

### **The FDA Does Approve:**
- New drugs and biologics (like vaccines and blood products)
- Medical devices (via a tiered clearance system)
- Human cells and tissues (through a risk-based approach)
- Food additives
- Color additives used in FDA-regulated products 
- Animal food additives and drugs

### **The FDA Does Not Approve:**
- Companies
- Compounded drugs
- Tobacco products
- Cosmetics
- Medical foods
- Infant formula
- Dietary supplements
- Food labels/nutrition facts
- Structure-function claims (like “calcium builds strong bones”)

## **FDA Recall vs. FDA Withdrawal**
So, what happens when a product is deemed unsafe, contaminated, or questionable? In cases of minor violations that wouldn’t involve legal action, the FDA requests a so-called ‘market withdrawal.’ The company isn’t in trouble per se, but they’re being asked to remove the product from distribution until the correction is made.

On the other hand, the FDA recalls a product when there’s a clear legal violation. Goods are removed from distribution and consumers are advised to either return or dispose of the product. Recalls are divided into three categories: 

1. **Class 1**: Product could cause serious harm or death
2. **Class 2**: Product can cause temporary or reversible health consequences
3. **Class 3**: Not likely to cause harm but still a violation

It’s estimated that over 4,000 drugs and devices are recalled each year.

## **The Push for Cosmetic Regulation**
The FD&C Act of 1938 does not require cosmetics manufacturers to register (it’s voluntary), and they are not obligated to follow [Good Manufacturing Practices (GMPs)](https://ispe.org/initiatives/regulatory-resources/gmp/what-is-gmp) the way drug companies are. Under current law, the FDA has no authority to recall cosmetics — the agency can only request that a manufacturer voluntarily recall a product. If a cosmetic manufacturer is making claims reserved for drugs or if their ingredients are found to mimic drugs, then the FDA can step in, as they’ve done with several [lash serum](https://aedit.com/aedition/eyelash-growth-serum-benefits-safety-results) makers over the past decade.

The need for cosmetic regulation came to a head in 2019 with the revelation that Johnson & Johnson concealed for decades that the talc in their baby powder could be contaminated with asbestos. The problem arose again with tween accessories giant Claire’s when it refused to recall several makeup products that independently tested positive for asbestos. Instead, it opted to withdraw the items from shelves while reassuring the public that its makeup is safe. 

Currently, Congress is considering two bills that would expand the FDA’s authority over cosmetics. The [Cosmetics Safety Enhancement Act of 2019](https://www.congress.gov/bill/116th-congress/house-bill/5279/text) would require manufacturers to establish product safety and report adverse effects, while empowering the FDA to conduct its own cosmetic safety testing. The [Safe Cosmetics and Personal Care Products Act](https://www.congress.gov/bill/116th-congress/house-bill/4296?q=%7B%22search%22%3A%5B%22increasing+accountability+at+VA%22%5D%7D&s=1&r=2) would require that all ingredients (including the notoriously-vague [‘fragrance’](https://aedit.com/aedition/fragrance-free-beauty-skincare-for-sensitive-skin)) be detailed on labels and would ban all toxic ingredients.

## **Safety & Efficacy**
Given that many consumer goods are not expressly approved prior to marketing, we’re generally left to trust that the manufacturers are following good practices and that the market will weed out those who aren’t. After all, it’s in a company’s best interest to meet its claims.

However, there are plenty of examples of dangerous products being marketed and widely used before the FDA stepped in (hello, [tobacco](https://aedit.com/aedition/impact-of-cigarette-smoking-vaping-on-skin-hair-teeth-health)). So, how skeptical should we be before purchasing? “In general, I would presume a large majority of the products to be safe,” Wilson says. “[Read the ingredient label](https://aedit.com/aedition/category/read-the-label) to see if the product contains ingredients that don't raise any red flags.”

If you’re not sure about an ingredient, do some research. “[Paula's Choice](https://www.paulaschoice.com/ingredient-dictionary) has a helpful ingredient dictionary based on relevant studies,” Wilson suggests. Another tip? Keep your sources varied. “Read all types of information — not just those stating that everything is toxic,” she cautions.

What about ‘green,’ ‘clean,’ ‘vegan,’ or ‘organic’ beauty products? [We’ve talked about green beauty recently](https://aedit.com/aedition/what-clean-green-natural-mean-for-beauty-makeup-skincare-products), but in terms of FDA regulation, these terms are simply buzzwords. “The only term that has a true meaning tied to it is ‘organic,’ which is attached to the USDA,” Wilson explains. “The FDA does not recognize any of the others. They are just marketing terms and are no indication of the product’s safety profile or if it's better than another product.”

## **The Takeaway**
While the FDA has certainly made the consumer landscape — including the beauty business — safer and more efficacious, it’s still up to us to do our homework before making cosmetics and personal care choices. With consumers demanding more transparency than ever from brands and manufacturers, it seems like only a matter of time before the laws evolve again. 

AEDITION complexion perfection-min

Beauty Collection | The AEDITION

Beauty

In this two-part series, we’re examining the history of the FDA, and the people, products, and events that contributed to the past and present of American food, drug, and cosmetic policy.

The Modern History Of FDA Food, Drug, And Cosmetic Regulation In The United States

The Ultimate Guide To U.S. Food, Drug, And Cosmetic Regulation, Part II

shutterstock 1286780089

Whether we’re strolling through Sephora, standing in line at the pharmacy, or tackling an online Target run, we tend to take for granted that the items in our basket — from [makeup](https://aedit.com/aedition/category/makeup) and personal care products to prescription and over-the-counter medications — are safe and effective. The same holds true for the cosmetic treatments and plastic surgery procedures recommended to us by medical professionals.

Thanks in large part to consumer protection laws and regulations in the United States, this is (mostly) a fair assumption. But that wasn’t always the case. In this two-part series, we are looking closely at the [U.S. Food and Drug Administration (FDA)](https://www.fda.gov/home): the people, products, and events contributing to the past, present, and future of American food, drug, and cosmetic policy. 

## **Land of the Free, Home of the Huckster**
It’s almost inconceivable for us to imagine a world without Starbucks and [self care](https://aedit.com/aedition/category/self-care). But back in the early years of the founding fathers, most Americans rarely bathed. They grew what they ate and had limited methods of food preservation. ‘Basics’ like soap and tooth powder weren’t widespread until the mid-nineteenth century.

Because the accepted standards of ‘medical care’ (hello, bloodletting?) were so scary, many Americans did not trust traditional doctors. This created the opportunity for the rise of patent medicines: concoctions that purported to alleviate or cure any number of ailments with little or no scientific basis.

So-called quack remedies hawked by traveling ‘snake oil’ salesmen (named for the supposedly exotic ingredients in their formulas) had equal potential to cure or kill. Enterprising patent medicine entrepreneurs were among the first American marketers to employ advertising tactics like testimonials and celebrity endorsements to convince the unsuspecting public.

## **The Earliest Days of U.S. Food & Drug Policy**
In 1813, the fledgling federal government passed the [Vaccine Act](https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2018.304348) to ensure a central, reliable supply of smallpox vaccine existed to combat one of the world's deadliest diseases. It was the first law passed by Congress that addressed the health of Americans. Nine years later, the law was repealed after a vaccine mixup resulted in several deaths. The incident stoked Americans’ distrust of traditional medicine.

A group of physicians met in Washington in 1820 to address the scary reality that many ‘medicines’ of the time were deadlier than the ailment they were meant to cure. Together they developed the [U.S. Pharmacopeia](https://www.usp.org/) — the first set of guidelines for medicine quality. Following these standards was, however, not obligatory.

## **Welcome to the Jungle**
By the mid-1800s, the Industrial Revolution began changing the consumer landscape. Factories mass produced food, clothing, and household items that could be shipped via the new railroads that were crisscrossing the country. Goods that were previously available only to the wealthy and elite became more readily available.

But, without any oversight, food and drug contamination was rampant. Consumers had no way of knowing whether the canned beef stew they bought was really even beef or, worse, if eating it would lead to a deadly case of food poisoning. In 1906, Upton Sinclair published *The Jungle*, a shocking exposé of the appalling conditions of meatpackers in Chicago. His descriptions of tainted, rotten meat fueled public outrage over the unscrupulous practices of food industry manufacturers. 

## **Is the Cure Worse Than the Disease?**
Even if a food, drug, or cosmetic manufacturer had no ill intent, the lack of research and scrutiny allowed plenty of unsafe products to flourish into the early twentieth century. Cocaine toothache tablets and heroin cough syrup (say what?) were just two of the remedies marketed to treat *children*.

With the amount of information now available at our fingertips, it’s hard to imagine falling victim to sensational medical claims and false advertising. Here’s a look at some of the popular (and dangerous!) turn-of-the-century quack medicines and devices that misled unsuspecting consumers:

### **Vapo-Cresolene**
[Vapo-Cresolene](https://www.nursing.virginia.edu/news/flashback-cresolene/) was touted as a cure for respiratory conditions ranging from sneezing to asthma and whooping cough. In reality, it was vaporized coal tar. The packaging instructed users to heat the tar in an enclosed room throughout the night, which led to poisoning in children from inhaling the toxic fumes. Vapo-Cresolene was one of the many ways companies sought to profit from the waste products of burgeoning industries. 

### **Mrs. Winslow’s Soothing Syrup**
First introduced in 1849 and widely marketed in the U.S. and U.K. as a cure-all for fussy babies, [Mrs. Winslow’s Soothing Syrup](https://www.woodlibrarymuseum.org/museum/item/529/mrs.-winslow's-soothing-syrup) was mostly a mix of morphine and alcohol. According to the company’s advertising lore — meant to gain a mother’s trust — “Mrs. Winslow” was allegedly a nurse who developed the formula. The suggested dosage of six to 10 drops for infants lulled them to sleep, but it’s estimated that thousands never woke up. Because there were no labeling requirements, mothers had no way of knowing that one teaspoon of syrup (recommended three to four times daily for babies six months and up) contained a lethal dose of morphine.

### **Liquozone**
Billed to the public as “liquid oxygen,” [Liquozone](https://www.sciencehistory.org/distillations/a-killer-of-a-cure) was a mixture of water and sulphuric and sulphurous acids, with traces of hydrochloric or hydrobromic acid. It’s inventor capitalized on the public’s ignorance and the widespread, mistaken belief that ozone gas has a purifying effect. Taking advantage of emerging germ theory, the manufacturer touted the liquid’s supposed antibacterial qualities, curing everything from ‘bowel troubles’ to cancer. The company was eventually discredited in court, though potentially dangerous ozone ‘purification’ devices are still being marketed today.

## **The Pure Food and Drug Act**
Public outcries over the widespread sickening and death of consumers, combined with the sensation caused by *The Jungle*, led the government to take action. In 1862, President Abraham Lincoln created the [Bureau of Chemistry](https://www.fda.gov/about-fda/history-fdas-fight-consumer-protection-and-public-health/history-fdas-internal-organization) under the [Department of Agriculture (USDA)](https://www.usda.gov/). In 1880, its chief chemist, Peter Collier, advocated for a federal food and drug law. Though the bill was defeated, more than 100 food and drug bills were introduced in Congress over the next quarter century.

Collier’s successor, Dr. Harvey W. Wiley, continued to campaign for legislation. He is known as the “Father of the [Pure Food and Drugs Act](https://www.fda.gov/about-fda/fdas-evolving-regulatory-powers/part-i-1906-food-and-drugs-act-and-its-enforcement),” which passed Congress in 1906 and was signed into law by President Theodore Roosevelt. According to the FDA, the law “prohibits interstate commerce in misbranded and adulterated foods, drinks and drugs.” The [Meat Inspection Act](https://www.fsis.usda.gov/wps/wcm/connect/fsis-content/fsis-questionable-content/celebrating-100-years-of-fmia/overview/ct_index) was passed the same day. In 1907, the USDA issued a list of seven chemical colors considered suitable for use in foods. Notably absent from the law, however, were provisions for drug and cosmetics safety. 

## **Early Challenges to the PFDA**
Patent medicine manufacturers were quick to contest the new regulations (and expose loopholes) of the Pure Food and Drug Act. After the government seized large quantities of a useless ‘remedy’ called Johnson's Mild Combination Treatment for Cancer, the Supreme Court ruled in favor of the manufacturer in [U.S. v. Johnson (1911)](https://supreme.justia.com/cases/federal/us/221/488/). The court declared that the act “does not prohibit false therapeutic claims but only false and misleading statements about the ingredients or identity of a drug.”

In response, Congress enacted the [Sherley Amendment in 1912](https://www.jstor.org/stable/4573181?seq=1#metadata_info_tab_contents), which made it illegal to label medicines with false therapeutic claims but stipulated that there must be an intent to defraud in order to convict (which proved to be very difficult to accomplish in court). In 1913, the [Gould Amendment](https://www.fda.gov/files/A-Century-of-Ensuring-Safe-Foods-and-Cosmetics.pdf) required food packages to be clearly labeled “in terms of weight, measure, or numerical count” on the outside. The following year, the [Harrison Narcotic Act](https://www.naabt.org/documents/Harrison_Narcotics_Tax_Act_1914.pdf) began requiring prescriptions and record keeping for narcotics.

Also in 1914, the Supreme Court ruled on food additives, deciding that the government must show that a chemical additive caused harm before the substance could be banned. In other words, just because a food contained a hazardous chemical, didn’t mean it was illegal. Because there were no codified safety standards, the government had to prove all over again — in every case — that a substance was hazardous.

## **The Takeaway**
These early steps toward regulating food, drugs, and cosmetics in America were crucial in the quest to protect people from the hazards of tainted and dangerous goods. Fortunately for U.S. consumers, it was only the beginning. Stay tuned for our [second installment of this story](https://aedit.com/aedition/modern-history-of-us-food-drug-cosmetic-regulation-fda), where we’ll explore the modern FDA — from its Great Depression-era origins to its relevance today.

The Early History Of FDA Food, Drug, And Cosmetic Regulation In The United States

The Ultimate Guide To U.S. Food, Drug, And Cosmetic Regulation, Part I

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Earlier this month, the United States Food and Drug Administration (FDA) issued [emergency use authorization](https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/moderna-covid-19-vaccine) for two coronavirus vaccines — one from Pfizer and one from Moderna. While the majority of vaccine recipients experience very mild side effects (think: headache, fatigue, and injection-site pain), a trio of participants with [dermal filler](https://aedit.com/aedition/everything-you-need-to-know-about-dermal-fillers) experienced localized facial swelling after receiving the Moderna vaccine. The localized areas of facial swelling occurred in the location of the filler.

In a December 17 [committee meeting](https://www.fda.gov/media/144451/download) focused on the Moderna COVID-19 vaccine, FDA medical officer Rachel Zhang, MD, reported three people with hyaluronic acid (HA)-based filler developed facial or lip swelling after they received the vaccine in Moderna’s phase 3 trial. Two of the patients had cheek filler injections six months *prior* to the vaccination, while the third got [lip filler](https://aedit.com/procedure/temporary-lip-fillers) two days *after* inoculation. 

For all three participants, the reactions were temporary and either resolved without intervention or required simple treatment. In the case of the patient who received lip injections two days *after* the vaccine, it’s unclear whether the inflammatory response was the result of the vaccine or simply the [normal swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) that accompanies the injection of water-binding gel filler.

So, what’s causing the reaction? What is clear thus far is that COVID-19 antibodies formed by the body in response to the COVID-19 vaccine **do not** fight or attack dermal fillers. Instead, the vaccine triggers a Type IV hypersensitivity reaction to the HA filler. Type IV hypersensitivity reactions are delayed allergic reactions to any foreign substance in the body. Many triggers can induce the late-onset response — including the flu vaccine, common cold, and certain medications — and it can happen several months to even a year after getting the injectable. 

More often than not, late-onset inflammatory reactions to HA fillers are easily treated with oral steroids. In some instances, the allergic reaction can cause the HA filler to be partially degraded, resulting in lumps and nodules. In these rare cases, the patient may decide to dissolve the filler altogether with hyaluronidase.

Delayed inflammation associated with HA fillers is not necessarily brand specific, though [a study published](https://journals.lww.com/prsgo/fulltext/2017/12000/late_onset_inflammatory_response_to_hyaluronic.4.aspx) in the December 2017 edition of *Plastic and Reconstructive Surgery - Global Open* found that in cases where two different brands were injected during the same session, sometimes only one type triggered a hypersensitivity reaction. The authors concluded the data “suggests that the technology used in the manufacturing process, and the subsequent differing products of degradation, may have an influence on potential allergic reactions to HA fillers.”

The reactions reported from the Moderna trial and previous evidence seems to [suggest a link](https://journals.lww.com/prsgo/fulltext/2017/12000/late_onset_inflammatory_response_to_hyaluronic.4.aspx) between the Juvéderm Vycross collection of filler — including Voluma, Vollure, and Volbella — and Type IV hypersensitivity reactions, but swelling has also been reported with brands like Restylane and, most recently, [Revance RHA](https://aedit.com/aedition/clean-injectable-filler-neurotoxin-trend). 

While dermal filler patients should be aware of the possibility of a localized inflammatory response to the Moderna COVID-19 vaccine, the cases are rare and the effects are self-limiting and readily treatable. The risks associated with receiving the COVID-19 vaccine have thus far proven to be very low and do not outweigh the benefits of delaying or not receiving the vaccine. If you have questions about potential side effects, be sure to consult with your provider.

AEDITION trendsetters-min

Now Trending Collection | The AEDITION

Now Trending

A trio of Moderna phase 3 trial participants with facial filler experienced temporary swelling after vaccination. Here’s what you need to know.

The Relationship Between The Moderna COVID-19 Vaccine And Dermal Filler Swelling

What You Need To Know About The COVID-19 Vaccine And Dermal Filler Swelling

shutterstock 1150521551

There’s a growing industry in post-surgery pillows, or specially made cushions that are all about facilitating [recovery](https://aedit.com/aedition/category/recovery) while you lounge, sit, or sleep. They’re not necessary — many patients have perfectly fine results propping themselves up with their own pillows, sleeping in recliners (for the surgeries that require torso elevation), or just being mindful of their [sleeping position](https://aedit.com/aedition/sleeping-better-after-cosmetic-surgery-aesthetic-procedures). But some swear by them, finding them the answer to easing the worries about putting pressure on the wrong spot and setting the healing process back. It’s all about comfort, preference, how active a sleeper you are, and your own nerves about staying in the best position — especially if the recommended posture isn’t your preferred position.

If you have a procedure coming up and are interested in purchasing a pillow, our first piece of advice is to talk to your doctor: He or she will have unique insight into your surgery, how you’re healing along the way, and what’s best for you. If you get the go ahead to look for a special pillow, finding the right one can feel a bit daunting. A quick Google search will tell you that there’s a lot of out there to choose from, spanning everything from butt-saving [BBL](https://aedit.com/procedure/brazilian-butt-lift) pillows and wedge pillows to elaborate systems meant to keep you in place from head to toe. 

Oh, and a couple notes from [Andrew P. Ordon, MD](https://www.ordonchopra.com/our-physicians/dr-ordon/), clinical professor of plastic surgery at the USC School of Medicine and co-host of *The Doctors*: 

1. Always look for the word ‘hypoallergenic’ on the pillow or cushion. 
2. When it comes to sheets to wrap them in, opt for smooth, non-abrasive cotton linens. “Even better if broken in and soft,” he says.

With all of this in mind, onward to narrowing down your options.

### **For Face & Upper Torso Work** 
After facial and upper body (think: breast enlargement) procedures, it’s all about elevating the head to reduce swelling and promote drainage while keeping you on your back. “It's always important to make sure there is no undue pressure on areas that just had an operation,” says David Shafer, MD, a double board certified plastic and reconstructive surgeon in New York City. Here, if you’re not using a stack of regular ol’ pillows or a husband-style pillow you might have around for reading, you have three basic options: 

- **Wedge Pillows**: Lift your torso up into a semi-fowler position (meaning your back is at a 45 degree angle) a la the [Sleep Number Adjustable Wedge Pillow](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.sleepnumber.com%2Fproducts%2Fadjustable-wedge-pillow).
- **Head-Cradling Cushions**: This style keeps your face from moving side to side like the [Deluxe CosMed Pillow With Satin Pillowcase](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.cosmedcomfort.com%2Fproduct%2Fcosmed-deluxe-pillow-with-charmeuse-satin-pillowcase%2F) or even [U-shaped pillows like the Modern Sleep U-Shape Memory Foam Travel Pillow](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.walmart.com%2Fip%2FModern-Sleep-U-Shape-Memory-Foam-Travel-Pillow-Neck-Pillow%2F41974843).
- **Contoured Side-Sleeping Pillow**: For folks who really can’t handle more than a night or two on their backs, Dr. Shafer recommends Sleep & Glow’s Omnia Pillow, which has cut-outs on either side for your face to reduce pressure. 

Beyond that, many doctors recommend tucking a pillow under your knees or lower legs to take the pressure off your lower back and facilitate blood flow. In fact, this is a good practice for all post-op patients. “I tell them to keep your ankles at knee level when in bed with a soft pillow under the knees to prevent venous blood from pooling in the lower legs, which can set you up for a blood clot,” says [Suzanne Trott, MD](https://drtrott.com/), a Beverly Hills-based board certified plastic and reconstructive surgeon. For those on the lookout for a dedicated pillow for the task, try [Ebung Leg Elevation Pillow](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.amazon.com%2FEbung-The-Best%2Fdp%2FB07KFPQTM8).

This all goes for work on the breasts, as well. Dr. Shafer notes that some like to use a specific between-boob strap-on cushion called the [Pillow Bra by Sleep and Glow](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.sleepandglow.com%2Fproduct%2F4) to keep the breasts in place during sleep. Not only can it keep you more comfortable but “it’s good for preventing wrinkles in the decolletage,” he says.

### **For Booty & Vaginal Work**
It’s during the day when pillows *really* matter for work on the rear end or “down there.” Some find a regular memory foam pillow helps take the pressure off when you sit, but Dr. Trott says there are special “donut” or “w” shaped pillows made of memory foam meant to keep weight off the buttocks when you sit. If there’s one area where doctors often recommend a special buy, this is, as BBL-type procedures come with upwards of a month of downtime. Try: [Royal Comfort BBL Booty Pillow](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.amazon.com%2FBBL-Booty-Pillow-After-Surgery%2Fdp%2FB07L1XPR6W).

At night, you’ll want to sleep on your stomach. That means you’ll likely need to create bumpers to keep you face down. Lots of regular pillows can work, but a regular ol’ body pillow can be a godsend here.

### **For a Tummy Tuck**
The concern after a [tummy tuck](https://aedit.com/procedure/abdominoplasty) is making sure not to stretch the incision site overnight. That’s why Dr. Ordon insists that abdominoplasty patients maintain “a flexed, jackknife position.” Sure, you can do this with your own pillows and bolsters under your upper body and legs. But, if you need help, an all-over body system, like the [Contour BackMax Foam Bed Wedge Pillow Support System](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.amazon.com%2FContour-Products-Backmax-Wedge-System%2Fdp%2FB000CA5AG2%2F), can be just what the doctor ordered. By elevating both the back and feet, they mimic the shape of a hospital bed on top of your mattress. 

### **For Liposuction**
Sleeping on your back allows for even weight distribution, which is why it’s often recommended after lipo. Creating bumpers around yourself with regular pillows or trying any of the flip-preventing pillow options mentioned above can be a help. If you had your arms or legs done, reserve a few. In such cases, it’s important to keep limbs elevated to keep blood flowing and keep swelling at a minimum, Dr. Ordon says.

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

How to select the best cushion after surgery. 

Best Post-Op Pillows For Recovering From Aesthetic Procedures

Your Guide To The Best Post-Op Pillows For Aesthetic Procedures

shutterstock 1185760375

Aside from thinking about the final result, one of the most preoccupying concerns when it comes to having an aesthetic procedure is how much [pain](https://aedit.com/aedition/how-much-plastic-surgery-really-hurts), [bruising](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox), and swelling it will cause. You might consider these elements to be completely separate, but they are actually closely linked. When it comes to post-surgical discomfort, the most likely culprit is swelling. It can be difficult for providers to predict exactly how much swelling a patient will experience during [recovery](https://aedit.com/aedition/category/recovery), but there are several strategies to help manage it. We’re breaking down exactly what post-operative swelling is, how to treat it, and what you can do to minimize it. 

## **What Is Swelling?**
Swelling is the body’s natural response to injury. Although aesthetic surgery is elective, the body still views the incision and work carried out as an injury. It kick starts the healing process accordingly. The first stage of the recovery process is the inflammatory phase, during which the body will send repair cells to the surgical site. The main symptoms of the inflammatory response are swelling and pain, with the former often causing the latter. The swelling itself is a result of the increased movement of fluids carrying white blood cells, growth factors, and enzymes to the area.

### **What Affects Swelling?**
Several factors will determine how much swelling someone experiences after a procedure, but it can be difficult to predict. Below are a few indicators: 

1. **The Procedure**: The type of procedure you have will impact how much swelling you experience. Generally speaking, Non- and minimally invasive procedures induce less swelling than invasive and surgical ones.
2. **The Part of the Body**: The face is particularly prone to swelling, while areas like the stomach tend to swell less. 
3. **Genetics & Lifestyle**: Your body will also have a natural tendency to swell more or less than others. These differences are mostly due to genetics, but your overall health and diet can play a part, too. 

Your provider will discuss any additional risk factors with you during the pre-op workup process, and they will be able to advise on what to expect during the recovery process based on your medical history and treatment plan.

### **How to Minimize the Risk of Swelling**
Minimizing the risk of swelling begins long before you go under the knife. Being in good physical health is important for any surgery. Your surgeon will likely have asked for several pre-op tests to make sure you are fit and healthy enough for the procedure, but staying in shape will help with your recovery, too. Some surgeons may also advise taking certain [vitamins and supplements](https://aedit.com/aedition/vitamins-supplements-to-avoid-before-cosmetic-surgery) ahead of the procedure to reduce swelling. Bromelain is one popular option, as are [vitamin A](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare) and [vitamin C](https://aedit.com/aedition/guide-to-topical-vitamin-c-in-skincare). [Anti-inflammatory diets](https://aedit.com/aedition/meal-plans-diet-before-after-cosmetic-surgery) rich in whole grains, plant-based fats and proteins, fruits and vegetables, and fresh herbs and spices and low in sodium can help combat post-surgical inflammation.

## **How to Manage Post-Op Swelling** 
Needless to say, you will be given specific post-operative care guidelines by your medical team that should be followed to a T. They will include strategies to manage swelling and the discomfort it can cause like: 

- **Wrap It Up**: If your recovery involves compression garments, be sure to wear them as instructed, as they will play a crucial role in your healing. 
- **Ice, Ice Baby**: Ice packs (especially in the first 24 to 48 hours) are key to reducing swelling and pain. You may even be given your first ice pack before leaving the clinic. 
- **Stay Lifted**: You may be advised to elevate the area you had surgery on, which usually means raising the torso. A wedge pillow can help keep you elevated comfortably. 
- **Move Around**: Staying as [active as possible](https://aedit.com/aedition/when-to-start-exercising-again-after-cosmetic-surgery-procedures) will help reduce swelling and boost your chances of a smooth recovery. Follow your medical team’s advice on how active you can be and when you can resume different levels of activity. 

Oh, and your [post-op diet](https://aedit.com/aedition/category/diet-and-nutrition) matters just as much as your prep-op one. You’re also going to want to stay hydrated and eat well. Staying healthy will give your body the nutrients it needs to recover optimally. 

### **How Long Does Post-Op Swelling Last?**
Depending on the invasiveness of the procedure, swelling usually peaks in the first days or weeks after a procedure and subsides from there. Even mild swelling in the days after a procedure can [hide or distort the results](https://aedit.com/aedition/treatment-for-post-plastic-surgery-depression-blues-during-recovery), so don’t be disheartened if you aren’t seeing the outcome you had hoped for right away. Your surgeon should give you a good indication of how long it will take after the procedure to see the final results, so be sure to keep that in mind — especially in the first few weeks post-op. 

It should be noted that residual swelling can linger for months. Most of the time, it is a natural part of the healing process and isn’t anything to worry about. But, if you notice a sudden increase in swelling, discharge, or issues with your incisions, be sure to consult with your provider. Additionally, be on the lookout for unexplained swelling in the legs — particularly if you haven’t been moving around much — as this could be a sign of more serious post-surgical complications. 

## **The Takeaway**
Recovering from an aesthetic surgery is a very personal experience. Swelling and discomfort in the days and weeks after a procedure are natural parts of the healing process, and you will likely be given [medication](https://aedit.com/aedition/opioid-crisis-plastic-surgery-recovery-pain-management) (prescription and/or over-the-counter) to help keep you as comfortable as possible. Following these tips and the instructions from your surgeon will help keep swelling to a minimum and ensure a more optimal recovery.

AEDITION minimalists-min

Wellness Collection | The AEDITION

Wellness

It can be difficult  to predict exactly how much swelling a patient will deal with during recovery, but there are several ways to manage it. 

How To Treat And Minimize Swelling After Cosmetic Surgery

Everything You Need To Know About Post-Surgery Swelling

soroush-karimi-ZcczBXrkXgA-unsplash

Are you looking for lusher, longer lashes without the mess of [mascara](https://aedit.com/aedition/best-lengthening-curling-volumizing-mascaras) or the maintenance and expense of [eyelash extensions](https://aedit.com/aedition/what-its-like-to-get-eyelash-extensions)? You’re not alone. The [DIY eyelash craze](https://aedit.com/aedition/false-eyelashes-mascara-for-thicker-fuller-lashes) has only accelerated since the start of COVID-19 pandemic with stay-at-home orders forcing people to miss their usual professional treatments and face masks putting a [renewed emphasis on the eyes](https://aedit.com/aedition/popularity-of-eyelid-surgery-cosmetic-eye-procedures-during-covid-19).

If you’re not naturally blessed with Lucy Boynton-level lash length and volume, you might be wondering about the benefits of eyelash growth serums. Do they work? Are they safe? To better understand the lash serum market, we spoke with a board certified dermatologist and eyelash industry expert to get the scoop.

## **How Lash Serum Works**
When we talk about promoting healthy hair growth on any part of the body, what we’re really discussing is the importance of [healthy hair follicles](https://aedit.com/aedition/at-home-hair-care-tips). Those tiny, tunnel-like structures in the epidermis are where hair bulbs (clusters of cells that are pushed out as they die) become strands of hair fibers. 

For normal hair growth on the scalp, brows, and lashes, those follicles need plenty of oxygen and nutrients. “Lash and brow serums work by directly supplying the hair follicles with vitamins, nutrients, and hair-promoting growth factors by applying with a brush or wand,” says [Adriana Lombardi, MD](https://aedit.com/provider/adriana-lombardi-md-12670), a board certified dermatologist and co-director of the Advanced Laser and Skin Cancer Center of New Jersey.

While women have been seeking thicker, longer, fuller lashes for millennia, modern lash serums were born by accident. “[Latisse®](https://aedit.com/procedure/latisse) was initially and still is a medication to treat glaucoma when applied into the eye,” Dr. Lombardi explains. “We found that patients using this product had significant growth of the eyelashes. Since then, it has been used on a brush applicator to apply to the eyelashes and eyebrows to stimulate growth.”

### **What are the active ingredients in lash serums?**
Most lash growth serums contain two main categories of ingredients: conditioners and growth stimulants. These typically include:

- **Botanical Extracts**: Powerful plant essences that can help hydrate and nourish skin.
- **Vitamins**: The most important of these is vitamin B7 (a.k.a. biotin), which helps turn the food we eat into energy and plays a key role in creating healthy skin, hair, and nails.
- **Ceramides**: These fat molecules (lipids) help skin retain moisture.
- **[Peptides](https://aedit.com/aedition/guide-to-topical-peptides-in-skincare)**: Small chain amino acids are the building blocks of collagen and other proteins essential for keeping skin and hair healthy.

You might be wondering if you can just go ahead and swipe your favorite brow serum on your lashes and vice versa. “Brows and lashes are different,”  explains Alicia Grande, founder and CEO of [Grande Cosmetics](https://grandecosmetics.com/). “They have different growth cycle lengths and are different in size.” As a result, product formulations tend to be slightly different, and their applicators are, too. If you are using Latisse®, many experts agree it can be applied (carefully!) on the brows to stimulate growth. 

## **Prescription vs. OTC Lash Serums**
In a nutshell, substances classified as ‘drugs’ elicit some sort of physiological change in your body (in this case, quantifiable eyelash growth), while cosmetic-grade products affect your appearance (shinier, plumper lashes, for example). Drugs like Latisse® undergo thorough examination by the United States Food and Drug Administration (FDA), whereas cosmetic OTC products do not have to go through the same testing protocols.

Whether a product is approved by the FDA as a drug also affects how companies can characterize and market the product. Claims made by a manufacturer are often just as important as the ingredients listed on the packaging. “Prescription products go through full-blown medical studies and can claim growth,” Grande says. 

Some over-the-counter serums — like [RapidLash](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.ulta.com%2Feyelash-enhancing-serum%3FproductId%3DxlsImpprod1640391), [RevitaLash](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.dermstore.com%2Fproduct_Advanced%2BEyelash%2BConditioner%2B%2B3%2BMonth%2BSupply_74311.htm), and [Rodan+Fields LashBoost](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.rodanandfields.com%2Fshop%2Fr-f-lash-boost%2Fp%2FENHLSH01) — contain growth-stimulating ingredients that behave similarly to bimatoprost, a prostaglandin analog that is the active ingredient in Latisse®. Others — like [GrandeLash-MD](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.sephora.com%2Fproduct%2Fgrandlash-tm-md-lash-enhancing-serum-P419219), [LashFOOD](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.sephora.com%2Fproduct%2Fphyto-medic-eyelash-enhancer-P384467), and [Vegamour](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fvegamour.com%2Fcollections%2Flash%2Fproducts%2Fgro-advanced-lash-serum%3Fvariant%3D30675405930611) — rely on conditioning compounds, many of them botanical. “GrandeLASH-MD enhances your lashes with lash-loving ingredients,” Grande shares. “When you give your body the right nutrients and right ingredients, you do see enhancement.”

### **How long does it take to see lash serum results?**
We’re all about instant gratification, but patience is a virtue when it comes to lash growth. Why does it take so long for lash serums to work? It has to do with the natural growth cycle of the hair. Regardless of whether you choose a prescription or OTC formula, you can usually expect to see initial results in about four weeks, with maximum results peaking after three months of use.

The catch? As soon as you stop applying the serum regularly, the benefits will fade. But don’t go thinking you can defy Mother Nature with a ‘more is more’ attitude. “We don’t recommend applying the product more than one swipe, once a day,” Grande says of GrandeLASH-MD. “ Our serums are formulated to work based on the growth cycle timetable of your lashes and brows, which you can’t speed up.”

## **Lash Serum Safety**
The FDA considers Latisse® to be safe and effective as long as it’s used under the supervision of a physician. “When patients complain of thinning eyelashes or eyebrows, I do recommend using Latisse®,” Dr. Lombardi says. “It works well and gives patients significant results.”

Like any drug, however, there are potential risks and side effects, including dry eyes, eyelid darkening, and, in rare cases, eye color change. “This was found if the medication gets into the eye and is used for long periods of time,” Dr. Lombardi says of the misconception. When the product is applied correctly, she notes that the risk eye color change is under one percent. A more common side effect? “It can commonly cause dermatitis where applied,” she says.

As we’ve established, things are less clear in the OTC market. Any product that contains a prostaglandin analog will likely carry similar risks to that of Latisse®. Consumers should always check the ingredients list and consult with their dermatologist before introducing new products into their skincare regimen. “While sensitivity is rare, there is always a possibility whenever introducing a new beauty product,” Grande explains. “We suggest testing our products on your hand first to determine if you have a sensitivity to it.”

More often than not, sensitivity or irritation occurs when products are not used as intended. “If irritation occurs, feel free to use the product every other day or so for a week or two,” she advises. “Then, resume daily use as instructed. A consumer study [of GrandeLASH-MD] was performed on 35 participants and the side effects were very minimal.”

### **Can You Use Lash Serum with Lash Extensions?**
Let’s dispel a common myth: If you’ve got [eyelash extensions](https://aedit.com/procedure/eyelash-extensions), you can — and should — use a lash serum to help prevent the loss and breakage of your natural eyelashes. Make sure, however, you choose a product that does not break down cyanoacrylate (i.e. the glue used in most lash extension treatments). Steer clear of products containing coconut oil or other oils (olive, jojoba, etc.) and look for lash serums that say “safe for lash extensions.”

Dr. Lombardi generally recommends foregoing lash extensions altogether in favor of Latisse®, as long as the patient is a good candidate. “Lash extensions are harmful to the overall health of the eyelash,” she explains. “Whenever you apply traction/glue to a hair follicle, you run the risk of causing irreversible damage to that follicle.” That damage can lead to hair thinning and loss, and the same holds true for eyebrows. “[Microblading](https://aedit.com/aedition/microblading-treatments-for-fuller-thicker-eyebrows) is done by creating trauma or micropores to the eyebrow area and placing dye,” she says. “This also has the potential to cause damage to the hair follicles in this area.”

## **How to Find the Best Lash Serum**
So, how do you decide whether to opt for a prescription or over-the-counter lash serum? It really comes down to your needs, budget, and biology. “Not all serums are created equal and what that means is, not all serums have the same ingredients,” Grande says. “But keep in mind, more expensive doesn’t always mean better.” 

If dramatic growth is your goal and you’re willing to accept potential side effects, prescription Latisse® could be a good option. If you’re looking for something more natural but still noticeable, an OTC brand can likely do the trick.

The best way to find an OTC eyelash growth serum that suits you is to seek recommendations from family and friends and research popular brands that have a proven track record. “GrandeLASH-MD has been on the market for over 12 years and won over 30 awards,” Grande shares. “We have a proprietary formula that has been proven effective to provide longer, thicker-looking lashes and at a fair price point.”

At the end of the day, it’s about safety, effectiveness, and education. “When patients are using a product, they should be aware of the risks and benefits,” Dr. Lombardi concludes. “And proper use should be explained.”

If you’re not naturally blessed with Lucy Boynton-level lashes, you might be wondering about the benefits of eyelash growth serums. Do they work? Are they safe? We asked the experts.

Eyelash Growth Serums: Benefits, Safety, And Results

The Truth About Lash Growth Serums

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There’s been a lot of buzz in recent years about the health benefits of fasting and calorie restriction. In fact, intermittent fasting was the top Google diet search trend in 2019. Proponents of these protocols have promised everything from weight loss (obviously) to anti-aging (we’re intrigued). We’re all for positive lifestyle changes — that’s a given. But before we say *sayonara* to our midnight snack, we want to know if it’s safe, effective, and scientifically backed. Here, we comb through the research and speak with the experts to get the — *ahem* — skinny.

## **Calorie Restriction vs. Dieting**
From the flapper-favorite cigarette diet and the postwar cabbage soup scheme to the modern keto craze, Americans are intimately familiar with the fantasy of fad diets promising fast results. These diet plans typically focus on one goal: weight loss. Depending on the science backing it up, sometimes that translates to better health. Other times, it results in rebound weight gain and nutritional deficiencies. 

While the idea of limiting calories to manage weight has been around for centuries, certain techniques have gained popularity in the past decade for their possible health and longevity benefits. Unlike diets, the practice of calorie restriction (CR) and intermittent fasting (IF) are aimed at promoting health and extending lifespan. Dropping pounds, meanwhile, may or may not be a fringe beneift.

## **Calorie Restriction vs. Intermittent Fasting**
Now that we know the difference between diets and calorie restriction, it’s time to understand what separates calorie restriction from intermittent fasting. To answer this fundamental question, we turned to the [National Institute on Aging (NIA)](https://www.nia.nih.gov/), a division of the United States National Institutes of Health (NIH). Here’s how the NIA [defines it](https://www.nia.nih.gov/health/calorie-restriction-and-fasting-diets-what-do-we-know):

- **Calorie Restriction**: Refers to “reducing average daily caloric intake below what is typical or habitual, without malnutrition or deprivation of essential nutrients.”
- **Fasting Diet**: Eating is severely limited or refrained from all together during certain times of the day, week, or month. 

When it comes to fasting diets like IF, the NIA says that a “practical effect” may be consuming fewer calories “because there is less time for regular eating.” Common fasting regimens include alternate-day fasting or restricted eating windows that maintain a prolonged daily fasting state.

## **The Science of Calorie Restriction & Intermittent Fasting**
In December 2019, Mark Mattson, PhD, a neuroscientist at the National Institute on Aging and a professor of neuroscience at Johns Hopkins University, and Rafael de Cabo, PhD, head of the NIA’s Aging, Metabolism and Nutrition Unit (AMNU), [published an article](https://www.nejm.org/doi/full/10.1056/NEJMra1905136?query=recirc_curatedRelated_article) in the *New England Journal of Medicine* that concluded:

*Evidence is accumulating that eating in a six-hour period and fasting for 18 hours can trigger a metabolic switch from glucose-based to ketone-based energy, with increased stress resistance, increased longevity, and a decreased incidence of diseases, including cancer and obesity.*

And that's just one piece of a growing body of research on the topic. “Numerous studies show that fasting and calorie restriction can improve our body composition (lean muscle mass to body fat ratio), lower blood glucose and insulin levels, increase growth hormone production, increase longevity, and reduce inflammatory markers,” says [Jennifer Hanway](https://jenniferhanway.com/), a board certified holistic nutritionist and personal trainer.

Let’s break that down:

- **Body Composition**: Having a favorable lean muscle mass to body fat ratio has been proven to ward off chronic diseases, [improve posture](https://aedit.com/aedition/how-to-improve-your-posture), and strengthen joints and bones.
- **Blood Glucose & Insulin Levels**: Keeping these in check lowers your risk of obesity, diabetes, and heart disease. It also helps in [healing](https://aedit.com/aedition/category/recovery) from injury, illness, and even aesthetic procedures.
- **Growth Hormone Production**: Release of growth hormones are necessary to maintain healthy tissues and organs.
- **Longevity**: Calorie restriction has been shown to increase lifespan in lab environments. Human studies suggest positive impacts on brain health and cognition, blood pressure, and resting heart rate.
- **Inflammatory Markers**: Studies of human immune cells show that fasting lessens chronic inflammation and has no adverse effect on the [immune system](https://aedit.com/aedition/at-home-wellness-routine-for-immunity-mental-health-stress) overall.

Scientists suspect that we’re evolutionarily wired to function optimally when alternating between periods of feast and famine. When we eat, the body releases insulin to help our cells process the glucose in our blood. Some excess glucose is stored in the liver as glycogen, while the rest is converted to fat. After 12 hours of fasting, we start tapping those glycogen reserves. After 18 hours, our fat cells begin sending fat to the liver to convert into energy. This releases ketone bodies — energy molecules that have been credited with improving neurological function, promoting cellular regeneration, fighting cancer, and more. This process is known as metabolic switching.

### **Calorie Restriction & Longevity**
When it comes to longevity, there’s a host of animal studies that suggests the promise of these restrictive eating protocols. Here’s a roundup:

- Rodent studies have shown that a 10 to 40 percent calorie reduction can result in longer lifespans with less incidence of disease — especially cancer.
- Studies involving the worm *C. elegans* show a fasting diet increased their lifespan by 40 percent.
- Ongoing NIH studies of rhesus monkeys have shown a decrease in age-related diseases (like cancer, diabetes, and cardiovascular disease) over 20 years. One study showed an increase in lifespan, while another did not.

But just because something works in worms or primates doesn’t mean it’ll hold true for humans. There is, however, some observational evidence to suggest that these protocols promote health. Taking that a step further, here’s a look at two recent human trials aimed at providing objective, quantitative results:

**[The CALERIE Study](https://www.nia.nih.gov/research/resource/comprehensive-assessment-long-term-effects-reducing-intake-energy-calerie)**: The Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) study supported by the NIH followed 218 normal to slightly overweight individuals for two years. Test subjects were randomly divided into two groups:

1. The calorie restriction group was told to reduce their daily intake by 25 percent
2. The control group was told to follow their regular diet

So what happened to those in the CR group? Though they, on average, reduced their daily caloric intake by 12 percent instead of 25, subjects lost an average of 10 percent of their body weight and, for the most part, kept it off for at least two years after the study concluded.

As for overall health, the participants in the CR group:

- Lowered their cholesterol and blood pressure, which reduces risk of diabetes, heart disease, and stroke
- Decreased levels of inflammatory factors and thyroid hormones, which some studies suggest may translate into a decrease in age-related disease

No significant negative impacts were detected, though some participants experienced periods of anemia. Researchers concluded that the CALERIE protocol is safe under a doctor’s supervision.

**[The TREAT Study](https://clinicaltrials.gov/ct2/show/NCT03393195)**: The Time Restricted Eating As Treatment (TREAT) study conducted by researchers at the University of California San Francisco, examined 116 overweight or obese individuals for 12 weeks. Participants were randomly divided into two groups: 

1. The consistent meal timing (CMT) group ate three meals daily at set times 
2. The time restricted eating (TRE) group ate whatever they wanted, but only between 12 p.m. and 8 p.m.

The results, [published recently in JAMA Internal Medicine](https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2771095), have caused some controversy because they show no statistically significant difference between the two groups. The study suggests that intermittent fasting for weight loss doesn’t work, with some of the participants in the TRE group even losing lean muscle mass.

These conclusions are being debated in the scientific community. Some experts say the research exemplifies why it’s so hard to study humans: Left to our own devices, we’re just not that consistent — even when given clear instructions. A number of study participants did not adhere to the exact eating requirements and some didn’t complete their surveys — both of which certainly impacted the findings. In many ways, these studies underscore the fact that we have much more to learn about the topic.

### **Intermittent Fasting & Skin Aging**
While living longer, healthier lives is certainly promising, is it too much to ask that we look more youthful and vibrant to boot? Hanway says that some of these biological benefits can indeed affect our outer beauty.

For starters, IF may help delay the skin’s aging process. “Intermittent fasting can have skin benefits due to its lowering of blood glucose and insulin levels,” she says. “When blood sugar is high, it can cause glycation of the skin, in which the sugar molecules bind to the collagen and elastin in our skin, preventing it from staying firm and supple and contributing to premature aging.”

But that’s not all. As we mentioned earlier, IF and CR can improve the body’s natural healing processes — including the skin. “Intermittent fasting increases our rate of autophagy, or cellular ‘clean-up,’ which can help our skin to repair faster and improve protection itself from internal and external stressors,” Hanway shares. Cheers to having our cake (between 10 a.m. and 6 p.m., of course) and eating it, too.

## **The Risks of Caloric Restriction & Intermittent Fasting**
From simple social challenges (*sorry, I don’t eat past 4 p.m.*) and ‘rebound’ overeating to a slower metabolism, fatigue, moodiness, and nutrient deficiencies, the list of possible complications from IF and CR protocols is long. “Intermittent fasting can be very stressful on the body and can be especially challenging for women, as they have a more complicated endocrine system than men,” Hanway cautions. As she explains, IF and CR can also lower metabolism and thyroid function, if taken to extremes. 

While we’ve discussed the potential benefits as far as aesthetics are concerned, it can quickly go the other way. ‘When a diet is low in protein, healthy fats, and micronutrients, it shows up as thinning or loss of hair, weak, brittle nails, and premature aging of the skin,” Hanway warns. To avoid such complications, calorie restriction and intermittent fasting should only be embarked upon under the supervision of a professional. It's crucial to maintain a healthy diet, including a mix of carbohydrates, protein, and healthy fats. 

## **The Takeaway**
While more research is needed, most experts agree that some forms of calorie restriction and intermittent fasting can be beneficial in the right candidates. For those interested in experimenting, Hanway offers a more moderate approach. “Many of the benefits of IF can be gained from a less restrictive form of fasting called Time Restricted Eating (TRE),” she explains.

With this scheduled protocol, you can maintain a relatively normal eating schedule. “Rather than jumping in the deep end with a long fast or fasting during the day, I recommend aiming for a minimum of 12 hours overnight between dinner and breakfast and three to four hours in-between meals,” she shares. “You can then gradually extend your overnight fast to up to 16 hours, but I do not recommend any longer than that.” 

Talk to your doctor or nutritionist to determine if this kind of eating plan may be right for you.

There’s been a lot of buzz in recent years about the health benefits of fasting and calorie restriction. Here, we comb through the research and speak with the experts to get the skinny.

The Impact Of Intermittent Fasting And Calorie Restriction On Skin, Aging, Longevity

Could Intermittent Fasting Be The Fountain Of Youth?

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Did you know there are nurse and doctor concierge and other VIP services that plastic surgeons in New York, Los Angeles, and other major cities offer their patients to [recover](https://aedit.com/aedition/category/recovery) comfortably and, in some cases, discreetly? Here’s what you need to know.

## **What Is Concierge Medicine?**
Concierge doctors, otherwise known as retainer-based medicine or direct primary care, are private providers (physicians and nurses) who charge their patients an annual fee between $1,000 to $25,000 for more personalized service. Keep in mind that fee doesn't replace health insurance. Rather, patients pay that fee to the doctor and still keep their health insurance to cover tests, hospitalization, and other things health-related needs. 

Concierge medicine generally comes with 24/7 access, a cell phone number to connect directly with the provider, same-day appointments, and visits that last as long as necessary (read: no racing in and out of exam rooms), among other amenities. The benefit for providers? The upfront fee, typically monthly, allows them to bring in more revenue per patient. Because of this, most concierge physicians can cap their patient base at around 300.

## **Concierge Medicine for Plastic Surgery Recovery**
So, how does this impact aesthetic medicine? “Concierge services are super hot with high-end cosmetic surgery right now,” says Lisa Cassileth, MD, a board certified plastic and reconstructive and founder of [Cassileth Plastic Surgery](https://www.drcassileth.com/) in Beverly Hills. It’s not only about having a plastic surgery practice reachable by phone, she says. Instead, the value lies in having  a concierge nurse appointed to follow your aftercare and see or contact you on a daily basis from the time of surgery onward. “This is your go-to person that is always available to you,” Dr. Cassileth shares. 

Whether they are employed by the patient or coordinated through the plastic surgeon, concierge nurses will ensure all [post-op recovery protocols](https://aedit.com/aedition/how-long-does-it-takes-to-recover-from-cosmetic-surgery-procedures) are followed — from changing dressings to traveling to follow up appointments and everything in between. “The nurse changes their compresses, checks on the swelling, administers any medications that may be needed,” explains [Jennifer Levine, MD](https://drjenniferlevine.com/), a double board certified facial plastic and reconstructive surgeon in New York City. “They can also help the patient wash their hair and bathe or take them to their postoperative appointments.” Dr. Levine says many of her patients opt to have a private-duty nurse stay with them after the surgery. 

The idea is to take all the guesswork out of the healing and recovery process, so patients can rest assured knowing they are well cared for. Dr. Cassileth notes that surgery can be overwhelming for patients, who don’t always know what’s normal and what’s not. “You can be told [what to eat](https://aedit.com/aedition/meal-plans-diet-before-after-cosmetic-surgery) and what to do, similar to when you stay at a high end hotel,” she says. Her practice offers a concierge nurse, who provides one-on-one care and support.

### **Additional Concierge Care**
Taking a nurse home with you after surgery isn’t the only form of bespoke care available. [Ryan Neinstein, MD](https://neinsteinplasticsurgery.com/), a board certified plastic and reconstructive surgeon in NYC, says that patients having less access to the office has prompted his practice to offer more concierge options. “We are able to provide pre-operative testing at home with registered nursing, driver services with COVID-19 protocols, and at-home [lymphatic drainage](https://aedit.com/aedition/benefits-of-lymphatic-drainage-massages-after-cosmetic-surgery),” he explains. “These services not only allow our patients to have an enhanced result and experience but allows us to employ more people than we would have before to take care of more people within our community.” 

At Dr. Levine’s practice, [LED light therapy](https://aedit.com/aedition/everything-you-need-to-know-about-the-benefits-of-light-therapy) and/or laser services are offered to help with [bruising and swelling](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox). Post-op, she usually gives the concierge caregiver or the patient her cell phone number in case they need to reach her. Her protocol is to check on patients the night of surgery and the day after the procedure to make sure they are doing well and that they do not have any questions or concerns.

## **The Takeaway**
While concierge medicine can cover everything from primary care to plastic surgery on an ongoing basis, aesthetic patients can also opt for short-term support after a procedure or surgery. If this type of care is of interest to you, ask your plastic surgeon during the [consultation](https://aedit.com/aedition/questions-to-ask-your-doctor-during-plastic-surgery-consultation) and pre-op process what kind of nursing services or customized care they offer. It will come at an [additional fee](https://aedit.com/aedition/how-much-cosmetic-surgery-costs), but the peace of mind can be priceless. As Dr. Cassileth says, “to be able to have a fairy godmother-type nurse always available to you is a great feeling.” 

Concierge and VIP services allow plastic surgery patients to recover comfortably and discreetly under the care of medical professionals. Here’s what you need to know.