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Lip augmentation is a catchall phrase that involves everything from minimally invasive lip fillers to surgical cosmetic procedures. But regardless of how you define it, treatments that improve the appearance of the lips are among the most popular cosmetic procedures in the United States.

While we've heard a lot about how to [increase the size of the lips](https://aedit.com/aedition/when-lip-fillers-are-not-enough), less discussed are treatment options for contouring a shapelier pout — and there is much more to the shape of the mouth than just the upper lip and lower lip. For starters, the highly sensitive pinkish part of the lip is known as the vermillion and is separated from the skin surrounding the mouth by a white roll known as the vermillion border. The central area of the upper lip, meanwhile, is the cupid's bow, and the groove that vertically runs from the cupid's bow portion of the lip to the nose is called the philtrum.

A defined cupid's bow can have a subtle but significant impact on overall shape of the lips, and that little V-shaped area in the middle of the top lip is now being treated with a range of procedures aimed at altering its curvature, reversing signs of aging, and improving contour. Here, we've rounded up three surgical and non-surgical cupid’s bow treatment plans and spoke to patients about their experience with each kind.

## **1. Injectable Fillers**
Dermal fillers are probably the first lip treatment option that comes to mind when you think about enhancing the mouth area. Lip injections are nothing new, but they rose to new fame when full, pillowy pouts (a la Kylie Jenner) became a must-have. But fillers aren't just good for addressing size concerns. They can also be a good option for those looking to mimic the contouring effects of lip liner in a longer lasting way.

Cupid’s bow lip fillers aim to alter the shape of the lip (as opposed to giving an all-round plumper look) for about six to 12 months (i.e. until the product wears off). The temporary nature makes it an ideal option for those looking to dip their toe in the lip enhancement arena without a big commitment. Patients can also ask for their philtrum columns to be filled to further define the cupid’s bow.

### **How do lip fillers work?**
Just like traditional lip augmentation treatments, the lips can be shaped by injecting [temporary hyaluronic acid (HA)-based fillers](https://aedit.com/procedure/temporary-lip-fillers) (like Juvéderm® or Restylane®) around the vermillion border. Technique varies by provider, but your practitioner will inject the product using ‘micro-droplets’ to create subtle definition.

### **What happens during the procedure?**
As with most cosmetic procedures, your appointment will likely start with a consultation during which your board certified dermatologist or plastic surgeon will look at the anatomy of the lips and learn about your aesthetic goals. Once it's time to inject, the practitioner will then numb the area (most doctors and patients opt for topical numbing agent) before placing small amounts of filler in the top lip. There is no downtime associated with fillers, though patients may experience side effects including swelling and/or bruising for a couple of days after treatment.

### **Patient Perspective**
*We spoke to Jess, who got filler to define her cupid’s bow because she was looking for a result that wasn’t quite as ‘done’ as more traditional fillers, about her experience with the procedure.*

<Dialogue>
  <Question party={The AEDITION}>
    Could you talk us through the procedure?
  </Question>
  <Response party={Jess}>
    I had a consultation the week before the procedure, so I was told what to expect during the procedure. I had numbing cream applied over my lips and then my dermatologist injected the filler. She was really gentle! I could feel it, but I wouldn’t say it was painful. It was more a strange sensation than pain. Once the injections were done, she went over aftercare with me again, and that was it. It was quick and easy. The procedure itself definitely shouldn’t put anyone off.
  </Response>
  <Question party={The AEDITION}>
    How was the recovery process?
  </Question>
  <Response party={Jess}>
    I decided to have my fillers done on a Friday after work to give myself the weekend to get over the bulk of the swelling and bruising. It actually wasn’t as bad as I had imagined. I thought I would need to stay in all weekend, but I ended up actually quite liking the look of my swollen lips! I was lucky to avoid bruising pretty much entirely, too.
  </Response>
  <Question party={The AEDITION}>
    Are you pleased with the results?
  </Question>
  <Response party={Jess}>
    The results are exactly what I was looking for. I would actually be more confident to have a more extensive area treated next time. The result is so subtle and elegant — not at all overdone. My cupid’s bow is so much more defined. I’m really pleased with it.
  </Response>
</Dialogue>

## **2. Lip Threading**
A newer treatment on the block, threading (not the hair removal kind) enhances the shape and volume of lips — and the cupid’s bow in particular. The procedure uses fine surgical thread to stimulate collagen production which in turn defines the vermilion border and makes lips look plumper without using fillers. The technique (which focuses more on definition than volume) is the same that is used for [thread lifts](https://aedit.com/procedure/pdo-thread-lift) on other parts of the face.

### **How does lip threading work?**
The treatment involves the placement of a poly-L-lactic acid (PLLA) thread that the body absorbs over time. The thread is inserted via a fine, tube-like needle, ‘anchored’ at a certain point, and then placed by removing the needle. Unlike fillers, final results develop in the weeks following the treatment, as more collagen is produced and blood flow to the area increases. Like hyaluronic acid fillers, the effects last six to 12 months. Unlike HA fillers, however, thread treatments are not easily reversed and some providers shy away from using threads around the mouth.

### **What happens during the procedure?**
After your consultation, a numbing cream is applied to the treatment area and dental blocks (the same injections you have when you go to the dentist’s office) will be administered. The provider will make incisions on either side of the mouth through which the fine tube with the string will be strung. Once it is properly placed, the tube is gently removed, leaving the thread in its place. While there is no downtime, your mouth area will likely feel numb for a little while after the procedure and swelling and/or bruising may persist for a few days.

### **Patient Perspective**
*After being unhappy with the unnatural results of filler, Jo chose a lip threading procedure to define her vermilion border.*

<Dialogue>
  <Question party={The AEDITION}>
    What was your lip threading procedure like?
  </Question>
  <Response party={Jo}>
    I had fillers in the past and wanted to try something different. The threading procedure was a bit more invasive than fillers. I had numbing injections for this, which I didn’t have for filler. But once they worked, the procedure was painless. Obviously having any needles near your mouth is going to be unpleasant to a point, but it’s bearable.
  </Response>
  <Question party={The AEDITION}>
    How was the recovery process?
  </Question>
  <Response party={Jo}>
    I work from home, so I was able to recover away from any prying eyes. There was some bruising that I wouldn’t really have wanted to show off! I could probably have covered it with makeup, but I just left it to run its course and it disappeared after maybe five days or so. Other than that, there was a little bit of pain as the anesthesia wore off on the day of, but I took some painkillers and went to bed. By morning it was fine. If you’re comparing fillers to threads, I would say the recovery was similar but a little more intense for threads.
  </Response>
  <Question party={The AEDITION}>
    Are you pleased with the results?
  </Question>
  <Response party={Jo}>
    Yes! They’re different to fillers. I think they look more natural, to be honest. I wasn’t that pleased with my profile look with fillers, but with the thread, my lips look really smooth and natural. My cupid’s bow was the main source of my issues with the area. Now it looks more defined and generally more youthful.
  </Response>
</Dialogue>

## **3. Lip Lift**
For those looking for long term results, [surgical lip lifts](https://aedit.com/aedition/lip-lift-procedure-instead-of-lip-filler) are a great option defining the cupid’s bow and the philtrum columns. The procedure involves surgically removing a section of skin under your nose to  lift the lip, leaving lips looking plumper, more defined, and lifted. It’s a procedure that can be performed under local anesthesia and results are permanent — save for usual signs of aging.

### **How does a lip lift work?**
Lip lifts work by, quite literally, lifting the lip. The rejuvenation procedure removes a small amount of skin between the top lip and the nose to create contoured and youthful-looking upper lip. The surgery is best suited to patients who are happy with the appearance of their lower lip, as the procedure addresses the upper lip only. Rather than add volume (as is the case with the previous two options), a lip lift will add definition and minimize any signs of aging in the area. There are several types of lip lifts that involve different incision placements and results. Consulting with a board certified plastic surgeon will ensure you receive the best treatment for your anatomy (for example, you will need a minimum distance of about 0.7 inches between the top of your lip and your nose to be eligible).

### **What happens during the procedure?**
During your initial consultation, your surgeon will advise on the type of lip lift that is best for you. On the day of the procedure, the surgeon will mark the incision sites and administer a local anesthetic injection to numb the area. A mild sedative may also be given to help patients relax. The hour-long procedure involves the surgeon removing the skin and securing the lower incision to the base of the nose to create an instant lift effect. Dissolvable sutures are usually used to close the wound, and there are about seven to 10 days of downtime. While the final results are immediately visible, a lip lift surgery takes three to six months to heal.

### **Patient Perspective**
*Emma had a lip lift to combat signs of aging around her mouth, including her cupid’s bow that was becoming less defined as she got older.*

<Dialogue>
  <Question party={The AEDITION}>
    What was your lip lift procedure like?
  </Question>
  <Response party={Emma}>
    I was given the option of having general anesthesia or local, and I opted for local. The first step was a few injections, which were not too pleasant but totally fine. Then I felt a little bit of pressure — no pain — while my surgeon did his thing, and I was told very clearly to let them know if I felt any discomfort. After the procedure, I had to wait around for a while for the nurse to approve that I was able to go home, and I was told about the aftercare instructions again. It was probably the most straightforward part of the process, to be honest.
  </Response>
  <Question party={The AEDITION}>
    How was the recovery process? 
  </Question>
  <Response party={Emma}>
    I took a week off work mostly to give myself a chance to not look terrible before going back to the office, but it wasn’t too bad. There was a certain level of swelling and bruising, but I had instructions on how to deal with that by icing the area and so forth. I had some painkillers to take, and I needed them for the first three days but was fine after that. The scar healed really well. It took longer than I would have expected, and I needed to be cautious with sun exposure to avoid damaging the new tissue, but it wasn’t too bad overall.
  </Response>
  <Question party={The AEDITION}>
    Are you pleased with the results?
  </Question>
  <Response party={Emma}>
    The surgery achieved the result I was looking for. My lips look more youthful and defined again. And it’s permanent, so I don’t need to fuss around with fillers every few months, which is great. I think as long as people are aware of the recovery process and they can take some time off during those initial few days then it’s a great option.
  </Response>
</Dialogue>

AEDITION rejuvenators-min

Medical Aesthetics Collection | The AEDITION

Aesthetics

A defined cupid's bow can have a subtle but significant impact on the overall shape of the lips. In honor of National Lip Appreciation Day, The AEDITION is rounding up three surgical and non-surgical procedures for a perkier pout.

Lip Augmentation Procedures For A More Defined Cupid's Bow

Why Cupid’s Bow Procedures Are The Next Generation Of Lip Augmentation

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Here’s a sobering statistic: [The National Institute on Drug Abuse reports](https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis#:~:text=What%20do%20we%20know%20about,for%20chronic%20pain%20misuse%20them.&text=Between%208%20and%2012%20percent%20develop%20an%20opioid%20use%20disorder.&text=An%20estimated%204%20to%206,prescription%20opioids%20transition%20to%20heroin.) that roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them. Between 8 and 12 percent of those patients go on to develop an opioid-use disorder. From there, an estimated 4 to 6 percent of people who misuse prescription opioids transition to heroin. 

It goes without saying that pain management is part of the post-procedure recovery process in aesthetic medicine, but many plastic surgery practices have been taking precautions and adjusting their approach to recovery in recent years as the opioid epidemic grows in the United States. “It's a cunning, baffling, powerful disease and it can happen to anyone,” says New York City-based dermatologist [Cheryl Karcher, MD](https://aedit.com/provider/cheryl-karcher-md-4323), who is [open about her own battle with addiction](https://www.nytimes.com/2016/07/24/fashion/cheryl-karcher-comeback-pill-popping-dermatologist.html) several years ago. “I am much more on the lookout now.”

Because it can be difficult to identify who will become addicted and who won’t, providers — especially those in the already scrutinized fields of cosmetic and plastic surgery — have  learned to take special care. 

“Plastic surgery has never been more prevalent, more revered, and, at the same time, more scrutinized,” says board certified plastic surgeon, [Ryan Neinstein, MD](https://neinsteinplasticsurgery.com/), of Neinstein Plastic Surgery in Manhattan. There are countless media stories of poor plastic surgery outcomes, he explains, and these are typically instances of procedures being performed by unqualified physicians in substandard facilities. “However, day in day out, plastic surgeons around the country are making surgery safer, faster, and more predictable,” he says. 

Here, three experts share the precautions they’ve taken against opioid abuse in their own practices and how they’ve adjusted their approaches to the plastic surgery recovery process in recent years. 

## **The Importance of Preoperative Counseling**
Dr. Karcher says that she now asks a lot more questions about personal and family history of addiction when she meets with her patients. She routinely recommends Tylenol (acetaminophen) or Tylenol with ibuprofen (like Advil) for pain. New York City-based board certified facial plastic surgeon [Jennifer Levine, MD](https://drjenniferlevine.com/), agrees that preoperative counseling is vital and lets her patients know that they may be uncomfortable, but the surgery is not especially painful. “Pain medication is available if they need it, but most patients do not require it,” she says. “Opiates are rarely necessary in my practice.”

## **Prescribing in Smaller Quantities**
Dr. Karcher says that if the aforementioned Tylenol is not enough or if she knows a patient will really need pain medication to get to the point where they can recover properly, a few pain pills will be prescribed. That said, the tight leash on these dangerous drugs can lead to those who need pain management not getting the medication they need. “I do, unfortunately, see patients that have needed opiates for other medical or surgical issues and were not given them,” she says. “I do think opiates have a place in very short-term pain management.” 

## **Responsible Discarding**
For Dr. Levine, most of her procedures are above the neck and, as such, most of her patients do not require opioids. “I use a local anesthetic during the surgery and some longer-acting local anesthetics for longer procedures such as facelifts,” she says. The majority of her patients only take acetaminophen after the surgery. “I do give all my patients a small supply of a pain medication such as Vicodin (hydrocodone/acetaminophen),” she says, adding that she “rarely” prescribes anything stronger. “Many of my patients come in after the surgery with the bottle of unused pain medication and ask me to discard it for them.”

## **The Next Generation of Pain Management**
One of the advances Dr. Neinstein has made to his practice is the use of a medication borrowed from the trauma world called tranexamic acid. The clotting promoter is used to treat heavy menstrual periods in women, and this low-cost drug can be added to the intravenous liquid given to a patient during surgery to aid the post-op recovery process. “This medication has quickly shown to safely contribute to minimizing blood loss,” he says. “Even in plastic surgery — where there is minimal blood loss — by reducing it even more we can further minimize the downtime and physiological change to our patients’ bodies.”

Three experts share the precautions they’ve taken against opioid abuse in their own practices and how they’ve adjusted their approaches to the plastic surgery recovery process in recent years.

The Future Of Opioid Use In Plastic Surgery

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According to the [American Society of Plastic Surgeons (ASPS)](https://www.plasticsurgery.org/news/press-releases/americans-spent-more-than-16-billion-on-cosmetic-plastic-surgery-in-2018), Americans spent some $16.5 million on cosmetic surgery and minimally invasive procedures in 2018 alone, and it is safe to say a good portion of that figure was an out-of-pocket expenditure for patients. With national cost averages ranging from $3,800 for a breast augmentation to upwards of $8,000 for a facelift, cosmetic surgery is no small expense and most treatments (surgical or otherwise) are not covered by health insurance.

That's not to say there aren’t exceptions to the rule. While elective procedures that are purely cosmetic in nature will always operate (pun intended) outside the realm of insurance companies, plastic surgery procedures that can be classified as 'medically necessary' are often part of insurance policies.

So, what makes an invasive or non-invasive procedure medically necessary and, therefore, covered by a health insurance plan? The AEDITION breaks it down.

## **What Makes a Procedure 'Medically Necessary'**
In June 1989, the [American Medical Association (AMA)](https://www.ama-assn.org/) adopted the following definitions of ‘cosmetic surgery’ and ‘reconstructive surgery’ that are used by health insurance companies to determine coverage.

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

In theory, the definitions are black and white: cosmetic procedures are not medically necessary; plastic and reconstructive surgery procedures are. In reality, there is quite a bit of gray area. Many procedures have a dual purpose that treats both an aesthetic concern *and* a functional health problem. If the provider can document the medically necessary component of the procedure and any non-surgical remediation that was previously taken to correct the health issue, Medicare or private insurance may very well cover the cost.

## **What Procedures May Be Covered By Insurance**
In order to successfully document the medical necessity of a procedure, providers must prove the surgery the patient is interested in directly addresses the quality of life concern(s) surrounding the body part or health problem in question. This process involves: 

1. Submitting photographic evidence (not just a written explanation) to the insurance company
2. Proving non-surgical or non-procedure remedies have already been explored 

While the exact standards may vary by insurance company, the [ASPS offers a recommended criteria](https://www.plasticsurgery.org/for-medical-professionals/health-policy/recommended-insurance-coverage-criteria) for distinguishing between a cosmetic surgery procedure and a plastic or reconstructive surgery that providers can use when explaining treatments that have a dual aesthetic and functional purpose. But what does that mean in layman's terms? Below is a guide to surgical and non-surgical procedures that sometimes qualify for insurance coverage. 

### **Abdominoplasty (a.k.a Tummy Tuck) & Panniculectomy** 
Weight loss procedures (think: gastric sleeves, lap gastric bands, and gastric bypass) are often covered by insurance for patients who have a high body mass index (BMI) coupled with comorbidities like heart disease or type 2 diabetes. In the [aftermath of a major weight loss](https://aedit.com/aedition/what-its-like-to-get-plastic-surgery-after-bariatric-surgery-weight-loss), there are a few cosmetic surgeries that may be considered functional procedures in order to improve a patient's quality of life:

- **Abdominoplasty**: A tummy tuck typically combines fat removal (i.e. liposuction) with skin removal and/or tightening, which may be required by patients in the aftermath of losing a significant amount of weight.
- **Panniculectomy**: The surgical procedure removes excess skin on patients who have lost a significant amount of weight (naturally or via a bariatric procedure).

While insurance coverage of a panniculectomy or [tummy tuck](https://aedit.com/procedure/abdominoplasty) is not as common as weight loss surgery, they may be deemed medically necessary if a patient is in pain, unable to participate in normal activities, or at risk of developing a skin condition.

### **Blepharoplasty (a.k.a. Eyelid Surgery)**
Aging eyelids don't just cause cosmetic concerns, drooping eyelids have the ability to impair vision. For patients who are dealing with poor eyesight as a result of sagging skin around the eyes, an [upper eyelid blepharoplasty](https://aedit.com/procedure/upper-eyelid-blepharoplasty) may be deemed medically necessary to correct the problem. During the surgery, a plastic or oculoplastic surgeon will remove excess skin to lift and open the eye. While many insurance policies will cover the functional component of the surgery, additional cosmetic improvements may need to be paid for out of pocket. It should also be noted that [lower eyelid blepharoplasty](https://aedit.com/procedure/lower-eyelid-blepharoplasty-transconjunctival-approach) is more difficult to classify as a functional procedure.

### **Botox®** 
No, [neurotoxin injections](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) to get rid of fine lines and wrinkles are not going to be covered by your insurance company, but there are therapeutic uses for Botox® that may be. In 2010, Botox® was approved by the U.S. Food and Drug Administration (FDA) to treat chronic migraine in patients over the age of 18. When injected around the pain fibers that are involved in headaches, Botox® blocks the release of chemicals involved in pain transmission. The FDA-recommended dosage is 155 units (administered every 10 to 12 weeks) for migraine patients, and the treatment is covered by most insurance plans (including Medicare and Medicaid).

### **Breast Surgery**
As you can probably guess, a [breast augmentation](https://aedit.com/procedure/breast-augmentation-with-implants) to cosmetically enhance the size or shape of the chest isn't going to be covered by health insurance plans, but certain kinds of breast surgery can be considered medically necessary:

- **Post-Mastectomy Breast Reconstruction**: As per the [1998 Women’s Health and Cancer Rights Act (WHCRA)](https://www.cancer.org/treatment/finding-and-paying-for-treatment/understanding-health-insurance/health-insurance-laws/womens-health-and-cancer-rights-act.html), group health plans that cover mastectomy (be it for breast cancer prevention or treatment) must also cover [breast reconstruction](https://aedit.com/aedition/comprehensive-guide-to-breast-reconstruction-nipple-reconstruction-after-breast-cancer) — in the form of prostheses (like breast implants) — and other procedures for both breasts. In such cases, providers do not need to document health problems or trials of alternative treatment. Medicare also covers bilateral breast reconstruction in post-mastectomy patients.
- **Reduction Mammoplasty (a.k.a. Breast Reduction)**: Women with symptomatic macromastia (large breasts) may deal with neck, nerve, shoulder, and back pain, breast discomfort, an inability to engage in certain activities, and/or dermatitis or rashes beneath the breasts secondary to the condition. In such cases, a [breast reduction surgery](https://aedit.com/procedure/breast-reduction) may be covered by insurance after six to 12 months (on average) of documentation is presented to show alternative treatments (think: visits to a physical therapist, chiropractor, or orthopedist) were unsuccessful.

It should be noted that [gynecomastia surgery](https://aedit.com/procedure/male-breast-reduction) (a.k.a. male breast reduction) is much more difficult to classify as a functional procedure than reduction mammoplasty for women — though the ASPS has compiled a [set of guidelines](https://www.plasticsurgery.org/Documents/Health-Policy/Positions/Gynecomastia_ICC.pdf) that encompasses pain and discomfort, suspected malignancy, and more and can be used for evaluating insurance coverage for both adolescents and adults.

### **Otoplasty (a.k.a. Ear Surgery)**
Otoplasty can be used to improve or correct the shape, proportion, and/or position of the ear. Such surgical procedures are performed in children and adults alike, and an [ear surgery](https://aedit.com/procedure/otoplasty) may be covered by health insurance if a provider is able to provide one of the following:

1. Document a medical problem (like hearing loss) caused by abnormal shaped ears
2. Document that the ear deformity is from a congenital abnormality

Unlike other procedures that require doctors also show the patient participated in a trial of alternative treatments, patients with a congenital abnormality of the ear do not need to first experiment with non-surgical remedies. 

### **Rhinoplasty (a.k.a Nose Job)**
Just as you probably have a friend who 'wanted' a nose job, you likely know someone who 'needed' a rhinoplasty. Difficulty breathing, nose bleeds, and sinus problems are just a few of the [health concerns that can lead a patient to need nose surgery](https://aedit.com/aedition/difference-between-cosmetic-rhinoplasty-vs-functional-rhinoplasty). After proving that non-invasive alternatives (like nasal spray) are ineffective, insurance may cover some or all of the procedure.

Medically speaking, the surgical procedure that corrects a deviated septum (one common cause of breathing issues) is known as a septoplasty and only addresses the inner workings of the nose. This procedure, which is almost always covered by insurance, has no bearing on the appearance of the nose. In some cases, a rhinoplasty that improves the shape or aesthetic of the external nose structure can be deemed medically necessary. Otherwise, patients who wish to make cosmetic changes (in addition to the functional improvements) may need to pay for that portion out of pocket.

## **The Takeaway**
Needless to say, there are many subtle intricacies that determine whether a procedure is deemed ‘cosmetic’ or ‘plastic and reconstructive.’ That distinction, however, plays a direct role in why it may or may not be covered by insurance. Consulting with a [board certified plastic surgeon](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) will provide clarity on whether your preferred surgical procedure could qualify for insurance coverage in accordance with your health plan.

Americans spent more than $16.5 billion on cosmetic procedures in 2018 with most patients paying out of pocket. But some plastic surgery is, in fact, covered by health insurance. Here, The AEDITION breaks down the ins and outs of coverage.

Is A Cosmetic Procedure Ever Covered By Insurance?

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If winter weather has you slacking on self care, you’re not alone. The most skin we’ve exposed in public since New Year’s Eve involved sneaking off our gloves for a second to scroll through a text thread. But while we’ve been curled up on the sofa, covered in a cashmere throw, catching up on *The Crown*, winter has been waning.

News flash: Soon it won’t be sweatpants season anymore. Soon it will be spring break, and, before you know it, time for short shorts. So, what are the best cosmetic treatments and procedures to get while March is coming in like a lion and out like a lamb and April showers are bringing May flowers? The AEDITION asked board certified dermatologists and plastic surgeons to share the most popular procedures for spring.

## **At-Home Springtime Skincare** 
As winter gives way to spring, the mercury rises and humidity increases — as does our time in the sun. In response, our skin begins producing more oil, which can lead to clogged pores, breakouts, and dullness. Plus, more sunlight means more potential skin damage, as well as greater sensitivity (especially if you’re using retinol and/or certain in-office facial treatments). It’s imperative that we adjust our skincare routine to compensate.

“Our skin and bodies go through a period of adjustment when the temperature, humidity, and other environmental factors change from season to season,” explains Beverly Hills-based board certified facial plastic surgeon [Jonathan Cabin, MD](https://aedit.com/provider/jonathan-cabin-md-956). “For springtime, I recommend a regimen that increases exfoliation along with oil reduction.” 

To address both concerns, he favors a “getting skin ready” protocol by [ZO Skin Health](https://zoskinhealth.com/) that can be customized by skin type and season. “When spring comes, I will make sure patients are more extensively exfoliating with the [ZO Exfoliating Cleanser](https://zoskinhealth.com/products/getting-skin-ready/exfoliating-cleanser) and [Dual Action Scrub](https://zoskinhealth.com/products/getting-skin-ready/dual-action-facial-scrub), along with the maximum-strength [ZO Oil Control Pad](https://zoskinhealth.com/products/getting-skin-ready/acne-treatment-pads), which contains high levels of oil-fighting glycolic acid,” he shares. 

Board certified dermatologist [Adriana Lombari, MD](https://aedit.com/provider/adriana-lombardi-md-12670), of Advanced Laser and Skin Cancer Center of New Jersey is also a proponent of glycolic acid for springtime exfoliation, and she also encourages patients to be mindful of the texture of their products. Instead of rich creams, she recommends introducing a lightweight moisturizing gel packed with [hydrating hyaluronic acid](https://aedit.com/aedition/guide-to-hyaluronic-acid-in-skincare-dermal-filler) and topical antioxidants “to help protect the skin from UV damage.” 

Speaking of UV damage, if you’ve been using winter’s hibernation period as a chance to beef up your anti-aging skincare routine, Dr. Cabin suggests toning it down for spring. “Skin is made more sensitive to sun by products containing maximum-strength [retinol](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare) and hydroquinone — ingredients that are otherwise powerful in age prevention,” he says. 

Instead of removing the ingredients from your routine all together, he recommends introducing gentler alternatives. [Skinbetter Science AlphaRet Overnight Cream](https://skinbetter.com/products/rejuvenate-alpharet-overnight-cream/) (a milder retinol) and [Even Tone Correcting Serum](https://skinbetter.com/products/rejuvenate-even-tone-correcting-serum/) (a non-hydroquinone toner) are two of his go-to swaps. “This combination preserves great skin in the spring and summer months, without risk of damage from more intense UV rays,” he shares.

While you should be rocking sunscreen all day, every day no matter the weather, getting back on track with your SPF application is especially crucial in the spring and summer. Dr. Cabin suggests [EltaMD UV Daily Broad-Spectrum SPF 40](https://www.dermstore.com/product_UV+Daily+BroadSpectrum+SPF+40_10106.htm) for the job. For men who don’t have an extensive collection of lotions and potions, board certified plastic surgeon [Jacob Unger, MD](https://aedit.com/provider/jacob-unger-md-2649), of Maxwell Aesthetics in Nashville, recommends a lightweight moisturizer with SPF — the multitasker makes it easier for guys to cover their skincare bases.

## **Professional Skincare Treatments for Spring**
“Spring is a time of renewal,” Dr. Cabin says. “It’s a great time to give the skin a little jumpstart, so it can start off fresh.” He recommends [microneedling with PRP](https://aedit.com/procedure/microneedling-with-prp) (i.e. platelet rich plasma) to give a glow to dull, tired complexions. The multi-functional cosmetic treatment uses a fine, vibrating needle pen or dermal roller to infuse a patient’s skin with stem cells and growth factors for immediate and long term results. “The skin is naturally stimulated to produce more collagen and elastin,” he explains. “This serves to soften fine lines and wrinkles, and give the skin an extra glow.” Microneedling does make skin more sensitive, so be sure to use extra sun protection.

In keeping with the radiance-boosting trend, Dr. Lombardi recommends a series of chemical peels and/or [intense pulsed light (IPL)](https://aedit.com/procedure/ipl) treatments. [Superficial](https://aedit.com/procedure/superficial-chemical-peels) and [medium-depth chemical peels](https://aedit.com/procedure/medium-depth-chemical-peels) improve skin tone and texture, while IPL can treat complexion concerns ranging from acne to sunspots to broken blood vessels. Dr. Lombardi likes that “these modalities lighten and brighten the skin” with minimal downtime, though it should be noted that IPL works best on patients with fair to medium skin tones.

For anyone seeking to slow down the signs of visible aging, it’s not too early (or late!) for Botox®. Dr. Cabin generally recommends [preventative neurotoxin injections](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) for patients beginning in their late twenties and early thirties because “it can smooth the skin in the short term, but — more importantly — prevent those pesky etched in lines from developing over the long run,” he says.

## **Cosmetic Surgery for Spring**
If the thought of swimsuit season has you feeling like Punxsutawney Phil (six more weeks of winter, please!), subtle changes to your daily wellness routine can have a big impact come summer. “Start exercising now,” Dr. Lombardi says. “Nothing can take its place." Dr. Cabin agrees that “diet and exercise” are the two most important components of maintaining a healthy lifestyle. “But, if you need a little help, there are surgical and non-surgical options for body contouring,” he shares.

### **Non-Surgical Cosmetic Procedures to Try for Spring**
Say ‘so long’ to veins, freeze fat, and address your abs without going under the knife (or hitting the gym!) with these minimally invasive procedures.

- **Body Contouring**: Devices like [EmSculpt®](https://aedit.com/aedition/why-everyone-is-talking-about-emsculpt) and CoolTone™ stimulate muscle contraction to tone and define the abdomen and buttocks. “One 30-minute session is equivalent to tens of thousands of crunches,” Dr. Lombardi says. A series of sessions is typically recommended to start, with periodic maintenance over time.
- **CoolSculpting®**: The popular [fat-freezing technique](https://aedit.com/procedure/cool-sculpting) treats and removes stubborn fat deposits. Most patients require multiple sessions, with results appearing over the course of six to 12 weeks.
- **Laser Vein Removal**: According to Dr. Lombardi, this in-office treatment to [close and eliminate spider veins](https://aedit.com/aedition/how-to-treat-and-prevent-varicose-veins-spider-veins) takes one to three sessions spaced about a month apart for best results. Patients must have untanned skin and avoid the sun both before and after the procedure to maximize success while minimizing complication risk.

### **Surgical Cosmetic Procedures to Try for Spring**
While there has been an advent of non-surgical body sculpting techniques, certain cosmetic surgery procedures stand the test of time. While liposuction or breast surgeries may have longer recovery times, the results are longer lasting with little to no maintenance. Booking more invasive procedures in late winter or early spring will ensure you are enjoying the results by summer. 

- **Hi-Def Liposuction**: “I prefer the term ‘soft-def’ liposuction,” says Dr. Unger, who advocates a less aggressive, more natural-looking approach to the [body sculpting trend](https://aedit.com/aedition/high-definition-liposuction-techniques-for-body-contouring). “For people whose BMI and weight is already in the ideal range, this technique allows for a more toned look that can be difficult to obtain through diet and exercise alone,” he shares. Downtime is about a week, with results visible in about three months.
- **BodyTite™**: Dr. Unger often uses this radiofrequency (RF)-based technology in conjunction with both traditional and hi-def liposuction “to help shrink wrap the skin.” He says the technique decreases bruising, so there’s less downtime. “Instead of a week or two of bruising, it’s more like three to seven days,” he explains. A popular warm weather procedure is a “bra roll” reduction, where Dr. Unger combines a bit of liposuction with BodyTite™ to tighten up that stubborn area. “I had a patient confess to me after her procedure that she’d posed for pictures in a strapless dress at her sister’s wedding just five days later,” he shares. “While I recommend waiting at least a few weeks, she had no bruising whatsoever.”
- **Breast Augmentation**: While it remains the most popular plastic surgery procedure for women, the options here have moved well beyond choosing between saline or silicone implants. Patients looking for subtle changes to their chest may opt for [fat transfer](https://aedit.com/procedure/breast-augmentation-with-fat-transfer) for added volume and/or a [radiofrequency-assisted (RFA) liposuction](https://aedit.com/procedure/radiofrequency-assisted-liposuction) procedure like BreastTite™ for firming and lifting. Recovery time for any breast procedure is about six to 12 weeks, so spring is the perfect time for anyone seeking a curvier summer silhouette.

## **Plan Ahead for Summer Surgeries**
It should come as no surprise that summer vacation is an extremely popular time for cosmetic surgery, since it’s easier for patients to take time off. “Summer is a transitional time — between schools or jobs — and it is frequently a perfect time to do procedures that may lead to changes that are more noticeable to peers,” Dr. Cabin says. If you’re considering a surgical procedure this summer (think: [rhinoplasty](https://aedit.com/procedure/open-rhinoplasty), [facelift](https://aedit.com/procedure/smas-facelift), or [tummy tuck](https://aedit.com/procedure/abdominoplasty)), now is the ideal time to start consulting with [board certified plastic surgeons](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology).

What are the best cosmetic treatments and procedures to get while March is coming in like a lion and out like a lamb and April showers are bringing May flowers? The AEDITION asked the experts.

Invasive Plastic Surgery And Non-Invasive Cosmetic Procedures For Spring

Cosmetic Surgery By Season: Invasive And Non-Invasive Procedures For Spring

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We live in a culture driven by instant gratification. But, when it comes to recovering from a cosmetic or plastic surgery procedure, patience is a virtue. From the immediate downtime to the larger recovery process that can span weeks or months, the path to realizing the final results of your treatment can be a lengthy one. Recovery time encompasses everything from when you get drains, sutures, or splints removed to how long it takes for incision site marks to fade.

Speaking of scars, plastic surgeons are experts at closing wounds and most cosmetic and plastic surgery incisions are made to be as discreet as possible. Even so, incision sites take time to heal, and patients can expect those marks to fade over the course of a year. In that 12-month period, the scar will contract, remodel, and fade. If a patient is unhappy with the appearance of the incision mark at that point, a [scar revision procedure](https://aedit.com/aedition/minimizing-scars-after-surgery) might be an option. To ensure optimal healing, patients should apply sunscreen to their scars daily (rain or shine!). Topical vitamin E and scar gels may provide additional relief, but nothing replaces sunscreen.

While every patient and surgical procedure is different, there are some general timelines you can expect your cosmetic surgery recovery to follow. Here, The AEDITION breaks down the healing process of some of the most popular cosmetic procedures.

## **For Face**
*Whether you are interested in a cosmetic procedure or plastic surgery, surgical facial procedures like rhinoplasty, blepharoplasty, and facelifts take anywhere from six to 12 months for full results to be realized.*

### **Blepharoplasty (a.k.a. Eyelid Surgery)**
Blepharoplasty is a surgical procedure that improves the appearance of the eyelids by removing excess skin or fat deposits. Both [upper](https://aedit.com/procedure/upper-eyelid-blepharoplasty) and [lower](https://aedit.com/procedure/lower-eyelid-blepharoplasty-transconjunctival-approach) eyelid surgeries are available, and they may be classified as either a plastic and reconstructive procedure or aesthetic surgery depending on the reason for the procedure. 

- **Bruising & Swelling**: Subsides 7 to 10 days post-op
- **Return to Work**: 1 week post-op (eyes may be tired or more prone to strain)
- **Resume Normal Activity**: 4 weeks post-op 
- **Final Results**: 3 to 6 months post-op

### **Browplasty (a.k.a. Brow Lift)**
Known as a [browplasty, brow lift, or forehead lift](https://aedit.com/procedure/endoscopic-brow-lift), the surgery involves raising the eyebrows to a more youthful position to reduce the appearance of fine lines and wrinkles, sagging skin, and hooded eyelids.

- **Remove Sutures**: 7 to 10 days post-op
- **Return to Work**: 7 to 10 days post-op
- **Bruising & Swelling**: Subsides 10 to 14 days post-op
- **Resume Normal Activity**: 2 to 4 weeks post-op
- **Final Results**: 3 to 6 months post-op 

### **Rhinoplasty (a.k.a. Nose Job)**
Nose jobs can be 'functional' (i.e. medically necessary) or 'cosmetic' (read: elective), but both types of [rhinoplasty](https://aedit.com/procedure/open-rhinoplasty) procedures require patients to be patient during the healing process.

- **Bruising & Swelling**: Subsides 10 to 14 days post-op; residual swelling for up to one year
- **Remove Splint**: 5 to 7 days post-op
- **Return to Work**: 1 week post-op
- **Resume Normal Activity**: 3 weeks post-op
- **Final Results**: 1 year post-op

### **Rhytidectomy (a.k.a. Facelift)** 
The gold standard of facial rejuvenation, a [facelift](https://aedit.com/procedure/smas-facelift) surgery has the ability to treat facial sagging and volume loss by lifting and firming the face. 

- **Bruising & Swelling**: Peaks 48 hours post-op; subsides over 10 to 14 days
- **Resume Wearing Makeup**: 1 week post-op
- **Remove Sutures**: 7 to 10 days post-op
- **Return to Work**: 7 to 10 days post-op
- **Resume Normal Activity**: 2 weeks post-op
- **Final Results**: 3 to 6 months post-op

### **Lower Rhytidectomy (a.k.a. Neck Lift)**
During a [neck lift](https://aedit.com/procedure/direct-neck-lift) procedure, incisions are made along the hairline and ear to remove excess skin and fat. A lower rhytidectomy yields a more defined neck and jawline, in addition to removing jowls. 

- **Remove Drains**: 2 days post-op
- **Remove Sutures**: 5 to 10 days post-op
- **Bruising & Swelling**: Subsides within 10 to 14 days; residual swelling for 3 months
- **Resume Normal Activity**: 2 weeks post-op
- **Final Results**: 6 months post-op

## **For Hair**
*Despite the advent of [non-surgical hair restoration treatments](https://aedit.com/aedition/kourtney-kardashian-prp-injections-to-treat-hair-loss), surgical hair transplants remain the go-to for patients looking to correct baldness and hair thinning. While initial results will be seen in the first four to five months, 12 to 18 months may be needed for full recovery.*

### **Hair Transplants**
The two main types of surgical hair transplants are the [follicular unit extraction (FUE)](https://aedit.com/procedure/follicular-unit-extraction-fue) technique and the [follicular unit transplant (FUT)](https://aedit.com/procedure/strip-harvesting) method. The former involves transplanting individual hair follicles, while the latter extracts a strip of hair. Both types of procedures have a similar recovery period.

- **Swelling & Tenderness**: Subsides 5 to 7 days post-op
- **Resume Wearing Hat**: 10 to 14 days post-op
- **Transplanted Hair Sheds**: 2 to 3 weeks post-op
- **Initial Results**: 4 to 5 months post-op
- **Final Results**: 12 to 18 months post-op

## **For Body**
*From breast surgery (think: augmentation, reduction, and lift) to tummy tucks, there are an array of surgical body contouring procedures that, after the initial downtime and recovery process, provide long lasting results.*

### **Abdominoplasty (a.k.a. Tummy Tuck)** 
Whether it's performed alone or as part of a larger mommy makeover, body lift, or post-weight loss procedure, a [tummy tuck](https://aedit.com/procedure/abdominoplasty) removes excess skin and excess fat, in addition to restoring muscle definition, for a more contoured abdomen.

- **Remove Drains**: 1 week post-op
- **Return to Work**: 2 to 4 weeks post-op
- **Resume Normal Activity**: 2 to 4 weeks post-op
- **Wear Compression Garments**: 6 to 8 weeks post-op
- **Bruising & Swelling**: Subsides 2 to 3 months post-op; residual swelling for up to 18 months
- **Final Results**: 4 to 6 months post-op

### **Augmentation Mammaplasty (a.k.a. Breast Augmentation)**
Breast augmentation can involve [breast implants](https://aedit.com/procedure/breast-augmentation-with-implants), autologous fat transfers, or a [hybrid](https://aedit.com/aedition/hybrid-breast-augmentation-with-implants-fat-transfer) of the two. In the case of implant and hybrid procedures, a secondary surgery will be needed to replace the implants after eight to 10 years. Patients who choose an autologous fat transfer can expect to lose 30 to 40 percent of the volume to reabsorption. Nonetheless, patients can expect similar recovery times for each type.

- **Return to Work**: 3 to 5 days post-op
- **Bruising & Swelling**: Peaks at 24 to 48 hours post-op; subsides over 2 to 3 months 
- **Resume Exercise**: 3 to 6 weeks post-op
- **Resume Wearing Underwire Bra**: 4 to 6 weeks post-op
- **Final Results**: 3 to 6 months post-op

### **Brazilian Butt Lift**
Like an breast augmentation with fat transfer, a [butt lift](https://aedit.com/procedure/butt-lift) involves transferring fat from one part of the body to the buttocks for improved shape and contour. Generally speaking, 60 to 80 percent of fat transfer typically survives.

- **Return to Work**: 10 to 14 days post-op
- **Resume Sitting & Laying on Buttocks**: 2 weeks post-op
- **Resume Normal Activity**: 8 weeks post-op
- **Final Results**: 6 months post-op

### **Liposuction**
[Liposuction](https://aedit.com/procedure/tumescent-liposuction) is typically performed as part of a larger surgery (think: a tummy tuck) or to complement another procedure. Regardless of the purpose, it results in permanent fat loss.

- **Return to Work**: 1 to 3 days post-op
- **Resume Normal Activity**: 1 week post-op
- **Bruising & Swelling**: Peaks 1 week post-op; subsides over 4 to 6 weeks
- **Wear Compression Garments**: 4 to 6 weeks post-op
- **Initial Results**: 3 to 6 months post-op
- **Final Results**: 1 year post-op

### **Mastopexy (a.k.a. Breast Lift)**
A [breast lift](https://aedit.com/procedure/breast-lift) surgery improves the projection and shape of the breast by removing excess skin and tightening the surrounding tissue. 

- **Return to Work**: 1 week post-op
- **Bruising & Swelling**: Peaks at 72 hours and subsides over 6 to 8 weeks
- **Resume Exercise**: 3 to 6 weeks post-op 
- **Resume Wearing Underwire Bra**: 6 to 8 weeks post-op
- **Final Results**: 4 to 6 months post-op

### **Reduction Mammaplasty (a.k.a. Breast Reduction)**
To alleviate any pain or discomfort caused by large breasts, a [breast reduction](https://aedit.com/procedure/breast-reduction) permanently removes excess skin and fat. 

- **Back & Shoulder Pain**: Immediate Relief
- **Return to Work**: 1 week post-op
- **Resume Exercise**: 3 to 4 weeks post-op 
- **Shop for New Bras**: 2 to 3 months post-op
- **Final Results**: 6 to 12 months post-op

## **The Takeaway**
Because no two patients or procedures are the same, recovering from cosmetic surgery is a very personal experience. Consulting with a [board certified plastic surgeon](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) will provide further clarity on what you can expect during the healing process, so you can ensure the best results.

We live in a world of instant gratification. But, when it comes to recovering from a plastic surgery procedure, patience is key. The AEDITION breaks down the healing process of some of the most popular cosmetic procedures.

How Long It Takes To Recover From Cosmetic Surgery Procedures 

How Long Does It Really Take To Recover From Cosmetic Surgery? 

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Whether it's monthly facials or quarterly Botox® appointments, minimally invasive and non-invasive cosmetic treatments have become a routine part of many people's beauty regimens thanks to their expediency and lack of downtime. Treating signs of aging, skin tone, sun damage, sagging skin, acne scars, and even a double chin (to name a few!) is all possible without going under the knife, but the results don't last forever.

So, how often do these non-invasive treatments need to be performed in order to maintain your desired results? Here, we break down the ideal frequency for some of the most popular non-surgical procedures.

### **Chemical Peel**
Whether you're looking for a quick radiance boost or a deep resurfacing, chemical peels can treat everything from visible signs of aging (think: fine lines and sun damage) to hyperpigmentation and scarring. The type of result you see and how often you can repeat the treatment depends on the strength of the acid(s) involved. Generally speaking, they are classified as [light](https://aedit.com/procedure/superficial-chemical-peels), [medium](https://aedit.com/procedure/medium-depth-chemical-peels), or [deep](https://aedit.com/procedure/deep-chemical-peels).

- **Light Chemical Peel**: Also known as a superficial chemical peel, an alpha hydroxy acids is used to lightly exfoliate the epidermis (read: outer) layer of the skin. Minor flaking may occur in the days after treatment, and the radiance-boosting benefits often last a couple of weeks. Treatments can be repeated every three to six weeks.
- **Medium Chemical Peel**: Medium depth chemical peels, which typically involve trichloroacetic acid (TCA), reach the papillary dermis layer of the skin (the uppermost layer of the dermis) and can correct uneven skin tone and texture. Patients can expect to deal with peeling skin for up to 10 days post-treatment, and the procedure can be repeated every three to six months for prolonged results.  
- **Deep Chemical Peel**: If ever there were a case for one-and-done, it would be this. The intensely exfoliating treatment reaches the lower layer of the dermis, which allows it to completely resurface the skin. Up to three months of recovery time may be needed to heal, and the procedure is rarely performed more than once on a single patient.

### **CoolSculpting®**
This non-surgical liposuction alternative permanently destroys fat cells by freezing targeted areas. The body contouring treatment is often used to treat stubborn fat deposits on the stomach, hips, thighs, and chin area. After one session, [Coolsculpting®](https://aedit.com/procedure/cool-sculpting) patients can expect to see a 25 to 30 percent fat reduction within about four months. A series of one to three treatments spaced at least 60 days apart are often needed to fully treat each problem area.

### **Dermal Filler** 
Injectable filler has become one of the gold standards of minimally invasive aesthetics thanks to ability to reshape the face sans surgery. From temporarily mimicking the effects of surgery (hi, [liquid rhinoplasty](https://aedit.com/procedure/liquid-rhinoplasty)) to reducing the appearance of fine lines and wrinkles, [dermal filler](https://aedit.com/aedition/everything-you-need-to-know-about-dermal-fillers) comes in a variety of forms that treat different areas and last for different lengths of time.

- **Hyaluronic Acid (HA) Filler**: The most temporary option is found under brand names like Juvederm®, Belotero®, and Restylane® and lasts six to 12 months as the body absorbs the particles.
- **Calcium Hydroxylapatite (CaHA) Filler**: CaHA injectables like Radiesse® can be expected to last 12 to 18 months thanks to the thicker viscosity that is ideal for treating deeper lines and wrinkles.
- **Polylactic Acid (PLA) Filler**: More than just a filler, PLA products like Sculptra® are classified as 'collagen stimulators' thanks to their ability to help skin naturally rebuild collagen over time, in addition to smoothing lines for 18 to 24 months.
- **Polymethyl-methacrylate Microspheres (PMMA) Filler**:  Bellafill® is the only FDA-approved PMMA injectable treatment on the market. The synthetic, biocompatible substance takes the shape of a microsphere under the skin that provides structure and firmness for about five years.
- **Polyalkylimide Filler**: Semi-permanent injections like Aquamid® have a layer of collagen form around them over time that can boost the filler-like results that already last for five-plus years.

### **Kybella®**
FDA approved to treat moderate to severe submental fat, the deoxycholic acid injection can eliminate a double chin and provide jawline definition. While the results are known to be long lasting, multiple [Kybella®](https://aedit.com/procedure/kybella) treatments may be needed to achieve desired results. A single treatment consists of up to 50 injections spaced one-centimeter apart, and up to six single treatments (staggered at least one month apart) may be administered. 
 
### **Laser Hair Removal** 
The laser therapy treatment is one of the most common cosmetic procedures in the U.S. and involves heating and killing the hair follicle to prevent future hair growth. Sessions are scheduled every four to six weeks to complement the natural hair growth cycle, with six to eight typically needed for full results. While [electrolysis](https://aedit.com/procedure/electrolysis) is the procedure FDA-approved for permanent hair removal, [laser hair removal](https://aedit.com/procedure/laser-hair-removal) touch ups are usually only needed every six to 12 months (if at all).

### **Laser Skin Resurfacing**
Like chemical peels, lasers can be used to treat a variety of skin concerns ranging from superficial to deeply resurfacing depending on the strength of the product used. Generally speaking, lasers fall into two categories, non-wounding and wounding, and the results can be judged accordingly.

- **Non-Ablative Laser Treatments**: Non-wounding lasers like [pulsed light](https://aedit.com/procedure/ipl), [pulsed dye lasers](https://aedit.com/procedure/pulsed-dye-laser), and [fractional](https://aedit.com/procedure/nonablative-fractional-lasers) lasers do not remove layers of skin, which means an initial series of treatments spaced four to six weeks apart will be for best results. From there, treatment plans can be restarted or touch ups can be administered a couple times a year, as skin tone or texture concerns return.
- **Ablative Laser Treatments**: These wounding treatments include [carbon dioxide](https://aedit.com/procedure/ablative-co2-laser) (CO2) and [erbium](https://aedit.com/procedure/ablative-erbium-laser) lasers that remove the outer layers of skin. Typically used to correct concerns in one treatment (versus the many treatments needed with non-ablative devices), results last several years.

### **Microneedling**
The collagen-inducing therapy is a minimally invasive procedure that stimulates the body's natural healing mechanisms to address skin concerns like laxity, fine lines, wrinkles, scarring, stretch marks, and pigmentation. Microneedles puncture the skin's surface to create micro wounds that activate collagen production. Combining [microneedling](https://aedit.com/procedure/microneedling) with [platelet-rich plasma](https://aedit.com/procedure/microneedling-with-prp) or [radiofrequency](https://aedit.com/procedure/microneedling-with-radiofrequency) can boost the results, but a series of three to six treatments spaced four to six weeks apart is usually needed to see best results.  

### **Neurotoxin Injections** 
Botulinum toxin type A (BoNT-A) injections temporarily paralyze underlying muscles to prevent contraction and smooth the appearance of fines lines and wrinkles (think: crow's feet, horizontal forehead lines, and frown lines). While they are colloquially called 'Botox,' the Allergan-manufactured injectable is actually one of four approved by the FDA. [Botox®, Dysport®, Jeuveau®, and Xeomin®](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) each come from different pharmaceutical companies and have their own unique formulations, though each can be expected to last about three to four months.

### **Theadlift** 
If a non-surgical facelift is what you're after, [thread lifts](https://aedit.com/procedure/thread-lift) provide lifting and firming effects for six months to one year (i.e. until the threads dissolve). The goal of a thread lift is to reposition underlying skin tissue by weaving a dissolvable polypropylene thread in a cross-hatch or basket weave pattern under the targeted area to provide an immediate lifting effect, in addition to long term collagen stimulation. 

### **Ultherapy®** 
Ultrasonic skin tightening, like [Ultherapy®](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy), utilizes concentrated ultrasound waves to create heat deep within the dermis that triggers the body's natural collagen and elastin production. Most patients only need one treatment to start and maintenance sessions beginning one- to two-years after the first procedure can sustain and improve the results.

## **The Takeaway**
Unlike [cosmetic surgery](https://aedit.com/aedition/how-long-do-cosmetic-surgery-plastic-surgery-results-last), which often requires weeks or months of recovery time, many non-invasive procedures allow patients to enjoy results with little to no downtime. What non-surgical procedures lack in invasiveness, however, they often make up for in maintenance. In addition to needing a series of treatments in order to see results (think: three microneedling appointments spaced four to six weeks apart), routine touch ups (like going in for more Botox® every three to four months) will likely be needed. Consulting with a [board certified dermatologist or plastic surgeon](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) will ensure you are on the best treatment plan for your needs.

From Botox® and filler to microneedling and ultrasonic skin tightening, here’s a guide to how frequently non-invasive treatments need to be performed in order to maintain your desired results.

How Often You Should Get Non-Surgical Cosmetic Procedures Like Botox, Dermal Filler, Chemical Peels

How Often Do You Need To Touch Up Non-Surgical Cosmetic Procedures?

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Nothing lasts forever — not even the results of cosmetic surgery. While going under the knife may have longer-lasting effects than non-surgical cosmetic treatments, most plastic surgery procedures still have a shelf life that can range from a few years to more than a decade.

No two surgeries are the same, but having a basic understanding of what will happen before, during, and after a procedure can help ensure that your expectations are properly managed. The longevity of cosmetic and plastic surgery results depends largely on (a) the patient and (b) the surgeon’s technique, but there are some general rules of thumb when it comes to how long you can expect your results to last.

While nothing replaces a consultation with a [board certified plastic surgeon](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology), we’ve put together a guide to the average lifespan of some of the most common cosmetic surgery procedures. From lifts (think: facelift, brow lift, neck lift, breast lift, and butt lift) and hair transplants to rhinoplasties and breast implants, here’s how long popular cosmetic surgery and plastic surgery procedures typically last.

## **For Face**
*Non-surgical injectables (think: Botox®, filler, and the like) and laser treatments may be all the rage for their lack of invasiveness and downtime, but sometimes going under the knife is needed for a more dramatic and long-term fix. Even so, a surgical procedure cannot prevent the future effects of aging, which is why very few facial plastic surgery and cosmetic procedures claim to last forever.* 

### **Blepharoplasty (a.k.a Eyelid Surgery)**
**Lifespan**: 10 years for upper eyelid blepharoplasty; Lifetime for lower eyelid blepharoplasty
Blepharoplasty is a surgical procedure that improves the appearance of the eyelids by removing excess skin or fat deposits from the orbital area. It can be performed on either the upper and lower eyelid, and, depending on the reason for the procedure, may be classified as either a plastic and reconstructive procedure or an aesthetic surgery. 

- **Upper Eyelid Blepharoplasty**: The results of [upper eyelid surgery](https://aedit.com/procedure/upper-eyelid-blepharoplasty) usually last about 10 years (as the face and eye area continue to age), at which another procedure may be necessary. 
- **Lower Eyelid Blepharoplasty**: Unlike its upper eyelid counterpart, the results of a [lower eyelid surgery](https://aedit.com/procedure/lower-eyelid-blepharoplasty-transcutaneous-approach) tend to last a lifetime and a followup procedure is rarely necessary.

For patients whose vision is impaired by sagging eyelids, for example, the surgery would be considered medically necessary and, therefore, covered by insurance. Patients who simply wish to rejuvenate the eye area for cosmetic reasons, meanwhile, the treatment would probably be considered elective. Either way, the results are typically the same.

### **Browplasty (a.k.a. Brow Lift)**
**Lifespan**: 5 to 10 years
Known as a browplasty, brow lift, or forehead lift, the surgery involves raising the brows to a more youthful position and, in the process, reducing the appearance of lines and wrinkles, sagging skin, and hooded eyelids. During an [endoscopic brow lift](https://aedit.com/procedure/endoscopic-brow-lift), the surgeon places an endoscope through small incisions made within the hairline to adjust the muscle and tissue beneath the skin. Because of the natural aging process, results of a browplasty are not forever. Most last five to 10 years.

### **Rhinoplasty (a.k.a. Nose Job)**
**Lifespan**: Lifetime 
Like blepharoplasty, a [nose job can be 'functional' (i.e. medically necessary) or 'cosmetic' (read: elective)](https://aedit.com/aedition/difference-between-cosmetic-rhinoplasty-vs-functional-rhinoplasty). Both classifications require a great deal of patience during the healing process, with full results often taking up to a year to reveal themselves. But, they are worth the wait. A rhinoplasty is one of the few surgical procedures that comes with permanent, lifetime results. 

### **Rhytidectomy (a.k.a. Facelift)** 
**Lifespan**: 10 years
The gold standard of facial rejuvenation, a [surgical facelift](https://aedit.com/procedure/smas-facelift) has the most dramatic and long lasting results of any of the available lifting and firming techniques on the market. It addresses facial sagging and volume loss in a way few other treatments do, but, even so, a rhytidectomy should only be expected to last, on average, 10 years or so as the skin and face continue to naturally age.

### **Lower Rhytidectomy (a.k.a. Neck Lift)**
**Lifespan**: 10 years
Like a facelift, a [neck lift](https://aedit.com/procedure/neck-lift-lower-rhytidectomy) also has about a 10-year lifespan due to the natural aging process. During the procedure, incisions are made along the hairline and ear to remove excess skin and fat. In addition to removing jowls, a lower rhytidectomy yields a more defined neck and jawline.

## **For Hair**
*Hair loss is a concern for men and women alike. While treatments like [platelet-rich plasma (PRP) injections](https://aedit.com/aedition/kourtney-kardashian-prp-injections-to-treat-hair-loss) are gaining popularity for their ability to improve hair regrowth over time, hair transplants remain among the most effective, albeit invasive, ways to correct hair loss.* 

### **Hair Transplants**
**Lifespan**: Lifetime 
Generally speaking, there are two types of hair transplants. Both involve harvesting healthy hair follicles from a donor site for implant on balding or thinning areas.

- [Follicular Unit Extraction (FUE)](https://aedit.com/procedure/follicular-unit-extraction-fue): Healthy hair follicles are extracted one by one from a patient's scalp and implanted to other areas around the head.
- [Follicular Unit Transplant (FUT)](https://aedit.com/procedure/strip-harvesting): Also known as strip harvesting, surgeons remove a section of hair from the back of the head (or another place it can be easily concealed). The strip is then dissected into smaller segments that can be implanted as needed.

In each case, the transplanted hair typically shed within the first two to three weeks before growing back. Full results can take up to 18 months and touch up treatments may be needed, but the results are considered permanent.

## **For Body**
*Like the face, surgical and invasive procedures for the body typically last longer than non-invasive treatments that are meant to address similar concerns. While many body surgeries do offer permanent results, that longevity is often caveated with the need to maintain a healthy weight or lifestyle.*

### **Abdominoplasty (a.k.a. Tummy Tuck)** 
**Lifespan**: Lifetime with healthy lifestyle
A [tummy tuck](https://aedit.com/procedure/abdominoplasty) is a multifaceted cosmetic procedure that removes excess skin and excess fat, in addition to restoring muscle definition, for a more contoured abdomen. While the loose skin and fat removal are permanent, lifestyle factors (think: weight changes) can impact the longevity and quality of the results.

### **Brazilian Butt Lift** 
**Lifespan**: Lifetime after initial reabsorption period
A [Brazilian Butt Lift](https://aedit.com/procedure/butt-lift) involves transferring fat from one part of the body to the buttocks for improved shape and contour. Because it is an autologous transfer, there is no fear of rejection, but it is expected that some percentage of the fat will be reabsorbed into the body. Generally speaking, 60 to 70 percent of transferred fat survives, yielding permanent results.

### **Breast Surgery**
**Lifespan**: 8 to 10 years for breast implants; Lifetime results with healthy lifestyle for breast lift and breast reduction 
There are three main types of breast surgery — augmentation, reduction, and lift — and each procedure has its own unique level of permanence:

- **Augmentation Mammaplasty (a.k.a. Breast Augmentation)**: While there is more than one kind of breast augmentation, [augmentation with breast implants](https://aedit.com/procedure/breast-augmentation-with-implants) require replacement every eight to 10 years to ensure safety.
- **Mastopexy (a.k.a. Breast Lift)**: Unlike a breast augmentation that addresses the size of the chest, a [breast lift](https://aedit.com/procedure/breast-lift) improves the projection and shape of the breast by removing excess skin and tightening the surrounding tissue. Weight changes and the aging process can cause sagging over time.
- **Reduction Mammaplasty (a.k.a. Breast Reduction)**: To alleviate any pain or discomfort caused by large breasts, a [breast reduction](https://aedit.com/procedure/breast-reduction) removes excess skin and fat. The removal process is permanent, though it does require patients to maintain their weight.

### **Liposuction**
**Lifespan**: Lifetime with healthy lifestyle 
Liposuction is typically performed as part of a larger surgery (think: a tummy tuck) or to complement another procedure, but, regardless of the application, it results in permanent fat loss. With that said, [lipo](https://aedit.com/procedure/tumescent-liposuction) cannot protect against future weight gain, so a healthy weight  and healthy lifestyle must be maintained to enjoy the contouring results.

## **The Takeaway**
As you can probably tell, how long the results of plastic surgery last depends on an array of factors. In some cases, procedures can be one and done, assuming a healthy lifestyle is maintained. In other cases, the aging process may create the need for follow-up treatments down the line. Consulting with a board certified plastic surgeon will help to level set your expectations prior to surgery and ensure the best results for your concern.

Nothing lasts forever — not even the results of cosmetic surgery. From facelifts and hair transplants to rhinoplasties and breast implants, here’s how long the results of popular plastic surgery procedures last.

How Long Cosmetic Surgery And Plastic Surgery Results Last 

How Long Do Cosmetic Surgery Results Really Last?

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We all have that friend who, according to their doctor, “needed” a [nose job](https://aedit.com/procedure/open-rhinoplasty), and then we have friends who simply wanted one. So, what’s the difference?

One of the few procedures that are common among men and women and performed from [teenage years](https://aedit.com/procedure/youthteen-rhinoplasty) through [adulthood](https://aedit.com/procedure/rejuvenation-rhinoplasty), rhinoplasty (a.k.a. nose job, nose surgery, nasal surgery) can be classified as both a medically necessary plastic surgery procedure and an elective cosmetic surgery depending on how and why it is performed.

Generally speaking, your friend who “needed” the procedure likely had what is called a ‘functional’ rhinoplasty, during which a surgeon worked to resolve internal structural issues — in addition to potentially making aesthetic changes. Because the surgery was performed for medical reasons, it very well may have been covered by insurance (typical of plastic and reconstructive procedures but not cosmetic ones).

Your friend who wanted to change the shape, size, or appearance of her nose without an underlying medical condition, meanwhile, probably underwent what is known as a ‘cosmetic’ [rhinoplasty](https://aedit.com/procedure/ultrasonic-rhinoplasty). The cosmetic surgery procedure focuses exclusively on the external bone structure and usually requires patients to pay out of pocket.

[According to the American Society of Plastic Surgeons](https://www.plasticsurgery.org/documents/News/Statistics/2018/plastic-surgery-statistics-full-report-2018.pdf), there were some 215,000 rhinoplasties performed in the U.S. in 2018 alone, and that statistic accounts for both functional and cosmetic procedures. If you’ve been considering a nasal surgery, here is a guide to the two classifications.

## **What Is a Functional Rhinoplasty?**
First things first, a functional rhinoplasty is a medically necessary procedure that is used to [correct breathing problems](https://aedit.com/procedure/endoscopic-rhinoplasty) and sinus concerns. While we may not be able to see the inside of the nose, there can be structural issues that pose medical risks. 

“The nose is the organ of breathing,” says [Oren Friedman, MD](https://aedit.com/provider/oren-friedman-md-1609), a Philadelphia-based board certified facial plastic surgeon and director of facial plastic surgery at the University of Pennsylvania. “We are meant to breathe through the nose and not the mouth.”

As Dr. Friedman explains, the most common reason a patient seeks a functional rhinoplasty is to improve breathing. Patients who have a deviated septum (i.e. a narrow or crooked nasal passage caused by genetics, accident, or trauma), for example, may require a septoplasty to straighten or repair the septum. Beyond correcting a deviated septum, a rhinoplasty can “strengthen the sidewalls of the nose, so that the nasal sidewalls do not collapse and, therefore, obstruct airflow when the patients breathe in,” he shares. For cases of congenital abnormalities of nasal anatomy (think: cleft lip nasal deformities), meanwhile, Dr. Friedman says “highly specialized surgical care of the nasal tip cartilages and skin” is required.

For patients dealing with intense allergies or sinus infections that cause the turbinates (i.e. small structures inside the nose that clean and humidify air that passes through) to swell, nasal surgery may be able provide relief. 

There are three pairs of turbinates in each nose, and, when the lower set (read: inferior turbinates) become swollen, they can cause nasal obstruction and make it more difficult to breathe. To fix the structural issues, doctors may recommend a turbinate reduction. While non-surgical treatments, like radiofrequency, can sometimes do the trick, surgery might be needed.

“Some patients require septum straightening surgery as well as turbinate reductions, however, we generally advise against removing significant portions of nasal turbinate tissue,” Dr. Friedman warns. “Turbinate tissue is vital to the function of the nose — namely, humidifying, warming, and filtering the air are enhanced by the presence of turbinate tissue. Removal of too much turbinate tissue will lead to irreversible nasal problems. Ask your surgeon to not remove much or any turbinate tissue when you undergo nasal surgery.”

Whether performed individually or in tandem, both a septoplasty and turbinate reduction take six months to a year to heal. While improved breathing can be expected, turbinates will grow back in time and the septum may never be perfectly straight.

## **What Is a Cosmetic Rhinoplasty?**
Cosmetic rhinoplasties, on the other hand, focus on the outside of the nose (i.e. the part of the nose you can visibly see). Typically, patients that undergo the cosmetic procedure are dissatisfied with the appearance of their nose. A rhinoplasty can be used to:

- [Reshape and resize the nose](https://aedit.com/procedure/ethnic-rhinoplasty)
- [Address crookedness and asymmetries](https://aedit.com/procedure/revision-rhinoplasty)
- Change the base or bridge of the nose (or both!)
- Conceal a hump or bump
- Correct a pinched or bulbous nasal tip 

“The most common structural reasons for which patients seek cosmetic rhinoplasty include a prominent hump or bump along the bridge of the nose that they wish to be reduced, prominent and bulbous tip cartilages of the nose that they wish to be made smaller and triangulated, and a crooked nose that a person may wish to straighten out,” Dr. Friedman says. “The structural components that most often need to be altered, therefore, include the nasal bones as well as the tip cartilages.”

While the surgery is limited to the nose, the results can help to balance the entire face. At the end of the day, cosmetic rhinoplasty surgery isn’t a medical necessity, but it can boost confidence and make patients more comfortable with their appearance. 

## **Comparing Rhinoplasties** 
There are plenty of differences between a functional rhinoplasty and a cosmetic rhinoplasty, but at least one thing is true of each: the procedure improves a patient’s quality of life. While it may be easy to classify one as purely aesthetic and the other as medical, many rhinoplasty surgeries end up being a combination of the two.

“This is one of the most common procedures for specialized nasal surgeons, and it gives an opportunity for the surgeon to enhance a patient's quality of life on two different levels,” Dr. Friedman says of the combination surgery. “First, we are able to improve their quality of life through improvements to their appearance, and secondly we are able to improve their quality of life through improved nasal breathing.”

Regardless of the reasoning behind the rhinoplasty, the recovery and healing processes are similar — though there are subtle differences. “If the nasal bones need to be contoured in a cosmetic procedure, there will likely be some external bruising which would not be present if only internal nasal surgery was being performed,” Dr. Friedman notes. “Other than the slight bruising that might occur, the internal swelling of the nose generally resolved in one week for each of the different types of nasal surgery.”

At the end of the day, most people enjoy the results of their procedure by the six-month mark, but it can take up to a year for the nose to fully heal. Additionally, it is important to discuss with your surgeon whether or not your procedure is purely functional, purely cosmetic, or a hybrid because it will impact whether your insurance provider covers some part of the cost.

## **The Takeaway**
Regardless of which type of rhinoplasty you’re after, the procedure is best performed under the care and guidance of a specialized surgeon to avoid complications and the need for revisions down the road. 


“Excellence in outcomes for these types of nasal surgeries relies on the surgeon's expertise in this highly sub-specialized field,” Dr. Friedman explains. “In order to avoid the need for revision rhinoplasty due to failure of the first operation, it is very important the patient make the extra effort to identify a plastic surgeon who specializes in both internal and external nasal surgery.”

Some people need a rhinoplasty for medical reasons, while other people want one due to aesthetic concerns. Here, a guide to the two classifications and what it means for patients.  

Difference Between Cosmetic Rhinoplasty and Functional Rhinoplasty

Cosmetic Rhinoplasty vs. Functional Rhinoplasty: What’s The Difference?

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You’ve done your homework and decided you’re interested in getting a surgical or non-surgical [cosmetic procedure](https://aedit.com/aedition/difference-between-plastic-surgeons-and-cosmetic-surgeons). So, what comes next? A consultation with a board certified plastic surgeon.

Just as you wouldn’t buy a car without test driving it, you should not choose a doctor for your cosmetic surgery, procedure, or treatment without exploring your options. An initial consultation allows you to do just that. In addition to learning more about the procedure you are interested in, it is also an opportunity for you to get a sense of the doctor’s personality and practice before deciding if he or she is the right provider for you.

## **Book More Than One Consultation**
As with most decisions in life, you’ll want to get more than one opinion. You should plan to consult with at least two doctors before moving ahead with your surgery or procedure. When deciding on who to book a plastic surgery consultation with, it is important to first consider the following: 

- What is the provider’s board certification(s)?
- Does he or she have hospital privileges?
- Is he or she recommended by someone you trust?

While referrals aren’t mandatory, [researching a doctor’s board certification(s)](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) and hospital privileges (yes, even if you’re interested in an outpatient procedure) are musts. Tools like the [AEDIT provider network](https://aedit.com/providers) can help you find qualified doctors in your area.

Once you narrow down your search and schedule consultations with the providers you want to meet, there are a couple of things to keep in mind about the process. While it is standard to consult with multiple doctors before settling on ‘the one,’ it is best to not reveal the names of the other doctors you are considering. Similarly, do not share the proposals you receive from one provider with another, for it may influence what they recommend for you.

## **Questions to Ask During a Cosmetic Surgery Consultation** 
*What should you discuss in the consultation room? From reviewing before-and-after photos to learning about the pre-op and post-op care, below is a guide to the most important questions to ask during a cosmetic surgery consultation to ensure you feel empowered to make the best decision.*

### **Aesthetic & Expertise** 
**1. What procedure(s) do you recommend for me?** 
You may have your heart set on a certain procedure or treatment, but you should plan to have a conversation with your doctor during your consultation about what he or she sees as the best course of action for you and your concerns. The decision is ultimately up to you, but the plastic surgeon will be able to take a more holistic look at the situation and potentially offer [a series of options](https://aedit.com/aedition/plastic-surgery-results-are-about-proportion-not-perfection) that you are a good candidate for.

**2. How often do you perform this procedure?**
While there are exceptions, it would make sense that the more frequently a provider performs a treatment or procedure, the more time they’ve had to refine their technique and specialize in it. Asking how often they perform the procedure they are recommending or the one you are interested in will help give you a better sense of their expertise.

**3. Are there before and after photos available?**
You’ll be hard pressed to find a plastic surgeon who doesn’t readily offer a look at their previous work in the form of before-and-after photos, but don’t be shy in asking for them. In addition to seeing how the results turned out for different types of patients, you’ll also get a better sense of the doctor’s aesthetic. 

**4. Would you be willing to put me in touch with previous patients?**
If the provider you’re consulting with didn’t come recommended from a friend or colleague, asking to speak with an existing patient (preferably one who underwent the same procedure you are interested in) can be a good way to learn more about the doctor, practice, and overall experience.

### **Cost & Pre-Op Care**
**5. What is the cost breakdown of this procedure?**
Because most cosmetic procedures are considered elective, they are not typically covered by insurance. They are also not cheap. Prices can vary dramatically from practice to practice, as can the way the cost is presented. To avoid hidden fees or surprises, ask for a comprehensive overview that includes pre-op and post-op care. While it is impossible to foresee complications, getting a sense of any additional expenses that may pop up (from recovery essentials to additional procedures) will allow you to budget accordingly. With that said, certain cases of rhinoplasty, eyelid procedures, and breast surgeries (to name a few) may be fully or partially subsidized by insurance, so be sure to check with your insurance provider before booking.

**6. How many pre-op appointments will be needed?**
If you’re interested in a surgical procedure, you’ve likely already considered the recovery time that may be required. But what about the time involved with pre-op prep? From bloodwork to imaging, there are tests to be run and assets to be secured prior to going under the knife or needle. Get a sense of what the timeline looks like from the day you book your procedure until your last follow-up appointment to ensure you are able to make the commitment.

**7. Is there anything I need to do prior to getting the procedure?**
Whether you need to [lose weight before scheduling a body contouring procedure](https://aedit.com/aedition/why-you-should-lose-weight-before-plastic-surgery) or press pause on your skincare routine in the days leading up to a treatment, you’ll want to have the provider give you a sense of any pre-operative instructions or guidelines. That way, you can consider how they may impact your daily life.

### **Safety** 
**8. Where will this procedure be performed?**
Whether your procedure is being performed in a [hospital or an outpatient surgery center](https://aedit.com/aedition/unexpected-things-to-know-about-the-plastic-surgery-operating-room), you’ll want to ensure the facility is accredited. Both are evaluated for safety by [The Joint Commission](https://www.qualitycheck.org/), though outpatient surgical facilities may also be accredited (voluntarily) by the [Accreditation Association for Ambulatory Health Care (AAAHC)](https://www.aaahc.org/). If you’re undergoing an outpatient procedure, be sure your doctor has hospital privileges to avoid possible risks in case of an emergency.

**9. Does this procedure require anesthesia?**
In addition to learning whether or not your procedure requires [sedation or anesthesia](https://aedit.com/aedition/everything-you-need-to-know-about-anesthesia), you’ll also want to know who will be administering it. Be sure there will be a board certified anesthesiologist or certified registered nurse anesthetist on hand to administer and monitor throughout the procedure. Knowing the type of anesthesia required will also inform whether or not you will need someone to give you a ride home and care for you post-op.

**10. What is the protocol if there are serious complications during the procedure?**
Statistically, even the most qualified doctors performing the most routine procedures can run into complications. One of the reasons it is important to establish that your provider has hospital privileges is in the event there is an emergency during an outpatient procedure. Confirming what processes are in place to deal with unexpected events in the operating room can provide peace of mind.

### **Recovery & Results**
**11. What is the downtime associated with this procedure?**
While there are plenty of minimally invasive procedures that you can schedule during your lunch break, most surgical procedures will require at least a couple days of recuperation. Ask the doctor to break down the recovery period, including how long it will be before you can resume certain levels of activity (from returning to work to exercising) and the side effects (think: pain, swelling, and bruising) you can expect to experience during each phase.

**12. Will I receive written post-op instructions?**
Sure, you may be able to wing the assembly of your IKEA furniture, but recovering from a cosmetic procedure that you just invested a lot of money in is not something you want to do blindly. Most doctors will have written post-operative instructions available for patients that detail everything from pain med and icing schedules to when you can resume basic day-to-day activities (think: showering, laying down, etc.). As simple as it may seem, you want to be sure that you will have something to refer back to when it comes time to navigate the recovery process.

**13. Is there a medical professional on call to answer post-op questions?**
No matter how much research you do beforehand and how thorough the written post-op instructions may be, you can pretty much guarantee that a question (or many!) will arise during the recovery process and require immediate assistance. In addition to good ol’ fashion phone calls, many practices now offer live chats on their websites that allow patients to speak with doctors, physician assistants, and/or nurses in real time. Check with the provider to see what types of services would be available to you.

**14. How many follow-up appointments will be necessary?**
While the exact number of post-op appointments varies by procedure, at least one follow-up is usually needed within the first week. That may be the only check-in needed for, say, an injectable treatment, but surgical patients can expect to meet with their cosmetic surgeon several times in the months following their procedure. Like pre-op care, it is important to have a sense of the timeline prior to booking.

**15. How long will it be before I see results?**
Any doctor will tell you that the healing process, like the procedure itself, depends on the patient, but there are general timelines that can shed some light on when you will start seeing the effects of the procedure and when you can expect a final result. While the results of some procedures are immediate, others can take a year (or more) to fully reveal themselves, so you’ll want to be sure your expectations and patience-level are managed beforehand. 

## **Additional Factors to Consider Before Choosing a Provider**  
*While qualifications and expertise are certainly key components of the decision-making process, there are intangibles related to a provider’s personality, bedside manner, and practice that cannot be underestimated. Even if the provider checks all the boxes above, be sure to also consider the following before choosing who to book your procedure with.*

### **Do you feel comfortable with the doctor?**
The doctor doesn’t need to be your best friend, but he or she should put you at ease. In addition to (hopefully) answering all of your questions, consider how you feel when speaking with the provider. Undergoing any procedure (even an elective one) is a big decision, and you should feel respected and empowered throughout the process.  

### **Are you comfortable with the practice and facilities?**
Did you wait long in the office before seeing the doctor for your consultation? Did the appointment feel rushed? How was the vibe in the waiting area and patient rooms? Taking notice of how you feel about these kinds of details should play a role in how you go about choosing a provider.

### **Is the provider's staff professional and courteous?**
Truth be told, you’ll probably be interacting more with the practice staff than you will with the doctor. From the receptionist to the nurses, pay attention to your interactions with the entire team and notice how they communicate with the provider. All of this will give you insight into what kind of care you can expect before, during, and after your procedure.

## **The Takeaway**
Choosing to undergo a cosmetic surgery procedure is an important decision in and of itself, but finding the right surgeon or doctor for your needs is key to achieving the outcome you desire. Scheduling initial consultations with at least two providers and arriving armed with a list of questions that covers everything from aesthetics and safety to cost and recovery can help you compare and contrast as you narrow down your search.

From reviewing before-and-after photos to learning about the pre-op and post-op care, here is a guide to the most important questions to ask during a cosmetic surgery consultation.

Questions To Ask Your Doctor During A Plastic Surgery Consultation 

15 Questions To Ask Your Doctor During A Plastic Surgery Consultation 

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If you're a regular reader of The AEDITION, you know we always emphasize finding a 'board certified' provider to perform your preferred cosmetic procedure. But what does it mean to be a board certified plastic surgeon or dermatologist? How do doctors go about becoming certified? We're here to shed some light on the board certification process and why it matters.

## **Medical Licensure vs. Board Certification**
First things first, a licensed doctor is not the same as a board certified one. A medical license is required for all doctors who wish to legally practice medicine in the United States, and medical licensure is handled at the state level by state medical boards. Doctors must receive individual licenses in each state they wish to practice in, and they must be renewed periodically.

While the protocol varies from state to state, you can be sure that all licensed physicians (at the minimum) graduated medical school, underwent some level of postgraduate residency training, and passed a comprehensive national licensing exam (either the United States Medical Licensure Examinations [USMLE] for medical doctors or the Comprehensive Osteopathic Medical Licensing Examination for doctors of osteopathic medicine).

Board certification, meanwhile, signifies that the physician has successfully completed a residency in their chosen specialty. In order to become board certified, a doctor must have completed his or her undergraduate education, medical school, one-year internship, a residency in their chosen specialty, and passed the residency board exam.   
  
Unlike a medical license, board certification is not required to practice medicine in the U.S., but it is an important tool in distinguishing whether or not a provider has specialized in a particular area. Additionally, board certification does not last forever. Many medical specialty boards now require recertification every 10 years or so, ensuring doctors keep on top of their skills.

## **Why Board Certification Matters**
Board certification is important for all fields of medicine, but it is particularly necessary in the aesthetic space. While it cannot guarantee the quality of results, it can certainly point you in the direction of qualified doctors for the procedure you are interested in or care you need.

Titles like cosmetic surgeon, plastic surgeon, and cosmetic dermatologist have [seemingly become interchangeable](https://aedit.com/aedition/difference-between-plastic-surgeons-and-cosmetic-surgeons), but the qualifications of such doctors can vary greatly. Because there is very little regulation governing how doctors refer to themselves, understanding your provider's board certification(s) can ensure you are consulting with a doctor or surgeon who is actually trained in plastic and reconstructive surgery, otolaryngology, ophthalmology, or dermatology (i.e. the specialties that most relate to aesthetic medicine).

## **How Doctors Become Board Certified**
The [American Board of Medical Specialties](https://www.abms.org/member-boards/) (ABMS) is comprised of 24 certifying boards that are known as the Member Boards of ABMS. Specialties range from internal medicine to radiology, and while it's pretty straightforward that a pediatrician would be certified by the American Board of Pediatrics or a gynecologist would be certified by the American Board of Obstetrics and Gynecology, gaining certification in aesthetic medicine is less clear.

Sure, there is an American Board of Plastic Surgery (ABPS) and American Board of Dermatology (ABD) that offer subspecialties in hand surgery, dermatopathology, and pediatric dermatology, but there are no member boards for specialities like oculoplastic surgery or cosmetic dentistry. Further complicating matters is the fact that there are board certifying organizations that exist outside of ABMS. While some have standards that are as rigorous as the written and oral examinations Member Boards administer, not all do.

When choosing a provider to perform a cosmetic procedure or cosmetic surgery, look for a specialist in the following categories:

### **Plastic and Reconstructive Surgery**
General plastic and reconstructive surgeons complete three to five years of general surgery training followed by a two to three year cosmetic and reconstructive plastic surgery residency. Plastic and reconstructive surgeons can pursue board certification via the [American Board of Plastic Surgery](https://www.abplasticsurgery.org/), and they may be dual-certified by the [American Board of Surgery](http://www.absurgery.org/) (ABS). While they are board certified to perform cosmetic and reconstructive surgeries on the face and body, their work often focuses on the breasts and body.

### **Facial Plastic and Reconstructive Surgery**
After completing a five-year residency in otolaryngology (a.k.a. ears, nose, and throat), facial plastic and reconstructive surgeons pursue year-long fellowships in cosmetic and reconstructive procedures specifically related to the face and neck (think: rhinoplasties, facelifts, chin and jaw surgeries, etc.). While there is no ABMS Member Board specifically for facial plastic and reconstructive surgery, they should be board certified by the [American Board of Otolaryngology – Head and Neck Surgery](https://www.aboto.org/) (ABOTO). The [American Board of Facial Plastic and Reconstructive Surgery](https://www.abfprs.org/) (ABFPRS) is also an accreditation that many facial plastic surgeons seek.

### **Dermatology**
Medical dermatologists diagnose, treat, and prevent conditions affecting the skin, hair, and nails. While there are subspecialties within the field, all dermatologists board certified by the [American Board of Dermatology](https://www.abderm.org/) undergo non-surgical, cosmetic dermatology training during their residency program. Dermatologic surgeons (i.e. those qualified to perform liposuction, fat transfer, and Mohs surgery, in addition to non-invasive treatments) are often fellows of the [American Society for Dermatologic Surgery](https://www.asds.net/) (ASDS). Asking to see before-and-after photos and inquiring as to how often they perform certain cosmetic treatments and procedures will shed further light on their aesthetic expertise.

### **Oculoplastic Surgery**
While a facial plastic surgeon is able to perform eyelid surgeries (like [blepharoplasty](https://aedit.com/procedure/upper-eyelid-blepharoplasty)), oculoplastic or oculofacial surgeons are experts in procedures that reconstruct the eyelids, tear ducts, and orbital area. They should be board certified by the [American Board of Ophthalmology](https://abop.org/) (ABOP) and have additional fellowship training with the [American Society of Ophthalmic Plastic and Reconstructive Surgery](https://www.asoprs.org/) (ASOPRS).

## **Fellowships & Societies**
Doctors who wish to further specialize in a particular area of medicine may choose to continue their training and education via a fellowship. Fellowship programs are often highly competitive and last one to three years each. Due to the lack of ABMS Member Boards in certain subspecialties, fellowships may be used to denote expertise. An ophthalmologist who wishes to subspecialize in oculoplastic surgery, for instance, would complete a two-year fellowship through the aforementioned ASOPRS.

Society memberships, meanwhile, offer another way (separate from licensing, board certification, and fellowships) for providers to continue their education, in addition to offering mentoring and networking opportunities. Below are some of the academies and societies related to aesthetic medicine, cosmetic surgery, and dermatology:

- [American Academy of Aesthetic Medicine](https://www.aaamed.org/) (AAAM)
- [American Academy of Cosmetic Dentistry](https://aacd.com/) (AACD)
- [American Academy of Cosmetic Surgery](https://www.cosmeticsurgery.org/) (AACS)
- [American Academy of Dermatology](https://www.aad.org/) (AAD)
- [American Academy of Facial Plastic & Reconstructive Surgery](https://www.aafprs.org/) (AAFPRS)
- [American Society of Aesthetic Plastic Surgery](https://www.smartbeautyguide.com/) (ASAPS)
- [American Society of Cosmetic Laser Surgery](https://www.cosmeticsurgery.org/page/SubspecialtyOrganiz) (ASCLS)
- [American Society for Dental Aesthetics](http://www.asdatoday.com/) (ASDA)
- [American Society of Dermatologic Surgery](https://www.asds.net/) (ASDS)
- [American Society of Hair Restoration Surgery](https://www.cosmeticsurgery.org/page/SubspecialtyOrganiz) (ASHRS)
- [American Society of Liposuction Surgery](https://www.cosmeticsurgery.org/page/SubspecialtyOrganiz) (ASLS)
- [American Society of Ophthalmic Plastic & Reconstructive Surgery](https://www.asoprs.org/) (ASOPRS)
- [American Society of Plastic Surgeons](https://www.plasticsurgery.org/) (ASPS)

While these affiliations are voluntary, a doctor may display their memberships as an indicator of interest and engagement in their specialty. 

## **The Takeaway**
There is perhaps no more important task in your aesthetic journey than finding the right physician to perform your cosmetic surgery procedure, and understanding the board certification process is a key part of that. While all the certifications, licenses, and credentials in the world cannot guarantee results, knowing that your doctor specializes in the procedure you are interested in is the first step toward ensuring you get the best care for your needs.

If you’re interested in a cosmetic procedure, you’ve likely been told to find a board certified provider. But what does it mean to be a board certified plastic surgeon or dermatologist? The AEDITION breaks it down.

How Plastic Surgeons And Cosmetic Dermatologists Become Board Certified 

What Does Board Certification Really Mean?

shutterstock 202742470 (1)

When preparing for the red carpet season, it takes a village. From the publicists to the stylists, makeup artists, facialists, and, of course, the dermatologists, there’s no such thing as an effortless look – it’s the result of months of effort. While most of us were reveling in the festivities of the holiday season, A-listers were hard at work preparing their bodies and faces for the most publicized events of the year.

Appearing on camera comes with perpetual scrutiny and with screens more high-def than ever, maintaining a clear complexion during the stress of awards season is often a priority for celebs. While we probably won’t find ourselves at the Oscars any time soon, the rules of the red carpet are transferable. Here, The AEDITION breaks down the cosmetic procedures and skin treatments that will have your complexion in tip-top share for any event. 

## **The Areas of Concern Before a Red Carpet Appearance**
Stars, they’re just like us! At least when it comes to skin concerns that is. Still prone to breakouts, age spots, and dry skin – especially with their hectic travel schedules – celebrities need to give their skin some TLC, too. 

New York-based board certified dermatologist [Julie Russak, MD](https://aedit.com/provider/jason-emer-md-722), notes that Hollywood’s elite can succumb to “acne issues, blackhead, pustules, stress and hormonal breakouts, pigmentation and discoloration in the skin, and dry or dehydrated skin.” So, even though celebrities might have access to the best of the best, they can’t escape the natural effects of being, well, human.

As a Hollywood-based board certified dermatologist, [Jason Emer, MD](https://aedit.com/provider/jason-emer-md-722), knows this all too well. “Many of my VIP patients are wanting their skin to look flawless on camera, especially in today’s high-def world,” Dr. Emer explains. “We address hyperpigmentation, discoloration caused by sun damage or age, melasma, and acne scars with a carefully curated combo of treatments.” 

He advises a series of tweakments in the weeks prior to an event. “The treatments that cause small injury to the skin to promote cell turnover and natural anti-aging through the healing process are the treatments that are most effective,” he says. “It’s important to allow for enough downtime to prevent appearing pink, scaly, or dry on the carpet.”

## **Cosmetic Treatments to Get Before a Red Carpet or Big Event**
So, what can really be done in a short period of time that will produce great results without you looking ‘done’? Whether there’s a red carpet in your future or you have a wedding or special occasion on the calendar, these are the minimally invasive treatments dermatologists recommend if you’re looking for a quick skin boost.

### **1. Neurotoxin Injections**
By and large one of the most well-known anti-aging treatments for a youthful look, [Botox® and its competitors](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) work to reduce the appearance of wrinkles by paralyzing the underlying muscles. According to board certified dermatologist [Nikhil Dhingra, MD](https://aedit.com/provider/nikhil-dhingra-md-17376), of Manhattan’s at Spring Street Dermatology, the best timeline for neurotoxin injections is a month prior to your event. “Botox® takes a full two weeks to take on its full form,” he shares. “Any touch-ups needed at that two-week mark take at least one to two weeks to show as well, so aim for a month prior to an event.” Another note: the results are temporary. Injections need to be redone every three to four months.

### **2. Radiofrequency Microneedling** 
Microneedling helps with the production of collagen through the penetration of small needles that into the skin. Pairing it with radiofrequency helps to further stimulate the body’s natural collagen production to create more rejuvenated skin. Favorited for its ability to create firmer skin with a low risk for side effects, Dr. Emer recommends [RF microneedling](https://aedit.com/procedure/microneedling-with-radiofrequency) two to three weeks before the big event for peak results.  

### **3. Chemical Peel**
Performed about three weeks in advance, a mild chemical peel can help treat minor skin discolorations and uneven skin texture. [As we’ve covered before](https://aedit.com/aedition/chemical-peel-vs-laser-treatment-what-is-best-for-your-skin), chemical peels are a skin resurfacing technique that can be done in a range of strengths from superficial to deep. Dr. Dhingra cautions against getting a deep chemical peel too close to the event because of the downtime associated with it penetrating the middle layer of skin. “Chemical peels are fantastic for texture and tone,” Dr. Dhingra shares. “But, with a week of downtime, give yourself ample time so you’re not shedding while facing the flashing bulbs of the media.” While a deep chemical peel has the power to remove moderate lines, freckles, age spots, and scars, a [superficial chemical peel](https://aedit.com/procedure/superficial-chemical-peels) is enough to improve the clarity and brightness of the complexion with much less downtime. The non-abrasive nature of using a mild acid to penetrate the outer layer of the skin makes it a favorite of celebs and those looking for a lunchtime treatment. 

### **4. Hydrafacial**
A [HydraFacial](https://aedit.com/procedure/hydrafacial) is a great last-minute treatment to give you a JLo-level glow. The multi-step process is both hydrating and exfoliating and involves a thorough cleansing, extractions, and serum application. Dr. Dhingra suggests getting it done in the days or weeks leading up to an event because it has a “transient effect” without much risk for irritation. “Getting in a HydraFacial a week before a big event can add glow and brightness when the lights hit,” Dr. Dhingra explains. 

### **5. PRP**
[Platelet-rich plasma (PRP)](https://aedit.com/procedure/microneedling-with-prp) is a blood plasma-based protein solution that is produced using the patient's own blood cells and is often combined with microneedling or as a part of the [Vampire Facial®](https://aedit.com/procedure/vampire-facelift) (a favorite of Kim Kardashian). The regenerative abilities of PRP are often noted by dermatologists because injecting PRP back into a patient's skin helps stimulate collagen production — giving the complexion a firming and brightening effect. For Dr. Russak, a PRP treatment is “ideally done in a series to address a variety of skincare concerns, such as brightness, pore size, superficial fine lines, and uneven tone and texture.” Give it a few weeks to work its magic as your skin begins to increase collagen production. 

### **6. Dermal Filler**
“Micro-augmentations utilizing small amounts of dermal filler such as Radiesse® or Juvederm® to subtly accentuate natural features and contour,” says Dr. Emer, will help maintain a younger appearance without looking as though any work has actually been done. [Dermal filler](https://aedit.com/aedition/everything-you-need-to-know-about-dermal-fillers) is a great option for those who want to give their cheekbones a volumizing boost, reduce the appearance of fine lines, or plump up their lips for a more shapely pout. Juvederm® uses hyaluronic acid that can help with the appearance of crow's feet, smile lines, and worry lines, but, like all filler, it should be done several weeks in advance to let the filler fully settle and to avoid any potential bruising. 

## **Cosmetic Treatments to Avoid Before a Red Carpet or Big Event**
“Deep resurfacing treatments with [erbium](https://aedit.com/procedure/ablative-erbium-laser) or [fraxel](https://aedit.com/procedure/nonablative-fractional-lasers) lasers, [intense pulsed light (IPL)](https://aedit.com/procedure/ipl) for red and brown pigment, [Ultherapy®](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy) ultrasound skin tightening, [threads](https://aedit.com/procedure/thread-lift) for lifting, [Kybella®](https://aedit.com/procedure/kybella) for submental chin fat, and [stronger chemical peels](https://aedit.com/procedure/deep-chemical-peels),” should be avoided in the weeks before a big event, explains Dr. Russak. While these procedures are quite effective, celebrities know that the camera will pick up every little detail and proper recovery time is needed for optimal results. “These are great treatments to have several months before your event,” she says. 

The most important treatments to avoid when getting ready for a high profile event? Anything that could potentially create an unexpected reaction that will have you out for the count. This means no new beauty products or facial treatments that you've never tried before. “You don’t want to end up in a scenario where you’re trying to do something to enhance your appearance that then backfires and draws attention to something you don’t want,” Dr. Dhingra says.

Instead, a well-executed, strategic procedure timeline coupled with a solid skincare routine is key. “The last tip leading up to a big event: don’t rock the boat with your skincare routine,” he advises. “A proper routine takes at least three months to work. Get that going ahead of time and stick to it through the event. You don’t want to risk an allergic reaction, extreme redness, peeling, or puffiness as a result of overzealous at-home product use.”

## **The Takeaway**
Whether you’re strutting down the red carpet at the SAG Awards or gearing up for wedding season, minimally invasive cosmetic procedures like injectables, facials, and chemical peels can give you that enviable Hollywood glow in a flash. Consulting with a board certified dermatologist or plastic surgeon will ensure your skin is ready for the spotlight. 

Preparing for awards season takes a village, especially when it comes to creating a camera-ready complexion. From Botox® to chemical peels, these are the treatments dermatologists recommend to get your skin red carpet – or special event – ready. 

Best Minimally Invasive Cosmetic Treatments For The Red Carpet And Special Events

The Cosmetic Treatments That Will Get You Red Carpet Ready 

shutterstock 373039213 (1)

As a beauty editor, I’ve been writing about the latest and greatest in the skincare and aesthetics space for years. While buzzy ingredients, tricked out lotions and potions, and new-age technologies with miracle claims pop up on the regular, there are a few tried-and-true workhorses that transcend trends. [Daily sunscreen](https://aedit.com/aedition/what-you-need-to-know-about-sunscreen) and [nightly retinol usage](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare) are two such stalwarts (I’ve mastered the former but, admittedly, still haven’t found my groove with the latter), as are neurotoxin injections.

Since Allergan’s Botox® was approved by the U.S. Food and Drug Administration (FDA) for the temporary improvement of moderate to severe glabellar lines (i.e. the frown lines between the eyebrows) in April 2002, it has become the go-to for anyone looking to reduce the appearance  of fine lines and wrinkles caused by facial expressions (think: frowning, squinting, smiling, and the like). 

<PullQuote attributedTo={Lesley Rabach, MD}>
  “Botox reduces the muscle’s ability to contract fully, thereby reducing/removing the wrinkle.”
</PullQuote>

Competitors like Dysport®, Jeuveau®, and Xeomin® have followed suit (get up to speed on the ins and outs of neuromodulators [HERE](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin)) — employing small doses of botulinum toxin type A (BoNT-A) to temporarily paralyze muscles for cosmetic effect. The lack of muscle contraction prevents the face from forming and/or deepening lines and wrinkles. The result? Smoother skin until it wears off.

Personally, I always felt the question wasn’t so much if I would go under the needle but rather when I would choose to do so. Even so, I hadn’t actually tried anything more invasive than a skincare routine nearing double digits in length and an occasional [facial](https://aedit.com/procedure/hydrafacial) or [light chemical peel](https://aedit.com/procedure/superficial-chemical-peels). But, as a soon-to-be 29 year old whose forehead lines were no longer disappearing like they once did, it felt like as good a time as any to give it a try. 

For my first Botox® appointment, I chose double board certified facial plastic surgeon [Lesley Rabach, MD](https://aedit.com/provider/lesley-rabach-md-17912), of LM Medical in Manhattan because I appreciate her less-is-more approach (when she started our conversation with the refrain “cosmetic procedures are a luxury not a necessity,” I knew I was in good hands) and trust her thoroughness (she answered all of my questions, plus ones I hadn’t thought of with the patience of a saint). 

<PullQuote attributedTo={Meg Storm}>
  “As a soon-to-be 29 year old whose forehead lines were no longer disappearing like they once did, it felt like as good a time as any to give Botox a try.”
</PullQuote>

After a consultation, Dr. Rabach injected 20 units of Botox® into my glabellar lines, above my brow bone, and into my upper forehead line. I lost count after the one injection between my brows and two above each brow, but it was no more than 10 or 12 pricks total that, despite making my sensitive eyes water, hardly felt like anything (more on the pain, or lack thereof, below!). Five days later, my results appeared; a few days after that, I went in for my follow up appointment (typical for first timers); and six weeks later, I am happy to report that I love the way it turned out.

Throughout the pre- and post-procedure process, I was most struck by how many friends said they couldn’t wait to hear about my experience because they had thought about getting Botox® — but just didn’t know where to start or what to expect. With their curiosity in mind, I’ve compiled a list of the nine things I believe are most useful to know before going under the needle for the first time:

### **1. There Is No Right or Wrong Time to Start**
While it may seem like people are opting to get Botox® and the like at an earlier age, there is no right or wrong time to begin treatment. As Dr. Rabach told me during my first appointment, no one *needs* Botox® (or any cosmetic procedure for that matter). But, if you are interested and in a position to start early, neurotoxin injections can potentially have a preventative effect.

<PullQuote attributedTo={Lesley Rabach, MD}>
  “We are so lucky to be in a world where we can prevent many aging processes that generations before us couldn’t. Botox is a wonderful tool to use in small amounts to prevent wrinkles from ever starting.” 
</PullQuote>

Needless to say, patients in their twenties and thirties will need less product than someone in their forties or fifties, but everyone will see results. “Patients who already have lines require more units to decrease the movement and often need adjunct procedures like peels, fillers, and microneedling to remove the lines that are etched in,” Dr. Rabach says. “Someone in their twenties may use a fraction of the number of units to maintain ageless skin.” 

### **2. A First-Time Consultation Is Important**
As with any procedure, finding a provider that makes you feel comfortable and, in this case, matches your aesthetic is of the utmost importance. [Booking a consultation](https://aedit.com/aedition/questions-to-ask-your-doctor-during-plastic-surgery-consultation) with a board certified plastic surgeon or dermatologist will help you get a sense of their work and bedside manner — and ensure that whatever you wish to have done is actually right for you. 

“We see new patients first for a consultation, medical history, and physical exam, followed by treatment,” Dr. Rabach explains. “Occasionally, patients want to have a consultation and wait to do the treatment on a later day, but most do both the same day.”

During my consultation, Dr. Rabach asked me where I thought I wanted Botox® as she studied my face. I explained the increasingly omnipresent nature of my forehead lines, and she proceeded to have me raise my eyebrows (my go-to facial expression), furrow my brow, and squint. Doing so allowed her to better understand my facial structure.

“I assess the function of the muscles and see how exactly the different muscle groups contract and pull the skin, so that I know where to place the Botox®,” she shares. “All of the muscles of the glabella (between the eyebrows), forehead, and around the eyes (crow’s feet) attach to the skin, which is why it causes wrinkling when they contract. Botox® reduces the muscle’s ability to contract fully, thereby reducing/removing the wrinkle.”

### **3. You Really Can Get It Done During Your Lunch Break**
Kelly, the patient coordinator at LM Medical, told me that the most common question she hears from patients other than “does it hurt?” is “can I get Botox® during my lunch break?” The short answer is: yes.

My first appointment (which included both a consultation and injections) lasted about an hour, but the majority of the time was spent filling out new-patient paperwork, having ‘before’ photos taken, and consulting with Dr. Rabach. The injections themselves took less than 10 minutes. Post-procedure, I iced my forehead for five minutes to help with any swelling or bruising and then headed back to work. Had I not told my colleagues where I was going, no one would have suspected a thing.

Prior to injecting, Dr. Rabach wiped my forehead down with an alcohol pad, which removed my makeup. She told me I could reapply beauty products (makeup and skincare) immediately, so feel free to bring along a touchup kit.

### **4. Be Mindful of Supplements and Allergies** 
Dr. Rabach says Botox® is “very well tolerated” by a large majority of the population for both cosmetic and therapeutic use, but it should be noted that diseases including Lambert-Eaton Syndrome, Myasthenia Gravis, ALS (Lou Gehrig’s Disease), and a few others are contraindicated. Additionally, allergies and meds should be considered. 

While your daily supplement regime won’t preclude you from getting injected, it may play a role in your recovery. “There are some supplements that potentially thin the blood, thereby making the chance of bruising — it is not very common but can occasionally occur — more likely,” she explains. “For this reason, we specifically ask about supplements. We ask about medications, of course, but have found that patients typically don’t think of supplements as medications. We like to be fully informed of our patient’s individual histories, so that we can set expectations.”

There are no medication contraindications to receiving Botox®, but aspirin and supplements like fish oil, ginseng, garlic, and ginkgo biloba (to name a few) can increase a patient’s chance of bleeding and, therefore, bruising. For the most seamless experience, lay off them before heading in for your appointment.

### **5. Workout *Before* Your Appointment** 
You may or may not be aware that Botox® arrives at your provider’s office in powder form and is mixed with saline and refrigerated prior to injecting. Because of the liquid nature of the combined formula, there is a theoretical risk that the solution could spread or move from the intended location. 

After my 2 p.m. treatment, Dr. Rabach told me not to exercise for the rest of the day and to try to stay upright (read: not lay down or bend over) for three hours — but the directive was provided out of an abundance of caution. “When Botox® is mixed to the company’s recommendations, as is done in my practice, [movement] is a very rare occurrence. However, we are seeing more and more facilities that dilute the Botox® too much,” she says. “This can make it more risky for the patient to lay down or workout. At LM Medical, we recommend not to lay down or workout because we are extra careful, but it really stays where we want it.”

### **6. A Vibrator Might Be Involved**
Yes, *that* kind of vibrator. During my appointment, Dr. Rabach hilariously told me that one of her early mentors gave her the tip to buy them in bulk from Amazon for the best deal... and results. Obviously, *Cosmo* [has thoroughly covered the practice](https://www.cosmopolitan.com/sex-love/a26324168/vibrators-pain-management-botox/), but, in all seriousness, the vibrator serves a very useful purpose.

“We have a lattice of very superficial sensory nerves and anything that touches the skin, they feel,” Dr. Rabach explains. “Using vibration during injection tricks the sensory nerves in the surrounding area to not ‘know’ exactly where the needle is coming and, therefore, makes the discomfort significantly less. Sometimes you can’t feel it at all!”

Dr. Rabach held the vibrator on the side of my forehead, asked me to make facial expressions, and injected into the lines that formed. I didn’t feel a thing, which may be a result of the vibrator or may have something to do with the fact that they quite literally use the tiniest needles on the market for the procedure. While I’ve been told I have a high pain tolerance, I don’t think anyone would tell you the injections feel like anything more than a pinprick.

Because my eyes are naturally watery, they teared up slightly, and there was a bit of blood left over that she quickly wiped away. Immediately following the treatment, there were small, bug bite-like bumps at each injection site. She handed me an ice pack to put on my forehead for five minutes and said the swelling would be gone entirely in 15 to 20 minutes. As promised, by the time I got back to my desk, there was no evidence I had anything done.

For the rest of the day, I felt like I had a very dull headache. My forehead felt a little tender to the touch (similar to how your arm feels after a vaccination) for the first 48 hours or so, but I really only noticed it when I washed my face and rubbed the area. 

### **7. Don’t Expect Results Right Away**
Given our culture is one of instant gratification, it’s important to understand that Botox® results aren’t immediate. In fact, you’ll spend the first three or four days wondering if your doctor even did anything. But, come day five, you’ll be wondering why you didn’t try this sooner. Two weeks post-treatment, you’ll be enjoying the full effect of your injections.

<PullQuote attributedTo={Meg Storm}>
  “Basically, I feel frozen but don’t look it. My makeup wears better without any forehead creasing, and I generally find that I look more refreshed —whether I get enough sleep or not.”
</PullQuote>

I happened to be home with my family for Thanksgiving on day five, and the fact that I got Botox® had all but slipped my mind until my mom asked me if I noticed a change yet. To my delight, I looked in the mirror and saw that the small lines that had started to etch themselves above my brows were softened — almost to the point of invisibility. And, when I raised my eyebrows (yes, they still moved!), my forehead could no longer contract the way it once did. Additionally, I found it difficult to furrow my brow (though, as I mentioned, I am more of a brow raiser than a furrower), which means a temporary farewell to my eleven lines. Basically, I feel frozen but don’t look it. My makeup wears better without any forehead creasing, and I generally find that I look more refreshed (whether I get enough sleep or not!).

### **8. You’ll Need a Follow-Up Appointment** 
As Dr. Rabach explained to me during my initial appointment, not all muscles are created equal. As a result, one side of your face may be stronger than the other, which means that one side may require a bit more treatment than the other — though it will be hard for your provider to know that during your first meeting. 

To ensure your injections are right for your facial structure, he or she will likely have you come about a week later (once the results have started to reveal themselves) to see if a touchup is necessary. I didn’t end up needing another needle, but the quick appointment was a good opportunity to have my ‘after’ photos taken and ask Dr. Rabach additional questions — chiefly, when I should come back for more because, in case you haven’t heard, Botox® isn’t permanent...

### **9. Results Are Temporary**
No matter which neurotoxin you try, the results aren’t immediate and they don’t last forever. Depending on the amount injected and the way your body processes it, most patients will find that injections last three to four months, at which point it would be time for another treatment.

“Botox® degrades over time and needs to be repeated,” Dr. Rabach says. “Individual results vary depending on each person, their metabolism, how many units the person received, as well as other factors. I occasionally hear of it lasting longer than four months, but the industry standard is three to four months for the majority of people. There isn’t much we can do to make it last longer.”

## **The Takeaway**
As you can probably tell, I am very happy with my Botox® results and can see myself getting treatments two or three times a year in the future. With that said, I went into my appointment with a few hesitations and plenty of questions, all of which my doctor was able to talk me through. If you take but one thing from this article, let it be this: [finding the right provider is key](http://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology).

“It is entirely normal to feel nervous about doing something new, especially on your face,” Dr. Rabach says. “You almost definitely will love the results because you will look exactly like yourself, only refreshed! It is important to always go to an experienced, board certified dermatologist or plastic surgeon who has intimate knowledge of the facial muscles, so that you get a phenomenal treatment.” 

After years covering the beauty and aesthetics industries, one editor decided it was time to say ‘so long’ to her forehead lines.

What To Know Before Getting Botox For The First Time

9 Things To Know Before Getting Botox For The First Time

shutterstock 703500976 (1)

It’s an undisputed fact that more men are getting cosmetic procedures. According to the American Society of Plastic Surgeons’ annual report, more than [1.3 million men in the United States went under the knife (or needle) in 2018](https://www.plasticsurgery.org/documents/News/Statistics/2018/plastic-surgery-statistics-full-report-2018.pdf) — a 29 percent increase since the year 2000. And while the majority of these procedures performed on men were minimally invasive, men still made up 13 percent of cosmetic procedures performed in the United States.

It’s not exactly surprising that men are increasingly seeking out the help of plastic surgeons to reach their aesthetic goals. Cosmetic surgery has never been gendered, but the divide can be traced back to our cultural misconceptions of what cosmetic surgery is and who gets it. Thanks to the internet and social media, both men and women have a greater understanding of just what these procedures entail and what they can do. “The conversation is a lot more sophisticated than it used to be,” says board certified plastic surgeon [Jacob Unger, MD](https://aedit.com/provider/jacob-unger-md-2649), of Maxwell Aesthetics in Nashville. He’s noticed an increase in male patients in his own practice in recent years.

Still, men who get cosmetic surgery are looking for different results and typically approach it differently than women. The biggest fear most men have when getting cosmetic surgery is that it is going being obvious that they got it. “They don’t want to look like they’ve had anything done,” says board certified plastic surgeon [Leif Rogers, MD](https://aedit.com/provider/leif-rogers-md-578), in Beverly Hills. They also want different results, particularly when it comes to common procedures like liposuction and rhinoplasty. Cosmetic surgery, after all, is not one size fits all, and men want the results to look masculine and blend with their existing features. 

Both Dr. Rogers and Dr. Unger’s patients reflect the current trends that the ASPS reports. “Men want a lot of body contouring, liposuction, and liposculpting,” says Dr. Unger. On the face, eye lifts and nose jobs reign supreme among men. “About a third of the rhinoplasties I do are on men,” notes Dr. Rogers.

The AEDITION asked the experts to break down the most common surgical and non-surgical cosmetic procedures for men, and what they have to say may surprise you.

## __1. Liposuction__
[Liposuction](https://aedit.com/procedure/liposuction) is consistently one of the top cosmetic procedures across the board, according to the ASPS, so it’s not surprising that it lands in the top spot for men as well. But that doesn’t mean that men and women are getting the same type of liposuction or looking for the same results. “Guys don’t want to be thin, they want to be defined,” says Dr. Unger. “They want to get rid of the pudge at their waist, but they also want obliques and the manly contours that make them look stronger.” For men, it’s not just about getting rid of unwanted fat, but augmenting and enhancing muscle. “They want broad shoulders, a narrow waist, and no hips,” agrees Dr. Rogers. 

To meet the desires of the male clients, Dr. Rogers, Dr. Unger, and many surgeons are using body contouring techniques with their liposuction. “I use the term lipo-sculpting or soft-definition liposuction,” says Dr. Unger. “The days of just removing fat and saying ‘job well done’ are over. What it really is now is definition liposuction.” That means not only removing fat, but doing it with the purpose of enhancing or creating muscle contours. 

In Dr. Rogers’ case, it also means sometimes redepositing the fat in other areas to further augment muscles. It’s particularly common, he says, in patients who want liposuction on their chest area. He often “puts some fat under the muscle or into the muscle to build the pectoral back up,” he says. “You actually still have volume, but it just looks like muscle versus fat.”

While there is no way of telling how many men are going to liposculpture or fat grafting for muscle augmentation since the ASPS does not differentiate between those procedures and liposuction, both doctors see in their own practices that it’s becoming the standard in male liposuction.

## __2. Gynecomastia (Male Breast Reduction)__
[Gynecomastia surgery](https://aedit.com/procedure/male-breast-reduction), or male breast reduction, is one of the other most common cosmetic procedures among men year over year. That’s partially because only men get it. Gynecomastia is the medical term for enlarged or feminized breasts in men and the surgical procedure usually involves removing the tissue in combination with liposuction to contour the area. Gynecomastia as a condition is common and affects about half of males at birth and one in four men age 50 to 69, [according to the Mayo Clinic](https://www.mayoclinic.org/diseases-conditions/gynecomastia/symptoms-causes/syc-20351793). 

As Dr. Rogers notes, however, getting a male breast reduction does not necessarily mean you’re getting a textbook gynecomastia procedure. “I have a lot of patients who are asking for liposuction or contour on their chest,” he says. “You could put them into the same category because I’m working on their chest, but they’re not there for gynecomastia specifically.” No matter how you slice it, whether these men are getting true gynecomastia surgery or not, it’s clear that procedures to augment and contour the chest are increasingly popular.

## __3. Blepharoplasty (a.k.a. Eyelid Surgery)__
“Men will come in and say, ‘I look tired and I look old’ but they don’t want a face lift,” says Dr. Rogers. The solution: an [eye lift](https://aedit.com/procedure/blepharoplasty-eyelid-surgery). Most men first notice signs of aging around their eyes and typically complain about eye bags or excess eyelid skin that they feel makes them look older. It’s expected, then, that blepharoplasty is consistently among the most popular procedures for men.

Eye lifts are performed on either the upper or lower lids (often both) and remove excess skin to smooth wrinkles and make the eye area appear smoother and more youthful. They’re popular among male patients, says Dr. Rogers, because they are relatively simple procedures that offer big results with little down time. “It’s a simple surgery,” he says. “The recovery is easy and there is little to no sign that you’ve had anything done.”

Dr. Unger notes that blepharoplasties among men are popular not only because, when performed properly, they aren’t obvious, but also because the results are subtle. “For men, it’s less about trying to be youthful and more about erasing the more obvious signs of aging around the eyes,” he says. 

## __4. Hair Transplant__
“Hair transplants are getting crazy popular,” says board certified plastic surgeon [Ben Paul, MD](https://aedit.com/provider/benjamin-paul-md-392), in New York City, who specializes in hair transplants and other hair-related procedures. [According to the American Hair Loss Association](https://www.americanhairloss.org/men_hair_loss/index.html), about two-thirds of men experience hair loss by the time they are 35 years old. That number climbs to 85 percent by the time they reach 50. The main culprit is androgenic alopecia (commonly referred to as male pattern baldness), and, as the name suggests, it is one of the issues men deal with most.

It’s understandable that hair transplants would be among the most popular cosmetic procedures for men, but one of the reasons that more men are seeking them out these days is that there have been technological advances that allow them to work better and leave less scarring. “In the past, the donor site was approached with a very big punch and many groups of hairs were transplanted together,” says Dr. Paul. That old way of doing it is what we call ‘hair plugs’ — and wasn’t very aesthetically pleasing.

“The average person has roughly 2.3 hairs per follicle,” he says. “Currently we do something called [follicular unit extraction](https://aedit.com/procedure/follicular-unit-extraction-fue) and that technique involves just taking the fundamental unit of hair (the follicle).” Individual donor follicles are taken from the back of the head and then transplanted into another area. “You can take up to half of the hair from the donor site before there is any visual decrease in density,” he says. The procedure has gotten so good, he says, that “we’re able to harvest through really small holes, so the healing is very rapid and the entire procedure is scalpel and suture free.”

While the procedure is time consuming (the average procedure takes six to eight hours), Dr. Paul says “the success rate is high with these techniques because you’re transplanting from your own body and you don’t have to worry that you’re going to reject yourself.” These new techniques are also effective treatments for facial hair and eyebrow hair.

## __5. Rhinoplasty (a.k.a. Nose Job)__
“A third of all the rhinoplasties I do are on men,” says Dr. Rogers, illustrating just how popular nose jobs are among men who get cosmetic surgery. “They’re great because they can completely change the way your face looks in one procedure and can make an enormous difference.”

Men, however, are usually looking for something different than women when it comes to their [rhinoplasty](https://aedit.com/procedure/rhinoplasty-nose-job). “In general men want a more masculine nose,” he says. “They usually want it a little straighter and less of what’s called a super tip break (when there is a little tip above the tip of the nose). They also usually want it a bit bigger.”

That’s because smaller noses tend to read more feminine, says Dr. Unger, as does an “overly-sculpted nose.” He’s noticed that his male rhinoplasty patients don’t want their noses to look too perfect. “They want to retain some flaws: not perfectly straight, not a perfectly refined tip, a little hint of a hub. It looks more natural and more masculine.”

## __6. Dermal Fillers__
Not all men who seek out cosmetic procedures are ready to go under the knife. [Dermal fillers](https://aedit.com/aedition/everything-you-need-to-know-about-dermal-fillers) are more common among men than surgical procedures that could address the same issues. Hyaluronic fillers like Juvederm® and Voluma® are typically used to replenish lost volume in areas like the cheeks, while poly-L-lactic acid (PLLA) and calcium hydroxyapatite (CaHA) fillers like Sculptra® and Radiesse® (respectively) are used because one of the most common places men want filler is along the jawline. 

“Men ask for filler along the jawline more than women,” says Dr. Rogers. “It can help with jowls because when you start getting them, you can make them go away with filler.” For many men, a sharp chin and strong jawline are signs of masculinity and youth, so using filler to keep the skin around the jaw from sagging is a common request.

## __7. Neurotoxin Injections__
Let’s just agree to stop calling it Brotox. [Neurotoxins](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) like Botox®, Dysport®, Jeuveau®, and Xeomin® are by far the most common cosmetic procedure for men. These injectable toxins smooth wrinkles on the forehead, between the eyebrows, and around the eyes, which makes them an easy way for men to combat visible signs of aging. 

Men, however, are not always looking for the same results as women. “Men can get away with some lines,” says Dr. Rogers. “Frankly, sometimes it looks better for them to have some.” His male patients are usually looking to smooth very deep wrinkles, but not completely erase lines altogether. The biggest thing men should consider when getting Botox®, he says, is who is administering it. “A lot of people have a ton of experience treating women, but not necessarily with men,” he warns. “You don’t want to get treated exactly the same way because you may get a frozen look.” Men usually need less neurotoxin to get the results they want.

More than 1.3 million men went under the knife (or needle!) in 2018 — a 29 percent increase since the year 2000 — and The AEDITION asked the experts about the most popular invasive and non-invasive cosmetic procedures. 

Top Surgical And Non-Surgical Cosmetic Procedures For Men

The Top 7 Cosmetic Procedures For Men

shutterstock 737351467

Just as brands like Band-Aid have become synonymous with adhesive bandages, Kleenex with tissues, and Wite-Out with correction fluid, “Botox” has been the colloquial term for botulinum toxin type A (BoNT-A) injections since it was approved by the U.S. Food and Drug Administration (FDA) for the temporary improvement of moderate to severe glabellar lines (i.e. the frown lines between the eyebrows) in April 2002. 

But Allergan’s wrinkle smoother isn’t the only BoNT-A injection in town. There is a quartet of cosmetic neurotoxins on the market — [Botox®](https://aedit.com/procedure/botox-facial), Dysport®, Jeuveau®, and Xeomin® — that each contain the same active ingredient (BoNT-A) and is FDA approved to treat the same aesthetic concerns. 

So, how do you differentiate between the four? The AEDITION is here to help. 

## **How Botulinum Toxin Type A Injections Work**
Before we get into nitpicking the differences between Botox®, Dysport®, Jeuveau®, and Xeomin®, it’s important to understand what they are and how they work. 

For starters, botulinum toxin type A is the primary active ingredient in each product. And, while BoNT is considered one of the strongest and most lethal toxins discovered to date, small doses of the neuromodulator have the ability to temporarily paralyze muscles for cosmetic effect. 

In aesthetic medicine, botulinum toxin is used to reduce the appearance of fine lines and wrinkles caused by [facial](https://aedit.com/procedure/botox-for-dimpled-chin) expressions (think: frowning, squinting, smiling, and the like) by injecting it into the muscles underlying the affected area. In turn, the lack of muscle contraction prevents the face from forming lines and wrinkles.

The result? Smoother skin for three to four months (or until it wears off). 

## **Comparing BoNT-A Injections** 
Now that you know what Botox®, Dysport®, Jeuveau®, and Xeomin® have in common, it’s time to understand what makes them unique — no matter how subtle the distinctions might be. 

“For the average patient, there is no difference between each of the products,” says [Jonathan Cabin, MD](https://aedit.com/provider/jonathan-cabin-md-956), a facial plastic and reconstructive surgeon at the Center for Advanced Facial Plastic Surgery in Beverly Hills. “All of the products last a similar amount of time, and they all provide similar results.” 

Yes, the comparison is, essentially, apples to apples. But, as any Granny Smith apple fan knows, there is a difference between the tart green ones and, say, a McIntosh. The same logic applies to botulinum toxin injections. 

First and foremost, the four injectables are made by different manufacturers, which leads to different costs, potencies, and formulations. While the active ingredient in each product is botulinum toxin type A, some also feature protein blends that may affect the diffusion and efficacy of the injection. Such subtleties are why it is important to find a provider who is well versed in the market. 

“Dosage is slightly different for each of the products and the results they offer are subtly different,” Dr. Cabin, who prefers Botox®, shares. “The most important factor is to find a practitioner who is a very experienced injector and is confident using the product you wish to have injected.” 

<CaptionImg url={https://images.ctfassets.net/zw35sfestf1t/7ecXXAhyuKOYWTIOSX89p5/5131e5d0d1b24a7227c172dce1b456be/B8cYFUQJ__1_.jpg}>
  A before and after comparison of one of Dr. Cabin's Botox® patients
</CaptionImg>

According to the [American Society of Plastic Surgeons](https://www.plasticsurgery.org/cosmetic-procedures/botulinum-toxin/safety), the most common side effects of any botulinum toxin injectable are bruising and pain at the injection site, flu-like symptoms, headache, nausea, redness, and temporary facial drooping. While rare, it is possible that the toxin may spread beyond the treatment area, which could lead to botulism-like symptoms including trouble breathing and swallowing, muscle weakness, and slurred speech. 

If you’re one of the 7.5 million Americans who received a wrinkle-relaxing injection in 2018 or are looking to join the ranks, here’s everything you need to know about the four FDA-approved BoNT injectables on the market.

### **Botox®** 

- **FDA Approval**: The OG was first approved by the FDA as a temporary aesthetic treatment to improve the appearance of frown lines between the eyebrows in April 2002. It has since been cleared to treat forehead lines and crow’s feet, too (in addition to all its "off label" uses). 

- **The Skinny**: Botox®, or onabotulinumtoxinA, is a product of Irish drugmaker Allergan, and it currently holds an estimated 80 percent of the BoNT-A injection market. With a molecular weight of 900 kDa, Allergan formulates botulinum toxin type A with protective proteins that a subset of patients may develop an antibody against over time, lessening the effectiveness of the treatment. The inactive ingredients in Botox® include human albumin (i.e. plasma proteins) and sodium chloride. There is also a therapeutic version of product that can be used to treat medical conditions like migraines, excessive sweating, and eye spasms (to name a few), but, as it relates to aesthetics, the average cost per unit is around $6 to the doctor and the number of units injected will depend on the area being treated. 

- **The Results**: Botox® is effective but not permanent. It takes about three to five days post-treatment for the results to appear (though it can take up to two weeks for the final effect to be visible), and it lasts about three to four months in most patients. The longevity depends on everything from the way a patient’s body metabolizes the product to the area being treated.

### **Dysport®**

- **FDA Approval**: Dysport® was first approved to treat frown lines in April 2009, and, like Botox®, also has therapeutic uses to calm muscle spasticity.

- **The Skinny**: A product of Medicis Pharmaceutical, Dysport® (a.k.a. abobotulinumtoxinA) is slightly less potent than Botox® due to its molecular weight. While both have the same 150 kDa of BoNT-A at their core, the weight of the protective proteins in Dysport® are not uniform like those in Botox®. As a result, Dysport® has a higher rate of diffusion, which makes it ideal for treating larger areas (think: foreheads) — though more product may be needed to achieve results. Nonetheless, the cost is generally comparable to Botox®. Like Botox®, it is formulated with human albumin, and Dysport® also contains lactose and cow’s milk protein — making it unsuitable for patients with milk allergies. 

- **The Results**: While the effects of Dysport® may show up sooner (within 24 hours) than Botox®, some studies have shown that they may not last as long. The shorter lifespan could make it a good choice for patients who are unsure about whether they will like the results of BoNT-A injections. 

### **Jeuveau®** 

- **FDA Approval**: The new kid on the block was approved exclusively for cosmetic use in February 2019. 

- **The Skinny**: You may recall the [splashy launch party](https://www.nytimes.com/2019/05/15/health/evolus-wrinkles-toxin-jeuveau.html) earlier this year that branded Jeuveau® (i.e. prabotulinumtoxinA) as “#NEWTOX.” Maker Evolus is hoping the newbie will prove to be a worthy competitor to Botox®, as they both carry a molecular weight of 900 kDa, are formulated with human albumin and sodium chloride, and offer similar results. But, with a price point 20 to 30 percent less than Botox® and marketing campaigns largely targeted at millennials, it would appear Jeuveau® is seeking to carve out its own patient niche. 

- **The Results**: Clinical data is limited due to the newness of the product, but trials have shown Jeuveau® to have a similar safety and efficacy profile to Botox®. Patients generally begin to see results in three to five days, and they last for three to six months.

### **Xeomin®** 

- **FDA Approval**: Xeomin® was approved by the FDA for the treatment of frown lines in July 2011 (and it has also been medically approved to correct muscle spasticity and, most recently, excessive drooling). 

- **The Skinny**: Merz-made Xeomin® (a.k.a. incobotulinumtoxinA) is unique in that it does not blend BoNT-A with complexing proteins (though inactive ingredients include human albumin and sucrose). As a result, the neurotoxin doesn’t need to be refrigerated and it may be slightly more comfortable to have injected because it is stored at room temperature. Xeomin® generally costs about the same as Botox® and Dysport® — but fewer units may be needed to achieve the desired result. Patients who show signs of resistance to Botox® and Dysport® may find success with Xeomin® due to the purified state of BoNT-A. 

-**The Results**: Results from Xeomin® injections take five to seven days to become visible and last a similar amount of time to Botox®, Dysport®, and Jeuveau®.

## **The Takeaway**
As you can see, each of the four neurotoxins have similar safety and efficacy profiles, but subtle differences do exist that may make one a better option for your particular needs. While nothing can replace a consultation with a board certified dermatologist or plastic surgeon, here are the key takeaways for each botulinum type A injectable.

### **Botox®**
- **Benefits**: Good for treating all areas — especially small ones (think: crow’s feet)
-**Onset**: 3-5 days
- **Results**: 3-4 months
- **Average Units**: 20 for forehead treatment
- **Drawbacks**: Patients may develop antibody resistance over time  

### **Dysport®**
- **Benefits**: Good for last-minute treatments because of faster onset time; ideal for treating larger areas (i.e. the forehead) because of diffusion 
- **Onset**: 24 hours 
- **Results**: 3-4 months
- **Average Units**: 50 for forehead treatment
- **Drawbacks**: Not suitable for small areas or patients with an allergy to lactose or cow's milk protein 

### **Jeuveau®**
- **Benefits**: Cosmetic nature eases government pricing regulations, which may lead to more affordability 
- **Onset**: 3-5 days
- **Results**: 3-4 months
- **Average Units**: 20 for forehead treatment
- **Drawbacks**: Newest to market, so long term safety and efficacy profiles have not been established 

### **Xeomin®**
- **Benefits**: Ideal for patients who have stopped responding to Botox® or Dysport®
- **Onset**: 5-7 days
- **Results**: 3-4 months
- **Average Units**: 20 for forehead treatment
- **Drawbacks**: Longer onset time

Wrinkle-smoothing botulinum toxin type A injections are the most common non-invasive aesthetic procedure in the U.S. And, while they are colloquially called “Botox,” there are actually four different BoNT-A injectables FDA-approved for cosmetic use. 

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