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While we colloquially know the condition as 'man boobs,' the medical term for the swelling of the male breast tissue is gynecomastia. [According to the Mayo Clinic](https://www.mayoclinic.org/diseases-conditions/gynecomastia/symptoms-causes/syc-20351793), at least 25 percent of men ages 50 to 69 are affected by gynecomastia, and gynecomastia surgery (read: [male breast reduction](https://aedit.com/procedure/male-breast-reduction)) is among the most popular cosmetic procedures in the United States. The American Society of Plastic Surgeons' (ASPS) [2018 Plastic Surgery Report](https://www.plasticsurgery.org/documents/News/Statistics/2018/cosmetic-procedures-men-2018.pdf) found that there were nearly 25,000 male breast reduction procedures performed in the U.S. last year — a 22 percent increase since the year 2000.

## __What Is Gynecomastia?__

Gynecomastia is an endocrinology disorder where there is swelling in male breast tissue. The cause of gynecomastia is a hormone imbalance where there is a higher percentage of estrogen than usual. During puberty, boys’ bodies mainly produce testosterone and only a little bit of estrogen, which is the dominant hormone in girls’ sexual growth. When testosterone levels are lower than usual, the ratio between the two sex hormones is unbalanced. The higher estrogen levels can stimulate the male breast tissue to swell up. While gynecomastia does not impact health, it can be a cosmetic concern with emotional ramifications.

## __Causes of Gynecomastia__

Gynecomastia can impact men at different stages of life and is often (though not always) caused by hormones. “At birth, newborn males often have enlarged breasts due to the residual effects of their mother's estrogen," says New York City-based plastic and reconstructive surgeon [Umbareen Mahmood, MD](https://aedit.com/provider/umbareen-mahmood-md-23). "A hormonal imbalance can again occur at puberty or in older men, resulting in a higher estrogen to testosterone ratio."

Boys born with enlarged breast tissue as a result of the estrogen in their mother's placenta will usually see the swelling dissipate after a few weeks. Pubertal gynecomastia, meanwhile, impacts young men during puberty (beginning as early as age 10) and can last for several years (up to age 18). Cases of gynecomastia peak again later in life. As men age, they experience declining levels of testosterone and an increase of fatty tissue, which can lead to senile gynecomastia.

But it's not just hormones. Causes of gynecomastia can include medical conditions like obesity, malnutrition, liver disease, hyperthyroidism, hypogonadism, prostate cancer, and kidney failure. It can also be a side effect of drugs (marijuana or heroin), prescription medications (anabolic steroids, corticosteroids, digoxin and calcium channel blockers, Flagyl, Propecia, Spironolactone, Valium, and Zantac to name a few), and even herbals (e.g. [lavender or tea tree oil](https://www.nih.gov/news-events/news-releases/lavender-tea-tree-oils-may-cause-breast-growth-boys)). "There is not necessarily a distinct difference in appearance based on etiology,” Dr. Mahmood says.

## __How to Diagnose Gynecomastia__

When gynecomastia first starts developing, the breast pain can be startling. The first sign may be a lump of fatty tissue (not unlike male breast cancer), and your doctor can perform a physical examination and tests (e.g. a mammography or blood tests) to rule out the possibility of cancer. As the swelling continues, the lump may feel tender to the touch but the sensitivity usually subsides. While one breast may initially be larger than the other, they tend to even out. 

Dr. Mahmood notes that the word 'gynecomastia' only refers to any enlargement of the male breast, but there are grading systems designed to categorize the various degrees of the condition. Dr. Mahmood personally recommends [the Simon and Rohrich classification models](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3706045/#JR27056-30), which have been condensed below:

- __Grade I__: Minor enlargement without excess skin (< 250g of breast tissue)
- __Grade IIa__: Moderate enlargement without excess skin (250 to 500g of breast tissue)
- __Grade IIb__: Moderate enlargement with minor excess skin (250 to 500g of breast tissue)
- __Grade III__: Severe enlargement (> 500g of breast tissue) with grade I ptosis (read: sagging)
- __Grade IV__: Severe enlargement with grade II or grade III ptosis 

## __Surgical Treatments for Gynecomastia__ 

While gynecomastia doesn’t necessarily cause medical concerns, male breast reduction procedures are on the rise to deal with the aesthetic and psychological impacts of the condition. The two most common (and effective!) procedures include liposuction, excision, or a combination of the two. 

“Patients with mild to moderate gynecomastia, involving breast enlargement with minimal gland hypertrophy and no excess skin, are good candidates for liposuction only,” says Dr. Mahmood. “Many patients also have a small amount of fibrous glandular tissue under the nipple and this part can be treated with direct excision by making a small incision around the areola. Techniques such as [power-assisted liposuction](https://aedit.com/procedure/power-assisted-liposuction) (PAL) or [ultrasound-assisted liposuction](https://aedit.com/procedure/ultrasound-assisted-liposuction) (UAL) are especially helpful when performing liposuction for gynecomastia as they can more effectively remove the fibrous tissue.”

More severe cases may require more invasive techniques. “Severe gynecomastia requires not only liposuction, but also skin excision to address the ptosis and excess skin,” Dr. Mahmood explains. “In many severe cases, the nipple-areola may need to be temporarily removed and replaced as a graft to a more appropriate position on the chest after the sagging skin and tissue has been removed.” 

During the recovery period, patients typically wear bandages and support garments to minimize swelling and support the chest as it heals. Depending on the type of procedure, a tube may temporarily be placed under the skin to drain excess fluid. Patients will experience swelling for several weeks, but most people can resume everyday activities within a few days.

The [ASPS reports](https://www.plasticsurgery.org/cosmetic-procedures/gynecomastia-surgery) the average cost of gynecomastia surgery in 2018 was around $4,000, and it should be noted that most insurance plans do not cover the procedure. 


## __Non-Surgical Treatments for Gynecomastia__ 

While non-invasive treatments for gynecomastia lack the same level of efficacy as their surgical counterparts, a recent study found there to be three classes of medical treatment for gynecomastia — androgens (i.e. testosterone, dihydrotestosterone, and danazol), anti-estrogens (clomiphene citrate and tamoxifen), and aromatase inhibitors (letrozole and anastrozole) — though many patients did not show significant improvement after the treatment.

“Testosterone can be given if patients have an abnormally low level of the hormone and danazol, a synthetic form of testosterone that decreases estrogen production, may be somewhat helpful,” Dr. Mahmood says. “Generally, there is no real medical treatment for gynecomastia.” 

Before turning to prescription medication, a better bet may be to eliminate any lifestyle factors that could be contributing to gynecomastia. “The first step in addressing gynecomastia is treating the underlying cause if it is due to a non-hormonal reason,” Dr. Mahmood explains. “This includes stopping any offending agents like medications or illicit drugs, removing a tumor, and treating underlying systemic disease.”

## __The Takeaway__

Gynecomastia affects a large percentage of the male population over the course of a lifetime, and, while the medical concerns related to the condition are minimal, men with enlarged breast tissue may seek treatment to reduce the size of their chest.

Whether patients opt for liposuction, excision, or a combination of the two, the results of gynecomastia surgery are generally permanent. It is important to note, however, that gynecomastia caused by non-hormonal factors like prescription medications, illicit drugs, or weight gain will require patients to maintain a healthy lifestyle. Consulting with a board certified plastic surgeon will ensure men receive the best course of treatment for their condition.

AEDITION rejuvenators-min

Medical Aesthetics Collection | The AEDITION

Aesthetics

Gynecomastia surgery (a.k.a. male breast reduction) is one of the most popular cosmetic procedures for men in the U.S. Here, a deep dive into the condition colloquially known as 'man boobs' and how to treat it.

Guide To Gynecomastia And Male Breast Reduction Surgery 

Everything You Need To Know About Gynecomastia

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Minimally invasive cosmetic procedures are on the rise. According to the American Society of Plastic Surgeons’ [2018 Plastic Surgery Statistics Report](https://www.plasticsurgery.org/documents/News/Statistics/2018/cosmetic-procedure-trends-2018.pdf), the market grew 163 percent between 2000 and 2018, and the trend is expected to continue tracking upward. 

Among the go-to treatments? Injectables (think: Botox® and filler) and non-invasive fat reduction, which just so happen to be among the best ways to non-surgically lift, firm, plump, and contour the face and neck. Whether you are looking to combat visual signs of aging like volume loss, fine lines and wrinkles, and sagging or are simply looking to further define your facial features, there is an array of non-invasive cosmetic procedures that can reshape the face — sans surgery.

## __Dermal Filler__

Fillers aren’t just for plumping your pout. [Soft tissue fillers](https://aedit.com/aedition/everything-you-need-to-know-about-dermal-fillers) like Juvéderm®, Radiesse®, Restylane®, and Sculptra® can be used to re-shape the entire face. Made of hyaluronic acid, collagen, calcium hydroxylapatite, and poly-L-lactic acid (PLLA) to name a few, filler can be injected into the skin to restore volume, smooth out fine lines and wrinkles, and enhance facial contour.

While it probably comes as no surprise that dermal filler is often employed under the eyes to eliminate bags, in the mid-face region to to sculpt cheekbones or add volume to sagging nasolabial folds, and on the lower face to define the jawline, a board certified dermatologist or plastic surgeon can recommend less obvious uses as well.

“Dermal fillers can be placed on the bone and within the muscle of the chin to augment its shape and projection,” explains board certified dermatologist [Rita Linkner, MD](https://aedit.com/provider/rita-linkner-md-8907), of New York’s Spring Street Dermatology. “The chin is oftentimes forgotten but adds so much to facial structure. A syringe of filler in this delicate area goes such a long way.”

Using filler to augment the chin is a non-surgical solution to refine a facial feature that previously would have required a more invasive cosmetic procedure — like a [facial implant](https://aedit.com/procedure/alloplastic-chin-implant) — to correct. So-called [liquid rhinoplasties](https://aedit.com/procedure/liquid-rhinoplasty) and [chemical brow lifts](https://aedit.com/procedure/chemical-brow-lift) are other common examples of filler being used to mimic the effects of traditional plastic surgery.

One key difference, however, between non-surgical cosmetic procedures and their surgical counterparts is the level of permanence. The results of dermal fillers, while immediate, last an average of six months to two years (depending on the region being treated) compared to the much longer lifespan of surgical procedures. But the downtime associated with filler is minimal, with only about a week (or less) of minor redness, swelling, or bruising.

## __Botulinum Toxin Type A Injections__ 

Easily confused with dermal filler, botulinum toxin type A (BoNT-A) injections (read: Botox® and its competitors) work in an entirely different way. While dermal filler quite literally fills in the hollows of the face to restore volume and fullness, [BoNT-A injectables](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) like Botox®, Dysport®, Jeuveau®, and Xeomin® are FDA approved to reduce the appearance of fine lines and wrinkles caused by repeated facial expressions (think: frowning, squinting, smiling, and the like) by injecting it into the muscles underlying the affected area. But their usefulness goes far beyond smoothing wrinkles.  

BoNT-A injections can be used to complement cosmetic surgery procedures like [blepharoplasty](https://aedit.com/procedure/blepharoplasty-eyelid-surgery) (a.k.a. eyelid surgery) or [brow lifts](https://aedit.com/procedure/brow-lift-forehead-lift-browplasty) and can be strategically injected to refine the face shape or define facial features. Botox® and the like can be used to slim out a round face, lift the corners of the mouth, and even soften the jawline (ideal for teeth grinders or those lacking definition).

“I inject neurotoxin into the masseter muscle to slim the face very commonly,” says Dr. Linkner. “It turns a square shaped face into a more aesthetically pleasing oval. Studies have been done that show the jawbone itself slims on CT scans with toxin use in the masseters. As the muscles exerts less pressure on the bone, the osteoclasts start to reshape the bone itself.”

Like dermal fillers, BoNT-A injections are temporary. Once injected, the results can take up to a week to kick in (patients may experience minor bruising and pain at the injection site) and typically last around three to six months.

## __Kybella®__

Another player in the minimally invasive injectable game? [Kybella®](https://aedit.com/procedure/kybella).

A form of deoxycholic acid (i.e. the naturally occurring molecule that aids in the breakdown and absorption of dietary fat in the body), Kybella® is FDA approved to reduce fat under the chin and thus improve the contour of the neck. Off-label uses include breaking down stubborn fat deposits on the stomach and back and above the knees and elbows.

When deoxycholic acid is injected directly into the submental fat under the chin, the fat-storing adipose tissue is destroyed. Over time, the fat cells are removed from the treated area via the body’s natural metabolic processes.

The best thing about Kybella®? The results are permanent. Dr. Linkner says that the body metabolizes the destroyed adipocytes (fat cells) over the proceeding six to eight weeks. Unlike [liposuction](https://aedit.com/procedure/liposuction), the fat will not redistribute, but most patients will need to multiple sessions (up to six), spaced at least a month apart to see the most optimal results. 

Additionally, there is a bit more downtime associated with Kybella® than, say, Botox® or dermal filler. “Expect a 36-hour period of swelling that truly peaks 12 hours post-procedure,” Dr. Linkner warns. “Bruising is common, so I give all my patients arnica post-Kybella.”

## __PDO Thread Lift__

While nothing can replace the long term lifting and firming benefits of a surgical [facelift](https://aedit.com/procedure/facelift-rhytidectomy), thread lifts are a worthy non-surgical alternative. Ideal for patients looking for facial rejuvenation (especially as it relates to the lower face and jowls), the minimally invasive cosmetic procedure involves the subcutaneous placement of polydioxanone (PDO) sutures to lift sagging tissue. 

Unlike facelifts, which surgically remove excess skin, [thread lift](https://aedit.com/procedure/pdo-thread-lift) techniques focus on repositioning the tissue beneath the surface of the skin. The result? A reshaped face with little to no downtime. In fact, Dr. Linkner says many of her patients can attend social engagements immediately after the procedure, which is performed under local anesthesia.

Like facelifts, however, thread lift results aren't permanent. While most facelifts last a decade or more, thread lifts typically have a one- to two-year lifespan because the sutures dissolve over time, allowing the tissue to move and sag.

## __The Takeaway__

Whether you are looking for a minimally invasive face-shaping procedure to replace or complement plastic surgery, volume-boosting fillers, fat-reducing injectables, and lifting thread lifts all provide face shaping benefits without going under the knife. While the results are not always permanent, cocktailing these cosmetic procedures under the care of a board certified dermatologist or plastic surgeon can produce restorative results with minimal downtime. 

From fillers to thread lifts, a guide to the best minimally invasive cosmetic procedures that can sculpt and contour the face — sans surgery.

How Minimally Invasive Cosmetic Procedures Can Reshape The Face Without Plastic Surgery

How To Reshape Your Face Without Plastic Surgery

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The American Society of Plastic Surgeons (ASPS) reports that there were [more than 1.3 million cosmetic procedures performed on men in 2018](https://www.plasticsurgery.org/news/press-releases/more-men-undergo-plastic-surgery-as-the-daddy-do-over-trend-rises-in-popularity). Aside from [Brotox](https://aedit.com/aedition/the-rise-of-brotox-injections) — ahem, Botox® — and soft tissue filler, laser treatments were among the most popular minimally invasive procedures. The ASPS' [2018 Plastic Surgery Statistics Report found](https://www.plasticsurgery.org/documents/News/Statistics/2018/cosmetic-procedures-men-2018.pdf) that there were about 185,000 laser hair removal procedures performed on men last year, in addition to the nearly 76,000 laser skin resurfacing services and 30,000 laser treatments for leg veins. 

Part of the popularity can undoubtedly be attributed to the breadth of aesthetic concerns lasers can treat and the ease at which they relieve them. While laser treatments can range from relatively superficial to invasive, the most common cosmetic concerns (think: hyperpigmentation, unwanted hair, skin tightening, etc.) can often be addressed over several appointments with very little downtime.

"These treatments are all generally very quick. Depending on the areas treated and amount to be treated, most face treatments are less than 10 minutes," says board certified dermatologist [Elliot Weiss, MD](https://www.laserskinsurgery.com/Dermatologists/Elliot-T-Weiss-MD), of Laser & Skin Surgery Center of New York East in Southampton. Dr. Weiss does note that cocktailing multiple laser procedures together (as many doctors will suggest) could add additional time to the office visit, and patients usually opt to numb their skin with a topical anesthetic for about 30 minutes before the treatment begins. But, if you are simply looking to have a dark spot removed or redness zapped, "typical downtime is minor," he says

From hair and tattoo removal to minimizing the appearance of fine lines and wrinkles, lasers can treat a wide variety of cosmetic concerns for men and women alike — though anatomical differences may impact the types of devices used and treatment plans recommended for male patients.

“The thickness of the skin, especially on the face and neck, is different in men versus women,” says board certified dermatologist [Ron Shelton, MD](https://www.laserskinsurgery.com/Dermatologists/Ronald-Shelton-MD), of Manhattan’s Laser & Skin Surgery of New York. “Energy levels are often adjusted to compensate for this.”

So, what are the most popular cosmetic laser procedures for guys? The AEDITION asks the experts.

## __1. Laser Therapy for Facial Redness and Broken Blood Vessels__  

In the case of patients dealing with redness on the face as a result of skin conditions like rosacea and telangiectasia or broken blood vessels and  spider veins, vascular lasers can improve tone and texture of the complexion. 

"For treating redness and blood vessels, the [pulsed dye laser](https://aedit.com/procedure/pulsed-dye-laser) (VBeam® Laser 595nm) and the Excel® V (long pulse 1064/532nm) are work horses," says Dr. Weiss. "The treated area will usually appear red for about a day and slight puffiness can occur for a few days, particularly when treating the upper cheeks. It typically requires multiple treatments to get the best results."

Dr. Shelton also uses both the VBeam® and Excel® V lasers to treat vascular concerns and says the procedure lasts five to 10 minutes on average, with three to five treatments (performed once a month) providing optimal results. Since the treatments are [non-ablative](https://aedit.com/procedure/nonablative-laser-skin-resurfacing) and do not result in open wounds, he usually recommends covering up any post-op redness or bruising with concealer or tinted sunblock.

## __2. Laser Skin Resurfacing for Acne Scars__

Because the effects of acne can linger long after the pimples heal, laser skin resurfacing can be combined with other cosmetic treatments to improve the appearance of acne scars by smoothing skin texture and boosting collagen production. 

[Fraxel® Dual](https://aedit.com/procedure/nonablative-fractional-lasers), for example, is a non-ablative (read: non-wounding) laser that combines two different wavelengths to address both pigmentation near the skin's surface and deeper tissue damage. Dr. Shelton says patients may experience about a week of downtime with swelling and redness after the 30-minute procedure and multiple sessions are needed for best results. 

Treatments like [Infini®](https://aedit.com/procedure/infini-rf) and Genius®, meanwhile, combine radiofrequency and microneedling over the course of several treatments to improve elastin and collagen production, which, in turn, smooths the skin. Both Fraxel® Dual and [microneedling with RF](https://aedit.com/procedure/microneedling-with-radiofrequency) treatments are safe for patients with darker skin tones. 

For those who prefer a one-and-done approach, the ablative [Fraxel® Repair](https://aedit.com/procedure/fraxel-repair) laser provides total facial rejuvenation by reducing age spots and scars, plumping and softening wrinkles, and improving overall skin health. The initial downtime associated with a Fraxel® Repair treatment is 10 to 12 days, and redness may persist for a month or more as the skin continues to heal. While the recovery period is longer than some of the less invasive options on the market, only one treatment is needed and the results are long lasting.

## __3. Laser Hair Removal__

"Generally speaking, laser treatments are tailored to an individual’s skin type and particular concern, not the gender," Dr. Weiss explains. "However, in instances like hair removal, men may have thicker, coarser hair that requires slightly different treatment parameters and, possibly, a greater number of treatments."

Just as male and female hair follicles are different, so too are the areas of the body they most often treat. Dr. Shelton says back and chest hair removal is "common," and he occasionally sees men who wish to treat pseudofolliculitis barbae (i.e. the razor bumps on the back of the neck) that he says is "exacerbated by wearing collared shirts." 

When it comes to removing facial hair, it is important that the practitioner is well-versed in the potential side effects of the lasers. "Laser hair removal is often adjusted for the thicker whiskers on men than the unwanted hair on women," Dr. Shelton explains. "Certain devices are not used on the bearded skin, if there is a concern of possible long-term hair loss. [Intense pulsed light](https://aedit.com/procedure/ipl-for-unwanted-hair) (IPL) and broadband light (BBL) are avoided on men’s bearded areas."

Considering a patient's skin tone is also important. "For [laser hair removal](https://aedit.com/procedure/laser-hair-removal), the wavelength is usually longer and the pulse duration of the laser pulse is longer for darker skin tones to minimize the risk of post-inflammatory hyperpigmentation," Dr. Shelton says. "It will take more treatments though and possibly be less effective than when laser hair removal is performed on lighter skin color." 

He is a fan of both the Lightsheer® and GentleMax® Pro lasers, which can treat most areas in 30 to 45 minutes. Dr. Shelton says patients can expect about a week of the redness and swelling as the dark stubble flakes off and re-treatment is needed every six to eight weeks for the body and every four to six weeks for the face until full results are realized.

## __4. Laser Skin Resurfacing for Sun Damage and Age Spots__

Whether it's sun spots, age spots, liver spots, or any of the other forms of hyperpigmentation that both men and women experience with age, laser treatments can even skin tone and texture and restore a more youthful appearance.

"Many sun spots can be effectively removed with a single session — provided the patient uses strict sun protection for at least a month after treatment," says Dr. Weiss, who finds the Q-switched ruby and Fraxel® Dual lasers to be among the "most effective on the market" for addressing sun spots and pigmentation.

After a treatment, Dr. Weiss says spots on the face will often look darker for approximately five to seven days before flaking off to reveal clear skin. That process takes about 10 to 14 days for pigment on the neck, two weeks for spots on the arms and hands, and "several weeks" for the legs. And, since even the most vigilant sunscreen wearers are still exposed to some degree of UV rays on a daily basis, he usually recommends annual Fraxel® procedures "to clear up any sun damage, boost the skin's collagen production, and maintain a healthy glow."

## __The Takeaway__

Given the scope of cosmetic concerns laser therapy can treat, it should come as no surprise that multiple devices can be used together to achieve the best results. 

"I frequently combine multiple lasers in a single session," says Dr. Weiss, who likes to pair the Q-switched ruby laser with the Fraxel® Dual to "provide a highly effective treatment for sun damage and pigmentation."  Dr. Shelton, meanwhile, treats patients who have both "unwanted brown spots or acne scars" *and* "facial redness" with a combo of the Fraxel® Dual and VBeam® lasers. 

Regardless of what you are looking to address, consulting a board certified dermatologist or plastic surgeon will ensure you receive the best course of laser treatment(s) for your concerns.

From removing unwanted hair to minimizing fine lines and wrinkles, lasers are one of the go-to minimally invasive cosmetic procedures for men and women alike. So, what are the most popular laser procedures for guys? The AEDITION asked the experts.

Best Cosmetic Laser Procedures For Men 

A Guide To The 4 Best Cosmetic Laser Treatments For Men 

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*When should I start getting Botox? Is it time to incorporate retinol into my skincare routine? What is a “mommy makeover”? How about a “daddy do over”? Do I really need to, as the saying goes, sacrifice my ass for my face? Should I swap my hyaluronic acid fillers for something a bit more permanent?* 

*When it comes to beauty and aesthetics, there is no such thing as one size fits all. But there are some tried and true principles that will keep you looking and feeling your best. In this series, [Coming of Age](https://aedit.com/aedition/category/coming-of-age), The AEDITION answers your most pressing questions about the best treatments, procedures, and practices — from surgery and skincare to health and wellness and everything in between — to consider at any age.*

It was Jane Fonda (now 81) who quipped that her “she bought herself a decade” when she got a facelift, while Sharon Osbourne, 67, has been opening up about going under the knife for her rhytidectomy in August. At 65 years old, Christie Brinkley recently started working with [Ultherapy®](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy) skin tightening, and 53-year-old Robin Wright has professed her love of [Botox®](https://aedit.com/procedure/botox). 

Needless to say, these stars can, first and foremost, credit a healthy lifestyle for their transcendent glow (a balanced diet, regular exercise routine, and daily sunscreen application are *always* musts), but they have also chosen to age on their own terms with the help of rejuvenating professional treatments that can serve both men and women alike. Here, The AEDITION dives into some of the best surgical and non-surgical cosmetic procedures to try after 50.

## __For the Face__

__Facelift__
While there are plenty of minimally invasive procedures that promise to lift and firm, the gold standard of gravity defying treatments will always be the rhytidectomy (a.k.a. [facelift](https://aedit.com/procedure/facelift-rhytidectomy)) thanks to its ability to reduce wrinkles and sagging skin around the face, neck, and jaw. 

Like any cosmetic procedure, the decision of when to get a facelift is a personal one — but there are some general markers to keep in mind. “Patients who were exposed to the sun regularly, who smoke, who have lost a significant amount of weight, who have undergone early menopause, or who have thinner skin (i.e. English or Irish heritage), will often age earlier and wish to have a facelift,” says New York City-based plastic surgeon [Melissa Doft, MD](https://aedit.com/provider/melissa-doft-md-63). “These patients usually visit the office in their early fifties, while patients with thicker skin (e.g. Asian, African Americans) may schedule in their later fifties.”

While facelift results are not permanent (they will be impacted by the aging process), they tend to last at least 10 to 15 years for most patients and, when coupled with less invasive treatments, can persist even longer. 

__Dermal Filler__
If a facelift is too still too invasive, you wish to complement your procedure, or you are simply looking to address a loss of volume, [dermal fillers](https://aedit.com/procedure/dermal-fillersinjectables) — like Juvéderm®, Radiesse®, Restylane®, and Sculptra® — can both smooth and plump the skin.

“Fillers are great for the aging face,” says Dr. Doft. “They are used to restore volume where it is lost with age and to camouflage wrinkles. Adding fillers to the wrinkles changes how light reflects onto the face, and the shadows become less significant.”

While filler temporarily restores lost volume, it cannot correct excessive skin sagging like a facelift. But the inverse is also true. In fact, some patients may experience hollowness in certain areas after a facelift, at which point their surgeon may recommend dermal filler to enhance the surgical results.

Since the hollowing of the face is one of the most common signs of aging, Dr. Doft recommends routine maintenance of soft tissue fillers every six months to a year.

__Dermabrasion__
If skin tone and texture is your concern, [dermabrasion](https://aedit.com/procedure/dermabrasion) (and the less invasive [microdermabrasion](https://aedit.com/procedure/microdermabrasion)) can be performed to brighten and even out the complexion. The deeply exfoliating procedure involves using an abrasive brush or wand to remove the outer layers of the skin.

Many patients liken the post-op sensation to that of a burn, which subsides in a few days. The healing process, however, lasts several months, and sun exposure should be avoided for a minimum of six months. Dr. Doft says she suggests microdermabrasion (which yields a more superficial exfoliation) for people who are looking for less downtime, but dermabrasion is more effective in targeting deep wrinkles.

## __For the Eyes__

__Blepharoplasty__
Another common symptom of aging is drooping and puffiness around the eyes. According to the [American Society of Plastic Surgeons 2018 Statistics Report](https://www.plasticsurgery.org/documents/News/Statistics/2018/plastic-surgery-statistics-report-2018.pdf), the most popular procedure among people over the age of 55 was blepharoplasty (i.e. [eyelid surgery](https://aedit.com/procedure/blepharoplasty-eyelid-surgery)). Yes, that means it was even more requested than a facelift. 

“As you age, the upper lid starts to sag and the lower lid fat becomes more prominent,” Dr. Doft explains. “A blepharoplasty will correct both and make your eyes look brighter and younger. Most patients will have a blepharoplasty alone in their late forties or fifties or in combination with a facelift.”

The procedure (usually performed under local anesthesia) takes about two hours to complete and involves cutting along the natural lines of the eyelids, separating the skin from the underlying tissue, and removing any excess fat and skin. 

“It is a very popular procedure and one which is easily tolerated,” she says. “I will often perform upper lid blepharoplasty under local anaesthesia in the office, but I usually will perform upper and lower eyelid surgery in the operating room.”

While the procedure is typically classified as cosmetic, patients who find that the excess skin interferes with their vision may be able to have their eye lift covered by insurance. After surgery, the eyelids usually heal in about two weeks. The results for the upper eyelid will last about five to seven years, while lower lids last indefinitely. But, as with a facelift, it is important to remember that the eyes will continue to age naturally.

__Brow Lift__
Frequently combined with other procedures (like a facelift), a [brow or forehead lift](https://aedit.com/procedure/brow-lift-forehead-lift-browplasty) can reduce the appearance of fine lines and wrinkles and address sagging skin. There are two types of brow lifts: classic and endoscopic. “The classic brow lift can make a more significant change than the endoscopic option,” says Dr. Doft. “But the endoscopic option leaves smaller scars and will affect hair regrowth less.” 

For both types, there is about two weeks of downtime and it is recommended to keep the head elevated and iced during that time.

## __For the Body__

__Sclerotherapy__
Due to poor circulation, genetics, hormones, skin tone, and more, varicose and spider veins can become more noticeable and troublesome with age. While they are not medically dangerous, they can cause aesthetic concerns and take form anywhere on the body — though the face (for spider veins) and legs (for varicose veins) are most common. 

While there are a few techniques to reduce the appearance of veins, [sclerotherapy](https://aedit.com/procedure/sclerotherapy) has become the go-to treatment. The targeted vein is injected with a fluid called a sclerosing agent, which irritates the vein and causes it to disappear. 

Dr. Doft recommends using sclerotherapy to treat medium and large veins, while laser treatments are the better choice for smaller ones. “It is important to treat the feeding veins that cause these small veins to appear,” she says. “I often recommend that patients consult with a vascular surgeon when they have a significant amount of varicose veins.”

There is minimal downtime from the treatment — though it may take around six weeks to see improvement and several sessions may be required. The upside? The results are permanent.

## __The Takeaway__

Whether you’re looking to take your minimally invasive cosmetic procedure routine to the next level or want to dive into the market for the first time, patients over 50 can consider an array of surgical and non-surgical procedures that lift, firm, and tone the face and body with long-lasting results. 

From facelifts to vein treatments, The AEDITION breaks down some of the best surgical and non-surgical rejuvenation procedures to try after 50.

Plastic Surgery and Cosmetic Procedures To Consider In Your 50s, 60s, 70s

Coming Of Age: The Best Procedures To Consider After 50

cristina-gottardi-u3hZnHpVxGc-unsplash

*When should I start getting Botox? Is it time to incorporate retinol into my skincare routine? What is a “mommy makeover”? How about a “daddy do over”? Do I really need to, as the saying goes, sacrifice my ass for my face? Should I swap my hyaluronic acid fillers for something a bit more permanent?* 

*When it comes to beauty and aesthetics, there is no such thing as one size fits all. But there are some tried and true principles that will keep you looking and feeling your best. In this series, [Coming of Age](https://aedit.com/aedition/category/coming-of-age), The AEDITION answers your most pressing questions about the best treatments, procedures, and practices — from surgery and skincare to health and wellness and everything in between — to consider at any age.*

In case you needed yet another reminder that the forties are the new thirties, Kourtney Kardashian, Rachel McAdams, and Adam Levine are just a few celebrities who turn the big 4-0 this year. 

Needless to say, the decade looks better than ever, and there are a growing number of non-surgical cosmetic procedures that can address visible signs of aging like fine lines and wrinkles, hyperpigmentation, skin laxity, and thinning hair. By taking a proactive approach to skin health and maintenance, patients can delay (or potentially even avoid) more invasive surgical procedures down the line. 

## __For the Face__

__Neurotoxin Injections__
If you didn’t start getting [Botox®, Dysport®, Jeuveau®, or Xeomin®](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) in your twenties and thirties, it is not too late! According to the [American Society of Plastic Surgeons 2018 Statistics Report](https://www.plasticsurgery.org/documents/News/Statistics/2018/plastic-surgery-statistics-full-report-2018.pdf), Botox® (and it’s competitors) is the most popular cosmetic treatment for people in their forties. 

New York City-based board certified dermatologist [Cheryl Karcher, MD](https://aedit.com/provider/cheryl-karcher-md-4323), says that she has plenty of patients who do not start regular Botox® treatments until their forties and fifties, and they do so for a variety of reasons. “Everyone is different,” she says. “Some people are frowners, some people are squinters. Some people have had severe damage to their skin others have taken really good care of their skin and do not have much damage — even in their forties and fifties.”

While the muscle-paralyzing agent is used to help prevent the formation of wrinkles during the twenties and thirties, it can continue to have a smoothing and softening effect by inhibiting the muscle movement that causes lines and wrinkles. The injections take about a week to kick in and touch ups are needed every three to six months for best results. 

__Dermal Fillers__
Because the body’s collagen and elastin production decreases with age, men and women alike may begin to notice sagging, reduced elasticity, and less volume in the face, neck, and body. For women, the hormonal changes that accompany menopause can further impact this process.

In these cases, [soft tissue fillers](https://aedit.com/procedure/dermal-fillersinjectables) can be used on various parts of the body (though they are most commonly used on the face) to plump and smooth unwanted lines and wrinkles. “Patients in their forties start losing a little more volume in the cheek area and they start getting jowls around the chin area,” says Dr. Karcher. “In that age group, I think fillers around the cheek and jawline are hugely transformative.”

Like neurotoxin injections, the results are both fast and effective — but maintenance is needed every six months to two years depending on the type or filler and area being treated. 

__Fractional Laser Treatments__
Uneven skin tone and texture is another complexion concern that increases with age (and the accompanying decrease in cell turnover). “By the time a patient is in their forties — depending on where they’ve grown up and what their lifestyle has been — signs of sun damage are usually present in the face. Brown spots called ‘solar lentigos’ and ‘mottled pigmentation’ are usually present,” says Dr. Karcher. “Also, due to the environment, the skin has lost some of its collagen and elastin and that’s were fine lines show up, a little bit of skin sagging shows up.”

[Laser skin resurfacing](https://aedit.com/procedure/laser-skin-resurfacing) — specifically, targeted fractional lasers, like Fraxel® — has the ability to solve many of these concerns. Whether you opt for an ablative or non-ablative treatment, the energy from the laser targets damage while stimulating collagen production, resulting in a brighter, smoother, *and* tighter complexion.

“Fraxel® helps rejuvenate the skin in a number of ways. It takes care of the mottled pigmentation, gets rid of the brown spots, and it also helps rebuild collagen and elastin,” says Dr. Karcher. “So, depending on how much damage a person has, anywhere from one to three Fraxel® treatments would be recommended.”

While wounding [ablative fractional lasers](https://aedit.com/procedure/ablative-fractional-lasers) have the ability to remove thin layers of skin for stronger results, the treatment comes with a longer downtime than their non-wounding [non-ablative](https://aedit.com/procedure/nonablative-fractional-lasers) counterparts. But it should be noted that non-ablative fractional laser can require anywhere from three to five sessions to see the brightening, toning, and evening effects. 

__Ultrasound Skin Tightening (a.k.a Ultherapy®)__
For tightening and firming without a facelift, [Ultherapy®](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy) is a non-invasive ultrasound-based cosmetic treatment that addresses skin laxity. It works by sending concentrated ultrasound waves deep into the skin and SMAS muscle. Unlike laser skin tightening methods, it targets the inner (not outer) layers of the skin. The ultrasound waves heat up the underlying tissue to activate the body’s healing response, which, in turn, stimulates collagen and elastin production. 

“Patients in their forties have lost collagen and elastin, and there’s a little bit of skin sagging,” Dr. Karcher explains. On the face, Ultherapy® can tighten the jawline, under eyes, and forehead, while lifting the eyebrows. It can also be used to firm the skin of the décolleté and even the stomach. 

While the procedure is more impactful than Botox® and fillers, it doesn’t quite reach facelift proportions. Like most laser treatments, it requires several treatments (spaced three to four weeks apart) and offers a solution for those looking for rejuvenation sans scalpel.  

## __For the Hair and Body__ 

__Body Sculpting__
In case you haven’t picked up on it yet, many of the body’s natural responses and processes start to slow with age. The metabolism is not least among them. Coupled with the decrease in skin elasticity, patients in their forties may opt for surgical and non-surgical body contouring procedures that can remove unwanted fat deposits from most parts of the body (think: love handles, abdomen, buttocks, and thighs). 

There are a number of treatments, at varying degrees of invasiveness, that fall under the ‘body sculpting’ umbrella. Non-surgical procedures like [CoolSculpting®](https://aedit.com/procedure/cool-sculpting), [SculpSure®](https://aedit.com/procedure/sculpsure), and UltraShape®, for example, eliminate excess fat by heating or freezing it. Newer options like [EmSculpt®](https://aedit.com/aedition/why-everyone-is-talking-about-emsculpt), meanwhile, offer toning and strengthening benefits by employing high-intensity, focused electromagnetic technology that mimics the effects of 20,000 crunches over the course of a 30 minute treatment. 

These non-surgical treatments come with minimal downtime (especially when compared to a [tummy tuck](https://aedit.com/procedure/tummy-tuck-abdominoplasty) or [liposuction](https://aedit.com/procedure/liposuction)), but three to four sessions will be needed to see results. While the effects are permanent and fully visible after about four to six months, they require patients to maintain their weight. 

__Hair Growth Treatments__
For men in particular, hair growth can slow in the forties, leading to a receding hairline, hair thinning, and baldness. For patients with severe hair loss, [hair transplant surgery](https://aedit.com/procedure/hair-transplant) is the most effective *and* most invasive solution. While there are several techniques (micro-grafting, slit grafting, punch grafting, etc.), each hair transplant method involves moving hair from another part of the body to the desired area. 

The most effective non-surgical hair loss solution for men and women alike is [platelet-rich plasma (a.k.a. PRP) injections](https://aedit.com/aedition/kourtney-kardashian-prp-injections-to-treat-hair-loss). Similar to a vampire facial on the face, the process involves injecting a PRP solution composed of the patient’s own platelets (usually drawn from the arm) into the scalp and affected areas. The blood acts like fertilizer, promoting stronger and thicker hair growth. Each treatment lasts about a half hour and patients have monthly visits for the first six months before switching to a bi-monthly schedule. 

Over-the-counter topicals and supplements like [Nutrafol®](https://nutrafol.com/) and [Rogaine®](https://www.rogaine.com/) can also yield results — especially when combined with PRP injections and other professional procedures.

## __The Takeaway__

Whether you’re dealing with skin laxity, hyperpigmentation, hair loss, or weight gain, there are an increasing number of minimally invasive cosmetic procedures to tighten, brighten, and rejuvenate the face and body for patients of all ages.

From laser skin resurfacing to surgical and non-surgical hair loss solutions, The AEDITION breaks down the best cosmetic treatments and procedures to try in your forties.

Plastic Surgery and Cosmetic Procedures To Consider In Your 40s

Coming Of Age: The Best Procedures To Consider In Your 40s

yuliya-kosolapova-Zp0VSsp5c5M-unsplash (1)

*Since 1985, October has served as Breast Cancer Awareness (BCA) Month — a period devoted to educating the public on the disease that, [according to the Centers for Disease Control and Prevention (CDC)](https://www.cdc.gov/cancer/breast/statistics/index.htm), is the second most common form of cancer in women, regardless of race or ethnicity. Men can also be diagnosed with breast cancer (albeit at a much lower rate), and The AEDITION is devoting much of its coverage this month to BCA, from expert guides to mastectomies and reconstructive breast surgery to powerful patient perspectives and roundups of products that give back. *

Now that you have a better understanding of the physical and emotional toll of breast reconstruction and the importance of finding the right surgical team (read our overview of how to approach the breast and nipple reconstruction process [HERE](https://aedit.com/aedition/post-mastectomy-breast-reconstruction-process-breast-cancer)), it is time to dive deeper into the surgical options that exist for post-mastectomy patients to reconstruct their breasts and nipples.

Generally speaking, there are two categories of breast reconstruction: implant based and autologous tissue (a.k.a. “flap”) based. In some cases, a combination is used to achieve the most natural and symmetrical results. Similarly, there are two main types of nipple reconstruction. One involves tattooing alone, while the other is a hybrid of reconstruction and tattooing.

“I want all of my patients to understand their options so that they can make the best choice for them,” says Nashville-based plastic surgeon [Jacob Unger, MD](https://aedit.com/provider/jacob-unger-md-2649), who performs hundreds of breast reconstructions a year. “And then my job is to give the best result I can under those constraints.”

Here, a comprehensive guide to the most common types of breast and nipple reconstruction.

## __Reconstruction with Breast Implants__

The most popular form of breast reconstruction, breast implants offer a shorter surgery and recovery time that other reconstructive procedures. Implant reconstruction can either be delayed (performed in the months following mastectomy) or direct (performed in conjunction with the mastectomy surgery), and medical advances — like skin-sparing mastectomies, cohesive gel silicone implants, and internal support technologies like [AlloDerm](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4184054/) and [GalaFLEX mesh](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5070449/) — have allowed surgeons to create increasingly natural-looking results.

Despite the popularity, the technique is not without fault. “The challenge with implant-based reconstruction is that there is no natural soft tissue of the breast to help camouflage and contour an implant or to help rearrange tissue and nipple position in the same way that you can when there’s native breast tissue,” says Dr. Unger.

With that in mind, it is important to understand the different facets of implant-based reconstruction.

### __Pre-Pectoral Implant Placement__

While breast implants (both reconstructive and cosmetic) have historically been placed under the pectoral muscle to help achieve a more natural look, the trend is now toward pre-pectoral (read: over-the-muscle) placement. 

“Pre-pectoral implants allow for an easier recovery with less pain and discomfort,” says UCLA plastic surgeon [Jason Roostaeian, MD](https://aedit.com/provider/jason-roostaeian-md-449). Another perk? The lack of animation deformity. “When you have an implant under the pec muscle and you flex it, and it makes things look a little off,” he shares.

![JacobUnger (1)](//images.ctfassets.net/zw35sfestf1t/4kGyMFWGZDViCo4RyAozgb/7b738a9b9c468daccac9743810d02f07/JacobUnger__1_.jpg)
*A before and after of Dr. Unger's pre-pectoral breast reconstruction following a nipple-sparing mastectomy.*

Ideal candidates for pre-pectoral placement are those with younger, thicker skin, which better camouflages the implant directly below. Technique is also important. “Wrapping the implant in dermal matrix (sterilized cadaver skin) allows you to contain the implant well and gives it an extra layer of coverage,” Dr. Roostaeian notes. “But the most important technique we use to disguise the implant is fat grafting.”

Rather than using an implant alone, plastic surgeons will often recommend a hybrid procedure that involves harvesting fat from a donor site (think: the belly, flanks, or inner thighs) to be injected around the breast implant. The result? Smoother and more natural looking breasts.

“Fat grafting has changed the way I do breast reconstruction,” says Beverly Hills-based plastic surgeon [Lief Rogers, MD](https://aedit.com/provider/leif-rogers-md-578). “It can improve the outcome of any breast reconstruction, creating a more natural appearance and giving me the ability to fine tune my results in a way not previously possible.”

Additionally, Dr. Rogers has been having success with a new liposuction-alternative called [Renuva](https://www.mtfbiologics.org/our-products/detail/renuva). “Renuva is a biological allograft product that stimulates your body to grow its own fat cells,” he says. “This would be an ideal product for small contour irregularities after breast reconstruction as opposed to using a patient’s own fat.” 

### __Delayed Reconstruction Using Implants__

Depending upon a patient’s individual anatomy and treatment plan, he or she may choose not to combine their mastectomy and reconstruction procedures. Similarly, surgeons may recommend delaying the placement of permanent breast implants until a later date for better results. 

In such cases, tissue expanders are sutured into the breast pocket immediately following the mastectomy. In the weeks and months following the surgery, the expanders are gradually inflated in a plastic surgeon’s office using air or saline. “A tissue expander preserves the space where the breast needs to be,” says Dr. Unger. And, since placing a heavy silicone implant into an empty breast pocket would compress the fragile blood supply that remains post-mastectomy and lead to tissue death, he notes that the tissue expander “allows the mastectomy flaps to rest without putting undo weight there.”

![dr jason plastic surgery breast reconstruction subpec implant f (2)](//images.ctfassets.net/zw35sfestf1t/QWzB5aIWpQK0olqHTiNQD/617149c0afa434bc6b455775044c2c95/dr_jason_plastic_surgery_breast_reconstruction_subpec_implant_f__2_.jpg)
*A before and after of Dr. Roostaeian's unilateral subpectoral breast and nipple reconstruction.*

Although the expansion process can be uncomfortable, tissue expanders have the additional benefit of giving both plastic surgeons and their patients time to home in on an aesthetic goal. Once the expanders reach the appropriate size, they are exchanged for permanent breast implants. Dr. Roostaeian’s patient Caroline* (diagnosed at 39) admits that the expanders proved to be a necessary evil. “My expanders didn’t look natural, and were sometimes very painful after they were filled,” she recalls. “But they helped me get a really good idea of what size implants would ultimately be best for me.”

After years of monitoring benign tumors and then a cancer diagnosis at age 31, Dr. Unger’s patient Laura says she chose a nipple-sparing double mastectomy because of the quality of reconstruction available today. “I was tired of the breasts I had, but I wasn’t ready to give them up completely,” she confides. “I was really lucky because he was able to place the expanders on top of the muscle, which was a lot easier recovery for me.” 

Laura chronicled her journey on Instagram [@laura_birdwell](https://www.instagram.com/laura_birdwell/?hl=en) and her blog, [tatatocancer.blog](https://tatatocancer.blog/), and, once her expanders were filled, Dr. Unger exchanged them for permanent implants and performed simultaneous fat grafting. Like many reconstruction patients, Laura then had an additional surgery to further refine her results. “I think they look better now than they did before,” she says of her breasts.

### __Direct-to-Implant Reconstruction__

In some cases, women can skip the expander step by having their permanent breast implants placed immediately after their mastectomy. With its promise of only one surgery (which means less anesthesia and recovery time), the direct-to-implant option is understandably appealing — though it’s not for everyone. 

According to Dr. Unger, good candidates are usually women with “smaller, ideally shaped breasts,” who “want to be close to the same size, are very healthy, and have very robust mastectomy flaps” (read: ample blood supply). 

Hayley, diagnosed at age 30, initially had a lumpectomy. “That gave me time,” she says of the procedure. “They got the tumor out, and found out it hadn’t spread.” In her search for a highly skilled surgeon with experience performing pre-pectoral, direct-to-implant reconstruction, Hayley found Dr. Roostaeian after interviewing five or six surgical teams.

During this kind of reconstruction, Dr. Roostaeian uses a new fluorescence imaging technology called SPY to evaluate blood flow right in the OR. “It’s another tool in our arsenal to help ensure the long-term success of the reconstruction,” he says.

Kelly, diagnosed at 45, opted for a unilateral mastectomy and immediate reconstruction with Dr. Rogers. “I had cosmetic implants, and I really liked how I looked before,” she shares. “Whether or not to have reconstruction was never a question in my mind.” 

She was able to undergo a sub-pectoral, direct-to-implant reconstruction, in part because she already had breast implants placed under the muscle. Dr. Rogers also replaced the implant in the non-cancer breast to ensure symmetry, and Kelly ended up having a couple of subsequent surgeries — including fat grafting and nipple reconstruction — for further refinement. Eight years later, she is still very happy with the results. “You can’t even tell the difference,” she says.

While there are plenty of direct to implant success stories, there is also risk. Because of the fragile nature of post-mastectomy skin flaps, many surgeons prefer the two-stage (expander followed by implant) process. “Everybody wants less surgery. Everybody wants to be done and have it behind them,” says [Michael Newman, MD](https://aedit.com/provider/michael-newman-md-795), a plastic surgeon at South Bay Plastic Surgeons in Torrance, CA. “But it’s more important for me to give them a more durable, long-term result.” He prefers using a tissue expander because “it’s very light” and “doesn’t put any pressure on the skin or the mesh,” which “allows the sutures to heal.”

Additionally, the procedure is seldom as ‘one and done’ as it sounds. Patients almost always require additional surgeries to achieve their aesthetic goals. “Direct to implant is a nice concept,” says Dr. Unger, “But the vast majority of the time, you’re going to need to go back to the operating room to touch things up or round things out or add some fat.” 

## __Flap Reconstruction__ 

Autologous tissue reconstruction — more commonly known as “flap surgery” — involves the transfer of tissue from one area of the body (i.e. a donor site) to the chest to create a breast mound. Surgeons can either shift the tissue from one area to another, leaving the primary blood supply of the donor site intact (a.k.a. a pedicle flap) or completely remove the tissue from its original spot and reattach it to the chest in a free flap procedure. 

Free flaps require intricate microsurgery, during which plastic surgeons suture blood vessels together under a microscope to re-establish the blood supply between the donor tissue and the chest. It’s meticulous and time-consuming work (bilateral free flap surgeries can take up to 12 hours to complete), and patients are closely monitored in the hospital for up to five days post-op to ensure the flap is viable. 

The recovery process can be more complex than implant surgery because patients have multiple surgical sites to contend with (the chest and the donor area), though patients report similar pain and discomfort levels with each type of procedure.

### __Types of Flap Reconstruction__

Because of the donor site component, there are a variety of flap procedures for a patient to choose from based on their anatomy and aesthetic goals. The names are based upon the donor sites, including those from the abdomen (TRAM and DIEP), back or shoulder (LAT), inner thigh (TUG), and buttocks (GAP).

![10-16-2019 Editorial Before-After BreastReconstruction](//images.ctfassets.net/zw35sfestf1t/6tVaTrX0SELcdJYzGiEfbF/430d029fe1f2c807e002d916c354e783/10-16-2019_Editorial_Before-After_BreastReconstruction.jpg)
*A before and after of Dr. Newman's bilateral DIEP flap breast and nipple reconstruction.*

Among the plastic surgeons we interviewed, the most popular flap surgeries are the latissimus dorsi (LAT) flap and the deep inferior epigastric perforator artery (DIEP) flap. While a LAT flap is often used in conjunction with a breast implant reconstruction for better results, the DIEP is a free flap procedure that removes abdominal skin and fat only (similar to a tummy tuck) to create a breast mound. 

#### __LAT Flap__
- __Donor Site__: Composed of muscle, skin, and fat from the back
- Type of Flap: A pedicle flap (it remains attached to its primary blood supply)
- __Scarring__: Creates a donor site scar along the back that can usually be concealed in the bra line and an oblong scar around the new breast mound
- __Surgery Time__: 5 to 7 hours, on average 

#### __DIEP Flap__
- __Donor Site__: Composed of skin and fat (no muscle) from the abdomen
- __Type of Flap__: A free flap (it is completely detached from its original blood supply)
- __Scarring__: Creates a donor site scar between the hip bones (similar to a cosmetic tummy tuck) and an oblong scar around the new breast mound
- __Surgery Time__: 8 to 12 hours, on average

### __Advantages of Flap Reconstruction__

While flap procedures are more complicated to perform and require longer surgery times, Dr. Roostaeian says they remain the “gold standard” for breast reconstruction because they create a result that most closely resembles and behaves like a natural breast.

Unlike an implant, the new breast mound feels more like a natural breast because it is created with the patient’s own fat and skin. In the case of unilateral reconstruction, the plastic surgeon will be better able to match the new breast to the unaffected breast. Additionally, breasts created from flap procedures can fluctuate in size and shape as a patient gains or loses weight. 

“Flap surgery is ideal for patients who’ve opted for unilateral reconstruction because that flap changes with your body,” says Dr. Roostaeian, who adds that the results are, long term, much more permanent than implants. “When you choose the implant route, you’re basically signing up for more surgeries in your life because implants tend to have some issues down the road.”

![Flap Reconstruction (1)](//images.ctfassets.net/zw35sfestf1t/35Yvu4Q4Y1iyJmiDjQDUHU/9a54e787069024a30d7755bb2ce90c84/Flap_Reconstruction__1_.jpg)
*A before and after of Dr. Rogers' unilateral flap breast and nipple reconstruction.*

That lack of future revisions led Marjan, one of Dr. Roostaeian’s DIEP flap patients who was 47 at the time of her surgery, to choose the procedure. “I told him that because I was young, I didn’t want to have to go under the knife in my seventies,” she recalls. 

Dr. Rogers’ patient Meredith* didn’t want breast implants because she thought they’d look unnatural and possibly interfere with her active lifestyle. “When Dr. Rogers explained that the DIEP procedure would be a tummy tuck — replacing my breasts with my own tissue — and I wouldn't have implants, I was all in,” she shares. “I knew it would be a long 12- to 13-hour surgery the day of, but I was ready to go for it.”

Though she was initially concerned about scarring and the longer recovery time, Meredith is “beyond satisfied” with her reconstruction. And, with her nipple reconstruction also complete, she says her breasts appear so natural that it looks like she had a [breast lift](https://aedit.com/procedure/breast-lift-mastopexy) and [abdominoplasty](https://aedit.com/procedure/tummy-tuck-abdominoplasty) (i.e. tummy tuck) — not a double mastectomy.

Flap surgery is also an option for women whose implant reconstruction failed due to radiation or persistent capsular contracture issues. Dr. Roostaeian’s patient Caroline originally had bilateral, implant-based reconstruction, but radiation damaged her tissue and caused healing problems. “Dr. Roostaeian told me that the only way to permanently address the situation was to have a DIEP flap,” she says. “It was daunting, and I didn’t think I had enough fat, but he was able to create a small breast and augment it with an implant. It’s so natural that I wish I’d had enough fat to do the other side too.”

## __Nipple Reconstruction__

While skin- and nipple-sparing mastectomies have become commonplace, the patient’s diagnosis may not always allow surgeons to keep the nipples intact. This leaves patients with two reconstruction options: tattooing alone or combination of surgical reconstruction and tattooing. 

In the former, a medical tattoo artist matches the new nipple and areola to the existing one (after unilateral mastectomy) or creates two new nipple/areolar complexes based on the patient’s aesthetic preferences (after bilateral mastectomy). Shading and color variations help create the illusion of depth and projection.

Surgical nipple reconstruction, meanwhile, takes about 45 minutes and can be done either in conjunction with a follow-up reconstructive surgery or alone under local anesthesia. Surgeons use skin from the center of the breast to create a nipple, leaving a small horizontal scar. Patients can then have the areola and nipple tattooed for a more natural looking color and to conceal any visible scarring.

## __The Takeaway__

Just as no two breast cancer diagnoses are the same, the reconstruction process is a deeply personal experience that patients may choose to undergo when it is most comfortable for them. With that said, understanding the options available prior to having a lumpectomy or mastectomy can ensure the patient ends up with the best results for their anatomy and aesthetic goals. Finding the right surgical team and seeking the support of women and men who have been through the experience can help to make sense of the process.  

*Patient names have been changed

From immediate and delayed implant reconstruction to the numerous types of flap surgeries, The AEDITION has compiled an in-depth guide to post-mastectomy breast and nipple reconstruction.

A Comprehensive Guide To Breast Reconstruction And Nipple Reconstruction

A Comprehensive Guide To Breast And Nipple Reconstruction

shutterstock 90148774

*When should I start getting Botox? Is it time to incorporate retinol into my skincare routine? What is a “mommy makeover”? How about a “daddy do over”? Do I really need to, as the saying goes, sacrifice my ass for my face? Should I swap my hyaluronic acid fillers for something a bit more permanent?* 

*When it comes to beauty and aesthetics, there is no such thing as one size fits all. But there are some tried and true principles that will keep you looking and feeling your best. In this series, [Coming of Age](https://aedit.com/aedition/category/coming-of-age), The AEDITION answers your most pressing questions about the best treatments, procedures, and practices — from surgery and skincare to health and wellness and everything in between — to consider at any age.*

Perhaps more than any other decade, the thirties are uniquely broken up into two parts: early and late. Aesthetically speaking, the “early” thirties are most similar to the twenties (check out guide to the decade [HERE](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-20s)) in that the signs of aging are minimal, but visible signs of aging become more apparent on the face as elastin and collagen production slows in the mid- to late-thirties. The result: A newfound loss of skin elacticity. Below the neck, pregnancy, weight changes, and other life events may make procedures like body contouring, breast surgery, and hair removal more pertinent. 

While preventive measures like a good skincare routine, healthy diet, and minimally invasive treatments (i.e. [microneedling](https://aedit.com/procedure/microneedling), [chemical peels](https://aedit.com/procedure/chemical-peels), and [botulinum toxin type A injections](https://aedit.com/procedure/botox)) continue to have value, the thirties may also be the time to consider corrective face and body procedures into your routine. 

## __For the Face__

__Botulinum Toxin Type A Injections__
Neurotoxin injections like Botox®, Dysport®, Jeuveau®, and Xeomin® (read our guide to the muscle-paralyzing quartet [HERE](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin)) can be both preventative and corrective when it comes to the formation and appearance of wrinkles. “They will not only soften any pre-existing wrinkles that they may have but also to prevent ones that will develop over time,” says [Gregory Buford, MD](https://aedit.com/provider/gregory-buford-md-1015), a Denver-based plastic surgeon and founder of Beauty by Buford.

In aesthetic medicine, BoNT-A is used to reduce the appearance of fine lines and wrinkles caused by facial 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. Common treatment areas include the forehead, crow’s feet, and smile and frown lines, and results usually last three to four months. 

__Dermal Filler__
If your concern is less about preventing wrinkles from forming and more about plumping up or filling in ones that have already taken shape, [soft tissue fillers](https://aedit.com/procedure/dermal-fillersinjectables) like Juvéderm®, Radiesse®, Restylane®, and Sculptra® can be injected into the skin to restore volume, smooth out fine lines and deep wrinkles, and enhance the face’s natural contours. 

Made of hyaluronic acid, collagen, calcium hydroxylapatite, and poly-L-lactic acid (PLLA), to name a few, Dr. Buford says filler can be an easy way to mimic natural plumping and shaping in a way that complements the face instead of dominating it. Like BoNT-A injections, the results of filler are temporary and last anywhere from six months to two years. 

## __For the Body__

__Body Contouring__
While [plastic surgery cannot serve as a substitute for weight loss surgery](https://aedit.com/aedition/why-you-should-lose-weight-before-plastic-surgery), there are both surgical and non-surgical ways to lift, firm, and tone the body. Dr. Buford notes that he has seen an increase in men in their thirties seeking body contouring options for the “love handles, abdominal wall, and chest.” In the latter case, he says many of these patients have clinical gynecomastia (a.k.a. enlarged breasts) and a [male breast reduction](https://aedit.com/procedure/male-breast-reduction-gynecomastia-surgery) may be performed.

Another common procedure: [liposuction](https://aedit.com/procedure/liposuction). The tried-and-true fat removal process works by suctioning excess fat from specific areas of the body (think: abdomen, thighs, hips, buttocks, upper arms, chest, and chin). It should be noted that while the fat cells are permanently removed during liposuction, patients can still regain any weight lost during the procedure if they do not stick to a proper diet and exercise. 

[Abdominoplasties](https://aedit.com/procedure/tummy-tuck-abdominoplasty) (read: tummy tucks) are also common for patients in their thirties — either alone or as part of a larger “mommy makeover” (*see below*). A tummy tuck can enhance contouring, reduce fat, and provide a lifted effect. For women who have been pregnant, a tummy tuck can serve as a means to bring the rectus abdominis muscles back together, if they became stretched or separated. Like liposuction, a tummy tuck also requires patients to maintain a healthy lifestyle post-procedure.

If you’re not in the market for surgery, non-invasive procedures like [CoolSculpting](https://aedit.com/procedure/cool-sculpting) and [EmSculpt](https://aedit.com/aedition/why-everyone-is-talking-about-emsculpt) offer toning benefits — sans scalpel. 

CoolSculpting destroys fat cells by freezing targeted fat deposits on the body (think: stomach, hips, thighs, chin, etc.) with an applicator applied to the skin. EmSculpt, meanwhile, improves abdominal muscle tone and strength by employing high-intensity, focused electromagnetic technology to induce 20,000 supramaximal muscle contractions over the course of a 30 minute treatment. Essentially, as you’re lying still, your body is experiencing the effects of 20,000 crunches. In both cases, best results require multiple sessions.

__Breast Procedures__
While men and women alike may choose to undergo a breast procedure in their thirties, women who have children may be particularly interested in a [breast lift](https://aedit.com/procedure/breast-lift), [augmentation](https://aedit.com/procedure/breast-augmentation-augmentation-mammaplasty), or [reduction](https://aedit.com/procedure/breast-reduction-reduction-mammaplasty) after giving birth and breastfeeding (or may wish to revise a previous procedure) because pregnancy can cause large fluctuations in breast volume.

“While we know that pregnancy is definitely going to affect some changes in a woman's body, but to what extent is highly variable,” Dr. Buford says. “Many of our patients comment that the results of their breast enhancement is actually better after having kids, while others see changes from pregnancy to their breast augmentation that require small revisions once the baby weight has come off.” 

At the end of the day, Dr. Buford says choosing a procedure type and timeline is a personal decision that varies from patient to patient. Breast augmentation, for example, enhances size and shape and can restore fullness. A breast lift, meanwhile, will lift the sagging skin and treat drooping, which can often be a result of weight gain, pregnancy, and/or breastfeeding. Alternatively, a breast reduction can reduce the size of the breasts, while [nipple surgery](https://aedit.com/procedure/nipple-correction), which is less common, can adjust the size of the areola and correct inversion. 

__Hair Removal__
While hair removal can be pursued at any age, years of shaving and waxing may lead men and women to consider a more permanent solution in their thirties. Hair removal is a relatively permanent procedure — in other words, once you complete the required sessions, you will never have to shave, pluck, or wax that area ever again — and there are two main types: electrolysis and laser hair removal. 

While electrolysis is the only treatment classified by the U.S. Food and Drug Administration (FDA) as a permanent hair removal solution, patients who opt for [laser hair removal](https://aedit.com/procedure/laser-hair-removal) often experience similarly long-lasting results. Laser treatments work by pulsating highly concentrated light deep into the skin, generating heat that kills the hair follicle and prevents further growth. Treatments are scheduled around the hair growth cycle (read: every four to six weeks), with each session targeting new follicles until most (if not all) of the hair has been destroyed. Six sessions are typically required and minimal maintenance may be needed for the first few years. 

[Electrolysis](https://aedit.com/procedure/electrolysis), meanwhile, disrupts growth by targeting the hair follicle with shortwave radio frequencies through an epilator (i.e. a very fine needle). The device is placed into the natural opening of the hair follicle and emits a small electrical current to destroy the follicle and prevent new growth. It requires patience though. Depending on the area being treated, patients may need up to 30 sessions for full results. 

__Mommy Makeover__
For women who do not plan to have more children, the late thirties can be the ideal time to undergo cosmetic surgery that had been previously postponed. One of the latest buzzwords in medical aesthetics in the so-called “mommy makeover,” which can encompass any number of procedures. While it depends on the judgement of the plastic surgeon and the patient’s needs, mommy makeovers often include some combination of a breast surgery (lift, augmentation, or reduction), tummy tuck, liposuction, and circumferential abdominoplasty (a.k.a. body lift). 

A [mommy makeover](https://aedit.com/aedition/the-mommy-makeover-how-to-bounce-back-after-a-baby) is usually performed all at once and on an out-patient basis, meaning you can recover in the comfort of your own home. Because of the number and invasiveness of the procedures, recovery can take several weeks or months. During that time heavy lifting (including babies!) is forbidden, so women considering a mommy makeover — or any type of surgery — need to ensure they have sufficient help during the recovery process.

Since this is an all-inclusive option, a mommy makeover is not for everyone, but it can be the perfect solution for those looking for total rejuvenation after childbirth. Dr. Buford recommends women wait at least two to three months after they are done breastfeeding to ensure their bodies have recovered and they have had time to lose the weight gained during pregnancy.

## __The Takeaway__

While preventative care (think: [daily sunscreen](https://aedit.com/aedition/what-you-need-to-know-about-sunscreen), a healthy diet, plenty of exercise, and a [good skincare routine](https://aedit.com/aedition/celebrity-aestheticians-share-fall-2019-skincare-ingredients-products)) should continue to play a big role in people’s aesthetic journeys throughout their thirties, the mid to latter part of the decade is an ideal time to consider everything from minimally invasive to invasive face and body procedures. BoNT-A injections and dermal fillers, for instance, can help keep fine lines and wrinkles at bay, while larger procedures like liposuction, breast surgery, and “mommy makeovers” address the body.

From dermal fillers to body contouring procedures for men and women alike, The AEDITION breaks down the best surgical and non-surgical treatments to try in your thirties.

Plastic Surgery and Cosmetic Procedures To Consider In Your 30s

Coming Of Age: The Best Procedures To Consider In Your 30s

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*When should I start getting Botox®? Is it time to incorporate retinol into my skincare routine? What is a “mommy makeover”? How about a “daddy do over”? Do I really need to, as the saying goes, sacrifice my butt for my face? Should I swap my temporary dermal fillers for something a bit more permanent?* 

*When it comes to beauty and aesthetics, there is no such thing as one size fits all. But there are some tried and true principles that will keep you looking and feeling your best. In this series, [Coming of Age](https://aedit.com/aedition/category/coming-of-age), The AEDITION answers your most pressing questions about the best treatments, procedures, and practices — from surgery and skincare to health and wellness and everything in between — to consider at any age.*

Depending on who you talk to, your twenties are either the best of times or the worst of times. But one thing is certain: there is never a better time to start taking care of your skin. Because it is the decade during which your complexion bounces back in a flash and fine lines and wrinkles are far from your mind, taking preventative measures with both professional and at-home treatments can pay dividends later on.

In addition to investing in a sunscreen you won’t mind wearing every single day (it’s a non-negotiable), maintaining a healthy lifestyle, and cultivating good skincare habits (think: *always* washing your face before bed), your twenties are the time to establish a relationship with a board certified dermatologist. Whether you are dealing with hormonal acne (sadly, pimples don’t magically disappear when you exit your teenage years), need a skin cancer screening, or are curious about injectables or other minimally invasive procedures, a professional opinion could go a long way towards long term skin health.

Below is a guide to some of the best cosmetic treatments and procedures to consider and healthy lifestyle habits to keep in your twenties!  

## __Minimally Invasive Treatments__

__Microneedling__
Not to be confused with microdermabrasion, [microneedling](https://aedit.com/procedure/microneedling) is a minimally invasive treatment that improves cell turnover and promotes collagen and elastin production (i.e. the proteins that support the structure of the skin) by using a handheld device covered in fine needles (like a dermaroller) to make small punctures in the skin. 

“We numb patients prior to treatment and use a pen to create micro-injuries in the skin,” says [Richard Brown, MD](https://aedit.com/provider/richard-brown-md-4646), an Arizona-based board certified plastic surgeon. “By doing this, we are mimicking the skin’s natural healing process — allowing for fresh blood supply, cell turnover, and the production of collagen and elastin.”

Microneedling is also great for treating atrophic (a.k.a. depressed) scars, specifically those caused by acne. Severe teenage and adult acne can damage the skin, and, if the body produces too little or too much collagen during the healing process, the skin will scar. The micro-wounds caused by microneedling help trigger the body’s natural healing process, which can lead to the improved appearance of scars.

Dr. Brown likes to alternate microneedling with chemical peels (more on those below!) and recommends sessions every four to six weeks. Perhaps unsurprisingly, the absorption rate of topical skincare products is greatly increased after treatment, though itchiness and redness may linger for a few days.

__Chemical Peels__
Speaking of [chemical peels](https://aedit.com/procedure/chemical-peels), the treatment relies on — you guessed it — chemical exfoliators like alpha- and beta-hydroxy acids, trichloroacetic acid, and carbolic acid to slough off dead skin cells and rejuvenate the skin (think: smoothing fine lines and correcting mild to moderate hyperpigmentation). With both at-home and professional-strength options available, the potency can be tailored to a patient’s skin type and level of sensitivity. 

“Typical facials cleanse the skin and may offer a bit of exfoliation and hydration, however, chemical peels can take off the top few layers of dead skin resulting in a more dramatic change in the skin’s appearance,” says Dr. Brown. “In my experience, facials feel nice for a day or so, but the results of a chemical peel and/or microneedling will have more impact on the skin’s health.”

Consulting with a dermatologist or plastic surgeon will ensure that you get the treatment that is right for you. And while redness and swelling can occur for up to a week after the treatment, Dr. Brown says brighter skin and a more even complexion can “last months” when coupled with “proper at home care and sun protection.”

__Injectables__ 
You’ve likely heard of the idea of “[preventative Botox](https://aedit.com/aedition/can-you-be-too-young-for-botox)” (i.e. using botulinum toxin type A injections to ward off future lines and wrinkles), but will introducing [Botox®, Dysport®, Jeuveau®, or Xeomin®](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) into your skincare regimen in your twenties really have a long term benefit? The short answer is yes.

“The sooner you prevent animation of the muscle, the sooner you prevent the permanent lines over time,” Dr. Brown explains. Botox® and its competitors are approved by the U.S. Food and Drug Administration (FDA) to temporarily reduce the appearance of glabellar lines (a.k.a. frown lines), crow’s feet, and forehead lines (and they have many “off label” anti-aging uses as well). 

When injected into an area of concern, botulinum toxin type A temporarily paralyzes the muscles and, in turn, eases the formation of lines and wrinkles caused by repeated facial expressions (think: frowning, squinting, smiling) that utilize said muscles. Once the fine lines and wrinkles form, they are harder to correct, so starting preventative treatments early could lead to smoother skin down the line. 

Regardless of which brand injectable you choose, results take about a week to kick in and typically last three to six months. Bruising and pain at the injection site are common, and, in rare cases, botulism-like symptoms (trouble breathing and swallowing, muscle weakness, and slurred speech) may occur.

## __Cosmetic and Plastic Surgery__

If you have more invasive procedures on the brain, your twenties may be the time to move ahead with them. With facial features fully developed and the body likely in peak health, patients in their twenties may find that they recover faster and bounce back better after reconstructive or cosmetic surgeries during this decade.

Popular facial plastic surgeries for 20-somethings include [rhinoplasties](https://aedit.com/procedure/rhinoplasty-nose-job) (a.k.a. nose jobs), [lip augmentations](https://aedit.com/procedure/lip-augmentation-and-injections), [otoplasties](https://aedit.com/procedure/otoplasty) (i.e. ear reshaping), and [blepharoplasties](https://aedit.com/procedure/blepharoplasty-eyelid-surgery) (eyelid surgery). 

One thing you may want to skip: breast enhancement (e.g. [breast augmentation](https://aedit.com/procedure/breast-augmentation-augmentation-mammaplasty), [breast lift](https://aedit.com/procedure/breast-lift), or [breast reduction](https://aedit.com/procedure/breast-reduction)).

“I always suggest that patients have breast surgery after having children. The only time I think it is okay to have breast surgery first is if the patient is younger and not planning children for many years ahead,” Dr. Brown says. “In that situation, I think it is okay to have a procedure if you feel that doing so is very important to you in the present moment in life. Just realize you possibly will need revisions after children.”

In general, Dr. Brown advises women to hold off on larger surgical procedures (particularly related to the breasts) until after childbirth because pregnancy can cause weight and volume fluctuations that directly affect the quality of skin. 

## __At-Home Care__

While there are plenty of procedures that’ll keep your complexion in tip-top shape, not every treatment option requires a trip to the doctor’s office. There are plenty of lifestyle factors that will promote skin health. 

It goes without saying that eating a well-balanced diet, drinking plenty of water, limiting alcohol consumption, not smoking, getting enough sleep, and exercising regularly are important practices at any point in life, but it should be noted that not embracing those healthy habits from a young age can lead to premature aging. 

Additionally, there is no better time than the present to adopt a skincare routine. Dr. Brown recommends a four-step regimen that includes a cleanser, moisturizer, sunscreen, and retinol. The latter is a jack of all trades that can treat everything from acne to wrinkles, though it may require a bit of patience to work up a tolerance. When it comes to sunscreen, you should be wearing SPF 30 at a minimum. Finding a broad spectrum formula that will protect against both UVA and UVB rays is also key (for everything you need to know about sunscreen, we’ve got a deepdive on the topic [HERE](https://www.aedit.com/aedition/what-you-need-to-know-about-sunscreen)).

While you can spend as much time in the skincare aisle as you’d like, Dr. Brown says nothing can compare to simply taking care of yourself with a healthy diet and lifestyle. 

## __The Takeaway__

Since the twenties are less about correcting and more about preventing, minimally invasive treatments like microneedling, chemical peels, and neurotoxin injections can offer both immediate and long term benefits. During this decade, facial features have also fully developed, which may mean it is an ideal time to consider reconstructive or cosmetic surgeries. Adopting a proper skincare and sun care routine is also beneficial, but nothing can replace a healthy lifestyle.

From chemical peels and preventative Botox® to daily sunscreen application and a healthy diet, The AEDITION breaks down the best treatments to try and healthy habits to develop in your twenties.

Plastic Surgery and Cosmetic Procedures To Consider In Your 20s

Coming Of Age: The Best Procedures To Consider In Your 20s

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While spring may be known to come in like a lion and go out like a lamb, the fall season offers its own kind of reality check. The lazy days of summer have slipped away, leaving us to deal with the aftermath of too much fun in the sun (think: UV damage, clogged pores, inflammation, and the like). 

But that’s not all. Autumn also serves as the calm before the holiday storm, which makes it the ideal time to take stock of your beauty routine and create a game plan for the busy months ahead.

So, what are the best invasive and non-invasive procedures to consider during sweater season? The AEDITON went straight to the experts for the scoop on how to make the transition from hot summer nights to brisk fall mornings as smooth as a freshly lasered complexion.

## __Is Plastic Surgery Seasonal?__

The short answer is: yes — and no. 

At the end of the day, when and why someone chooses to get a cosmetic procedure is more circumstantial than seasonal. “It’s really more about your lifestyle rather than the season,” says Scottsdale, Arizona-based plastic surgeon [Richard Brown, MD](https://aedit.com/provider/richard-brown-md-4646). “It’s about who you are, what you do, and when you can get time off to recover.” 

Teachers and students, for example, tend to schedule their procedures (especially nose jobs) during the summer months to coincide with school break. Others may use vacation time or plan something between Christmas and New Year’s. But that’s not to say that the time of year shouldn’t be at least taken into account.

Cosmetic surgeries like [breast augmentation](https://aedit.com/procedure/breast-augmentation-augmentation-mammaplasty), [breast reduction](https://aedit.com/procedure/breast-reduction-reduction-mammaplasty), and body contouring tend to be more popular in northern (read: colder) regions during the autumn and winter months because they can be more easily concealed under the seasons’ layers of clothing. Additionally, facial surgeries and skin resurfacing, which require minimal sun exposure afterwards, are best performed when patients can heal indoors. And Dr. Brown says that reconstructive surgeries, like [Mohs for skin cancer](https://aedit.com/aedition/all-about-mohs-surgery-for-skin-cancer) or an [earlobe repair](https://aedit.com/procedure/earlobe-surgery), are often scheduled during the fall and winter months to minimize post-surgery sun. [Correcting UV-related damage](https://aedit.com/aedition/cosmetic-procedures-treatments-to-correct-sun-damage) (think: hyperpigmentation, crepiness, etc.) and scheduling pre-holiday tweakments are also things to consider come fall.

## __The Concern: Reversing Summer Sun Damage__

After several sweaty months of slathering on sunscreen and spending hours outdoors, chances are your face is freaking out. Clogged pores, breakouts, fine lines, and sunspots are often the unwelcome souvenirs of our summer vacations. “When we’re talking about skin damage, the biggest player is the sun,” says Philadelphia plastic surgeon [Jason Bloom, MD](https://aedit.com/provider/jason-bloom-md-2248). “Summer is the time to protect, and fall is the time to repair.” 

When it comes to determining what treatment is right for you, Dr. Bloom notes that the techniques used to repair sun damaged skin are as much dependent on the patient’s available downtime as they are on the state of his or her complexion. 

The general rule of thumb: the more intensive the treatment, the more recovery time required.

Beverly Hills facial plastic surgeon [Jonathan Cabin, MD](https://aedit.com/provider/jonathan-cabin-md-956), for instance, has four different treatment plans for evening out post-summer skin tone and texture that involve everything from makeup to lasers.

- __For a Quick Fix:__ Apply a Full Coverage Foundation 

When in doubt, concealer and foundation are the simplest way to lessen the appearance of sunspots and other forms of hyperpigmentation — and don’t forget that they can be used on the face and body (think: neck, décolleté, shoulders). Dr. Cabin likes products by [Oxygenetix](https://www.oxygenetix.com/) because they offer a breathable, full coverage finish. 

- __For a Short Term Glow:__ Try Microneedling with Platelet-Rich Plasma (PRP)

Also known as a “[vampire facial](https://aedit.com/procedure/microneedling-with-prp),” the minimally invasive procedure helps boost radiance, even out skin tone, and treat wrinkles with minimal downtime (about five to seven days of swelling and/or redness) and both immediate and long term results. In a nutshell, the microneedling process involves creating micro-punctures in the skin with a needle-lined device. Those wounds stimulate collagen production by activating the body’s natural healing process. Massaging the skin with the PRP concentration, meanwhile, further boosts the reparative response. 

The result? A radiant, more even complexion. “PRP microneedling immediately creates swelling, which lends that temporary glow,” explains Dr. Cabin. “It also has a cumulative effect of building more elastin and collagen.” He recommends three treatments over the course of three months for full results and then twice yearly maintenance after that.

- __For Seriously Smoother Skin:__ Opt for a Fractionated CO2 Laser Treatment 

Dr. Cabin says he steers clear of some of the heavily marketed, less aggressive lasers in favor of this tired-and-true resurfacing powerhouse. “If a laser treatment promises very little pain or downtime, chances are it’s just not that effective,” he warns. “[Fractionated CO2 laser](https://aedit.com/procedure/ablative-co2-laser) for skin resurfacing is the gold standard. It very, very aggressively treats the top layer of the skin, stimulating the body to create new layers of cells.” 

Although highly effective for the right candidate, this treatment isn’t advisable for patients with melasma or darker skin tones, as it can exacerbate pigmentation in those cases. Additionally, it’s a lengthy process — requiring weeks of pre-op skincare prep and six weeks or more of recovery.

- __For Long Term Maintenance:__ Invest in a Seasonal Skincare Routine

The best skincare routines are practiced daily and customized seasonally. “If it were up to me, every patient would be on a really high-grade skincare regimen,” says Dr. Cabin. “It’s probably the best thing you can do to prevent and reverse skin damage.” 

If you opted for a milder routine for summer (since ingredients like retinoids can increase sun sensitivity), fall is the time to beef things up. Dr. Cabin recommends a combination of vitamin C for antioxidant and brightening benefits, a prescription hydroquinone to lighten hyperpigmentation, and a vitamin A derivative, like tretinoin, to stimulate collagen production. And don’t forget about sunscreen! Even though you may not be hitting the beach, daily UV exposure is just as damaging and certain treatments and skincare can make the complexion more sensitive.

Dr. Cabin also adds [neuromodulator injections](https://aedit.com/procedure/botox) like Botox®, Dysport®, Jeuveau®, and Xeomin® (check out our guide to botulinum toxin type-A injectables [HERE](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin)) into the mix to keep wrinkles at bay year round. By inhibiting muscle contraction, the toxin both prevents and reverses the formation of fine lines and wrinkles.

## __The Concern: Pre-Holiday Tweakments and Treatments__

Just as summer bodies are made in the winter, holiday-ready complexions are made in the fall — and so are appointments for more invasive procedures. Due to the high holiday season demand, all three surgeons agree that the most critical consideration for fall is planning for the end of the year. “The busiest time is around the holidays because that’s when everyone is trying to get stuff done,” says Dr. Cabin. 

Another consideration? Insurance. Dr. Brown notes that if part or all of your procedure will be covered by insurance, it is important to book as early as possible to ensure that you can secure a surgery slot before the end of the year.

Whether you want to look your best for the holiday party season or you’re planning a cosmetic procedure to coincide with your time off from work, it is important to keep in mind the time commitment involved. “Always ask about what the downtime is,” advises Dr. Cabin. “You have to really consider everything in your schedule so you’re not going to be looking like you’ve had something done when you have to be in the public eye.” 

While your board certified plastic surgeon or dermatologist will walk you through the pre- and post-op timeline and care instructions, we’ve put together a cheat sheet with the approximate time it will take to have you looking your best after some of the season’s most popular invasive and non-invasive surgeries and treatments. Here, a general timeline of when you can expect to be “camera ready” following a procedure: 

__Minimally Invasive Cosmetic Procedures__ 
- [Botulinum Toxin Type-A Injections](https://aedit.com/procedure/botox): Initial results in 3 to 5 days, full results in 2 weeks 
- [Chemical Peel](https://aedit.com/procedure/chemical-peels): Varies by intensity (light peels have a few days of flaking and sensitivity; redness from medium peels can persist for upwards of a month; deep peels require two weeks of total downtime and then two months or more of recovery)
- [Dermal Filler](https://aedit.com/procedure/dermal-fillersinjectables): Swelling and bruising resolve in 5 to 7 days, full results in 2 weeks 
- [Microneedling](https://aedit.com/procedure/microneedling): Redness and swelling subside in about a week, while peak glow kicks in at 2 weeks

__Moderately Invasive Cosmetic Procedures__ 
- [CO2 Laser Skin Resurfacing](https://aedit.com/procedure/ablative-co2-laser): Dr. Cabin puts his patients on a 6-week pre-treatment skincare routine to maximize results, which are usually seen around 6 weeks post-op
- [Laser Hair Removal](https://aedit.com/procedure/hair-removal): Minimum 3 months of no sun exposure on treatment area is recommended, and 3 to 7 sessions (spaced 4 to 6 weeks apart) are usually required for best results 

__Invasive Cosmetic Surgeries__ 
- [Facelift](https://aedit.com/procedure/facelift-rhytidectomy): Many patients are back to work in 2 weeks, but notice true healing after the 6 week mark 
- [Liposuction](https://aedit.com/procedure/liposuction): Full activities can usually resume at 3 weeks post-op, around which time swelling and bruising also resolve 
- [Rhinoplasty](https://aedit.com/procedure/rhinoplasty-nose-job): While you’ll likely be feeling like yourself again after 6 weeks, 3 months is preferable as swelling subsides
- [Tummy Tuck](https://aedit.com/procedure/tummy-tuck-abdominoplasty): You’ll want to leave yourself at least 6 weeks post-op before any major events

While this guide is merely an estimate of the time it will take to have you back hitting the town, remember that busy surgeons book up fast (the three we interviewed are currently scheduling for end of year), so don’t delay if you have a time-sensitive situation. Dr. Bloom also suggests that patients considering plastic surgery procedures this winter schedule their consultations now.

From correcting summer sun damage to preparing for the holiday season, The AEDITION spoke to three board certified plastic surgeons about the best invasive and non-invasive cosmetic procedures to consider for autumn.

Plastic Surgery By Season: Invasive and Non-Invasive Cosmetic Procedures For Fall 

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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), 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 in to 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 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 [Johathan 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.” 

![B8cYFUQJ (1)](//images.ctfassets.net/zw35sfestf1t/7ecXXAhyuKOYWTIOSX89p5/5131e5d0d1b24a7227c172dce1b456be/B8cYFUQJ__1_.jpg)
*A before and after comparison of one of Dr. Cabin's Botox® patients* 

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 metabolises 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 is 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 less 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. 

Comparing Botulinum Toxin Type A Injections: A Guide To Botox, Dysport, Jeuveau, and Xeomin

Comparing Neurotoxins: Botox, Dysport, Jeuveau, and Xeomin

shutterstock 654533584

Labor Day has come and gone, which means the unofficial end of summer is upon us. And whether your warm weather plans included beach days, farmer’s market jaunts, camping trips, or outdoor runs, there is little doubt you’ve soaked up a bit of sun. 

While lathering up with a broad-spectrum sunscreen is a necessary first-line of defense, most people don’t apply enough and/or forget to reapply throughout the day. The result? DNA-altering damage that persists well after the sun goes down.

A [2015 Yale University study](https://news.yale.edu/2015/02/19/sunlight-continues-damage-skin-dark) found that sunlight can continue to affect the skin whether you’re back inside or not. UV rays from the sun or tanning beds can damage the DNA in melanocytes (the cells that make the melanin that gives skin its color), and that danger lingers for hours after exposure. The damage is a major cause of skin cancer (i.e. the most common form of cancer in the U.S.), and it can also cause an overproduction of melanin that leads to dark spots and hyperpigmentation. 

Even more alarming? The visible sun damage that begins to manifest as said dark spots in your thirties and forties may be the byproduct of childhood fun in the sun. “Sun damage occurs very early on, and we know now through research, that you could have had a sunburn as a child and years later it could show up as a melanoma,” says Philadelphia-based plastic surgeon [Jason Bloom, MD](https://aedit.com/provider/jason-bloom-md-2248), who recommends daily sunscreen application and a yearly skin check with a dermatologist as precautions.

During a skin cancer screening, a dermatologist will look for any new spots or changes to existing ones, but you can be vigilant at home, too. “Pay attention to a mole that’s getting bigger, or darker or changing, or itchy, or bleeding,” says Dr. Bloom, for the abnormalities could be warning signs.

While first establishing that hyperpigmentation is benign is paramount, cosmetic concerns related to sunspots may endure. The [2018 Survey on Dermatologic Procedures](https://www.asds.net/skin-experts/news-room/press-releases/asds-members-performed-more-than-125-million-treatments-in-2018) from the American Society for Dermatologic Surgery (ASDS) found that sun damage treatments were up 63 percent in the last two years alone.

[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, says that the visible damage caused by UV rays presents as “areas of hyperpigmentation or sunspots that are typically shades of brown and red.” But that’s not all. Dr. Cabin says that “poor skin quality” in the form of “thin or inelastic skin” and “wrinkling” is also common. 

So, what are the best ways to restore even skin tone and texture? Here, a guide to the best treatments and procedures to improve the appearance of sun damage.

## __In-Office Procedures__ 

### __Chemical Peels__
Used to treat everything from acne to wrinkles, [chemical peels](https://aedit.com/procedure/chemical-peels) work by employing a blend of acids to chemically exfoliate the skin. The entire process is relatively simple and can be customized for more tailored results. 

During the treatment, your provider will determine the solution strength best suited for your skin type and concern. Formulas range from relatively [mild alpha- and beta-hydroxy acid cocktails](https://aedit.com/procedure/superficial-chemical-peels) to deeper [trichloroacetic](https://aedit.com/procedure/tca-peel) and carbolic acids, and patients may experience tingling and/or burning sensations during the treatment. 

While a [strong peel](https://aedit.com/procedure/deep-chemical-peels) may only require one session (but months of downtime), milder versions often call for multiple visits, and professional sessions cost anywhere from $300 to $3,000 depending on the strength. In the days following the peel, dead skin cells will begin to flake off, leaving behind a smoother and brighter complexion. 

While the tried-and-true treatment is great for improving skin tone for patients of all ages, Dr. Bloom is particularly fond of the preventative benefits of peeling. “I encourage my millennial patients to start early on getting glycolic, fruit, and salicylic peels,” says. Dr. Bloom. “It helps maintain a healthy visage and takes off any signs of early sun damage and aging.”

### __Microneedling with Platelet-Rich Plasma (PRP)__
Commonly known as the “vampire facial,” this ever-popular treatment option can correct sun damage — in addition to all its other anti-aging benefits. “With one or more treatments, we can make fine lines and wrinkles fade,” says Dr. Bloom. “The result is glowing, healthy, and even skin.”

A standard [microneedling](https://aedit.com/procedure/microneedling-treatment) session involves a practitioner rolling a handheld device covered in fine needles over the surface of the skin to create micro-punctures. While that process alone stimulates collagen production and improves skin health, the addition of platelet-rich plasma (a.k.a. PRP) only improves the results. 

The two-part [microneedling with PRP](https://aedit.com/procedure/microneedling-with-prp) procedure first involves a medical professional drawing five to 15 milliliters of blood from the patient (Dr. Bloom says the collection is done in the office) that is put into a centrifuge to isolate the platelets that will form the PRP solution. After microneedling the affected area, the practitioner will massage the PRP blend into the skin so that it can penetrate the microwounds created by the dermaroller. 

The treatment lasts about 30 to 45 minutes, and a bit of redness or swelling may persist for a few days. Sessions cost around $750 each.

### __Lasers__
[Laser skin resurfacing](https://aedit.com/procedure/laser-skin-resurfacing) is one of the most effective corrective procedures available, but, since the laser market runs deep, it can be confusing to know where to start. While consulting with a board certified dermatologist or plastic surgeon will ensure that you get the right treatment for your skin type and the severity of your concern, [Sejal Shah, MD](https://smarterskindermatology.com/), of Manhattan’s SmarterSkin Dermatology, says CO2, Fraxel, and picosecond lasers are among the most popular for targeting the “wrinkles, textural changes, and pigmentation” caused by UV damage.

- __CO2 Lasers__: A popular laser for skin resurfacing, [carbon dioxide lasers](https://aedit.com/procedure/ablative-co2-laser) are used to tackle deep wrinkles, age spots, and enlarged pores caused by sun exposure. The latest generation of the technology uses either short pulsed light energy or continuous light beams to remove thin layers of skin with minimal impact to the surrounding tissue. While recovery can take several weeks, the results can last several years. “A single treatment cost $3,500, but I do recommend maintenance with a lighter laser,” says Dr. Shah. 

- __Erbium Lasers__: Safer for darker skin tones than their CO2 counterparts, [erbium lasers](https://aedit.com/procedure/ablative-erbium-laser) can treat superficial to moderately deep lines and wrinkles on the face, hands, neck, and chest. “A non-ablative fractionated 2940nm erbium laser is a powerful device for skin rejuvenation, fine lines, wrinkles, and acne scars,” says [Samer Jaber, MD](https://aedit.com/provider/samer-jaber-md-3882), of Washington Square Dermatology in NYC. Post-procedure downtime usually lasts no longer than a week with minimal swelling and/or bruising possible. 

- __Fraxel Lasers__: With the ability to address everything from hyperpigmentation and wrinkles to acne scars all over the body, the energy from a [Fraxel laser](https://aedit.com/procedure/fraxel-repair) creates microscopic beams of energy that target only a fraction (hence, the name) of skin at a time. “I usually recommend three to five sessions, and then yearly maintenance,” says Dr. Shah. Each treatment costs an average of $1,000 with up to a week of downtime.

- __Picosecond Lasers__: While the laser type is most commonly associated with tattoo removal thanks to its ability to shatter pigment in all skin types, it can also be used to target specific dark spots on the skin. [Picosecond lasers](https://aedit.com/procedure/nonablative-fractional-lasers) release energy in short nanosecond bursts without cooling the skin's surface, so the energy reaches multiples layers of skin. “I usually recommend three to six sessions,” says Dr. Shah, who adds that each can cost about $750. The quick visits last 15 to 20 minutes, and it can take up to a week for the treated brown spots to flake off.

__Ultherapy__
If you are looking for a procedure that can address skin laxity — not just tone and texture — [Ultherapy](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy) is a popular non-invasive option for lifting and tightening loose skin without downtime. “Ultrasound energy heats the deep layers of the skin, creating micro-injuries to the same layer that is lifted during a facelift,” explains Dr. Jaber. “As the skin heals, new collagen is produced creating a lift.”

In addition to providing on firming effect on parts of the face (think: brow and chin) and neck, Ultherapy can also improve the appearance of lines and wrinkles on the décolletage. The procedure takes anywhere from 30 to 90 minutes depending on the treatment area, and starts around $1,000. It can take up to six months for the full effects to become visible, and patients may opt for maintenance treatments every one to two years. 

## __At-Home Care__

Not every sun damage treatment requires a trip to the dermatologist or plastic surgeon. A good skincare regimen not only complements whatever professional procedures you have opted to have done but also helps to prevent future damage. Oh, and it all starts with — you guessed it — [sunscreen](https://aedit.com/aedition/what-you-need-to-know-about-sunscreen). 

“I can’t stress enough how important sunscreen is for everyday use,” says Dr. Bloom, who recommends applying a broad-spectrum formula was SPF 30 or higher to *all* visible skin (think: shoulders, legs, hands, tops of feet) — not just the face. 

And there’s a lot more where that came from. Topical antioxidants in the form of vitamins C and E are known for their brightening effect, in addition to providing a much needed line of defense against free radical damage. A vitamin A derivative like retinol is also great for treating visible signs of aging like hyperpigmentation, lines, and wrinkles, and keeping skin hydrated is also a must. “I encourage the use of topical antioxidants, moisturizers, and retinoids,” says Dr. Shah, to address skin tone and texture. 


With Labor Day in the rearview mirror, it’s time to atone for those summer skin sins. Here, The AEDITION breaks down the best minimally invasive treatments and procedures to improve the appearance of the damage caused by the sun.

The Best Cosmetic Procedures And Treatments To Correct Sun Damage

The Best Cosmetic Procedures To Correct Sun Damage

shutterstock 411405994

While summer is typically the time to enjoy shorts and higher hemlines, not everyone welcomes the opportunity to show some leg. For those dealing with inflamed varicose veins and spider veins, the struggle of slipping into your beach best can be all too real. And it’s not just about veinity — ahem, vanity. The tracks of purple-blue squiggles dotting the gams can be painful, too.

“Leg vein disease impacting blood vessels is a very common condition that affects up to 50 percent of all adults,” says Washington Square Dermatology’s [Samer Jaber, MD](https://aedit.com/provider/samer-jaber-md-3882). Varicose and spider veins form when regular blood flow is interrupted, causing blood to pool in the veins. While it isn’t always easy to control the onset of varicose or spider veins, there are plenty of ways to improve the condition — and it all starts with a proper diagnosis.

## __Varicose Veins vs. Spider Veins__

For starters, varicose veins and spider veins are not the same thing. “They are two very distinct conditions and need to be treated accordingly,” says NYC-based dermatologist [Cheryl Karcher, MD](https://aedit.com/provider/cheryl-karcher-md-4323), who specializes in treating spider veins.

Perhaps the most obvious difference between the two is size. Known for their large diameter (three millimeters or greater) and raised appearance, varicose veins are swollen blood vessels that often twist and turn in a rope-like pattern. Spider veins, on the other hand, are smaller (usually around one millimeter) red, blue, or purple vessels. While both are visible through the surface of the skin, spider veins do not bulge like their varicose counterparts. 

Another distinction? The side effects that accompany them. 

Symptoms of varicose veins include leg cramping and/or heaviness that can often be painful, but spider veins are generally considered painless and don’t directly pose any health risks beyond cosmetic concerns.

While both most commonly appear on the legs, spider veins can also present on the face — and the list of potential causes for each runs deep.  “Although women are more likely to develop venous diseases than men, factors such as aging, family history, prolonged periods of standing or sitting, smoking, not getting enough exercise, hormonal changes during pregnancy or due to birth control, a history of blood clots, or injury to the veins can lead to either condition,” says Dr. Jaber. 

Once properly diagnosed, however, there are plenty of remedies — ranging from minimally invasive treatments to surgical procedures — that can bring back smooth, vein-free skin. 

## __How to Treat Varicose Veins and Spider Veins__ 

Patients who begin to notice the appearance of veins and experience symptoms like leg aching or cramping, mild swelling, or itchiness may wish to consult with their doctor about diagnosis and treatment options (anyone who suddenly experiences severely inflamed veins, discoloration, or ulceration of the skin should immediately contact his or her provider). 

During the visit, your doctor will likely perform a doppler ultrasound or venogram to get a better sense of the severity of the condition before deciding how to proceed. “There’s not much you can do to prevent spider veins or varicose veins,” says Dr. Karcher. “But your treatment options are both safe and easy.”

Here, The AEDITION breaks down some of the most effective ways to address venous disorders like varicose and spider veins, which involve either closing the veins or removing them entirely. 

## __Vein Closure Procedures__ 

### __Sclerotherapy__
Among the most popular treatments for both spider and small varicose veins, [sclerotherapy](https://aedit.com/procedure/sclerotherapy) is a minimally invasive closure procedure that involves injecting a solution (i.e. sclerosing agent) into damaged veins to force the pooled blood to reroute through healthier veins. The injected vein will collapse and be reabsorbed into local tissue before it eventually fades.

Sclerotherapy is not only effective in diminishing the appearance of veins, but it also helps reduce pain and cramping in patients who suffer from severe varicose veins. The treatment lasts anywhere between 15 to 45 minutes and costs about $350. Studies have shown that as many as 50 to 80 percent of injected veins can be eliminated in a single sclerotherapy session (though multiple visits may be required), but how quickly a patient sees results depends on the severity of his or her condition. 

“The vessels first turn red, then purple, then brown, and, finally, yellow,” says Dr. Karcher. “These can take a few weeks to fade, but within a month or more you will be free of any veins.”

### __Laser Therapy__
[Laser therapy](https://aedit.com/procedure/laser-treatment-for-varicose-veins) is a non-invasive option for those looking to close veins in sensitive areas (think: the face) or are allergic to certain injection solutions. Strong bursts of laser light target the red color of the blood cells in the veins and break them down. 

For smaller spider veins, the resulting blood clots usually dissipate immediately with very little healing time required. Dr. Jaber, for example, uses an Nd:YAG laser to treat small spider veins. In the case of larger veins, the areas targeted during laser treatment will first darken before disappearing in one to three months. 

Laser therapy is more expensive than some of the other treatment options — costing an average of $450 per session — but each in-office procedure lasts just 15 to 20 minutes. Multiple sessions are often required in order to see the best results, and those appointments are usually spaced six to 12 weeks apart.

### __Endovenous Ablation Therapy__
The minimally invasive treatment uses laser or radiofrequency (RF) energy to cauterize abnormal veins. A small incision is made in the affected area through which a thin tube carrying the laser or RF device is inserted. An ultrasound is used to visualize the vein, and the heat burns the blood vessel. This causes the veins to close, turn into scar tissue, and, eventually, disappear.

Post-op, the patient’s leg is wrapped in a compression stocking to aid the healing process and prevent blood clots. Priced at an average of $3,000, the treatment effectively leads to the regression of visible varicose veins — but sclerotherapy or laser therapy is usually recommended to prevent the condition from recurring.

### __Endoscopic Vein Surgery__
Recommended for those dealing with severe cases of varicose veins that could lead to skin ulcers, the surgery involves closing the vein using a small tube with a camera. The doctor will make a minor incision and insert the camera-bearing tool into the vein for viewing while a harmonic scalpel is used to simultaneously cut and cauterize it. The procedure typically costs between $1,500 and $3,000 and lasts 30 to 60 minutes. Patients can resume normal activities in one to two weeks.

## __Vein Removal Procedures__ 

### __Ambulatory Phlebectomy__
An [ambulatory phlebectomy](https://aedit.com/procedure/ambulatory-phlebectomy-for-varicose-veins) procedure is reserved for the treatment of larger varicose veins that are close to the surface of the skin. Local anesthesia is administered and small incisions are made to remove the affected vein — segment by segment. Patients go home on the same day and may experience mild postoperative pain, swelling, or bruising. The treatment typically costs an average of $1,000 per leg.

### __Vein Stripping and Ligation__
Performed under general anesthesia, [vein stripping and ligation](https://aedit.com/procedure/ligation-and-stripping-for-varicose-veins) is the most invasive treatment option of the bunch. The surgical procedure is used to treat the most serious cases of varicose veins (think: the kind that result in swelling, skin changes, pain, and ulceration).

Surgeons cut into the skin and tie off the veins before removing them. Most providers will try to leave the saphenous vein (i.e. the longest vein in the body that runs the length of the leg — from the foot to the thigh) in case it is ever needed for grafting during a heart bypass surgery. The vein removal relieves symptoms associated with varicose veins and costs anywhere from $1,500 to $3,000. Full recovery may take up to a month.

## __How To Prevent Varicose Veins and Spider Veins__ 

Ultimately, as Dr. Jaber says, “the best treatment for varicose veins is prevention.” Lifestyle changes like losing weight (for overweight and obsese patients), exercising regularly (to increase muscle tone), refraining from sitting or standing for too long, and not spending too much time in high heels or tight clothing can all help mitigate the chances of developing varicose and spider veins. Keeping legs elevated and wearing compression stockings can also help those who are at risk of developing venous disorders. Finally, maintaining a healthy diet is also recommended. 

Carly Simon may have been talking about a different kind of vanity. But, if you’re part of the 50 percent of adults living with a leg vein disorder, The AEDITION is here with the best way to treat and prevent varicose and spider veins. 

How To Treat And Prevent Varicose Veins and Spider Veins

You’re So Vein: How To Treat Varicose And Spider Veins

shutterstock 595101689-min-min-min

In a world of rapidly evolving beauty standards, and where we have instant and continuous access to media and commercial images, women aren’t the only ones who can feel pressure to live up to an aesthetic ideal. More men are seeking to make changes with the help of cosmetic procedures designed specifically for a male audience.

 
**The Rise of Plastic Surgery for Men**

From the male corsets of the 1700's to the bodybuilder bulking of the 1980's, there has always been social pressure on men to look a certain way. However, the world today is very different from even 20 years ago: increased access to media images, the invention of social media, awareness of celebrity culture, and a rise in image and video enhancement practices, are all factors that have made men increasingly aware of their appearance.

Culturally and socially, it has become more acceptable for men to have cosmetic surgery. According to the American Society of Plastic Surgeons, 1.5 million men went under the knife for cosmetic reasons in 2015. That's more than three times the number who got work done in 1997.

60% of Los Angeles dermatologic surgeon Jason Emer, MD’s patients are male and many of his treatments are designed specifically for them. "Men are finally becoming more open to health, maintenance, prevention, and they want to avoid aging,” says Dr. Emer. "They’re more open to talking about their bodies and want Botox®, peels, skincare, fillers, body sculpting, and the ‘man shot’ to enhance their genitals. Men also want chest surgery using implants and sometimes the feminization of features".

It’s now easier than ever to receive treatment for issues specific to men. Medical advancements mean that surgery is safer than ever before, downtime is shorter, and perhaps most significantly, the stigma around men getting work done is gradually disappearing. Here are some of the most popular procedures among men today.

 

**Body Sculpting**

“Men want six packs, tight abs and a masculine chest,” according to Dr. Emer, and there are plenty of body sculpting treatments available to help them achieve these goals. Body sculpting, also known as body contouring, uses various methods to shape the body to create a leaner, more toned and muscular figure, and remove excess fat from areas where it isn’t wanted. It can also help remove excess skin due to weight loss.

[Hi-Definition Liposculpture](https://aedit.com/procedure/liposculpture) is one of the most popular surgical procedures offered at Dr. Emer’s clinic. It combines regular liposuction with multiple other technologies, such as lasers, ultrasound, or radio frequency energy, to remove layers of fat that lie deep under the skin while at the same time sculpting the body into a desirable shape. The process creates a sleeker silhouette, helps to reduce the appearance of cellulite, and is generally used for sculpting the torso and upper arms area. 

Dr. Emer often performs liposuction along with a water-assisted Body Jet fat removal system, which helps prevent swelling after surgery, and laser and radiofrequency technologies which heat and tighten the skin and disrupt fat, allowing for fat breakdown and (if applicable) scar tissue removal. He says these combinations result in a more defined and desirable shape. 

As with all surgical procedures, there is always some level of risk associated with Hi-Definition Liposculpture and before embarking on the treatment, every patient needs a thorough consultation with a board-certified surgeon to make sure they are a viable candidate. This includes checking the customer’s current health state and lifestyle, as well as addressing any potential allergies that could cause issues with the procedure. The recovery time is dependent on the patient, but most will experience a little discomfort during the first few days, but after two or three weeks should be able to get back to everyday life. 

The cost of Hi-Definition Liposculpture varies widely depending on the provider and how many areas are treated, but can cost anywhere between $5,000 and $50,000.


**Male Breast Reduction**

One of the most common aspects of their physique that leads many men to cosmetic surgery is male breasts, fatty deposits in the chest area rather than toned pectoral muscles. Fat naturally appears in the chest as men age or gain weight, but can cause embarrassment and insecurity. Sometimes all the dieting and exercise in the world can’t shift these stubborn fat deposits. 

A popular option for [male breast reduction is gynecomastia surgery](https://aedit.com/procedure/male-breast-reduction) which removes fat and sometimes skin in order to create a sleek and contoured chest area. 

Generally, the patient is put under general anesthetic and liposuction is used. Small incisions are made under the skin and a cannula is inserted to loosen up the excess fat. Excision is also used to remove excess skin and reshape the area.

The recovery time for this procedure is usually within two to three weeks and the average cost of gynecomastia surgery is between $3,500 and $4,000, according to the American Society of Plastic Surgeons,


**Genital Rejuvenation**

Many men feel insecure about the size and shape of their genitals and some seek cosmetic surgery to help. “Rejuvenation of the genital area using the Priapus Shot® (P-Shot®) or fillers for the penis area are among the most popular procedures for men," according to Dr. Emer.

The P-Shot® is an injection made up of platelet-rich plasma (PRP) which is believed to encourage cell production and help rejuvenate the skin. The procedure claims to produce a larger, more symmetrical penis with fewer wrinkles and a generally more attractive appearance. As well as encouraging growth, the P-Shot® is primarily designed to help men with erectile dysfunction achieve stronger erections, more sexual satisfaction, and increased self-confidence. The recovery time for the P-Shot® is minimal, as it is a non-invasive procedure. Patients are usually advised to undergo two separate treatments to ensure lasting results. The average cost of one procedure is around $1,700, with the second procedure costing about $1,400.

Another type of [genital rejuvenation is penile filler](https://aedit.com/procedure/penis-enlargement-dermal-fillers). This involves a series of small injections into the genital region, generally into the base of the penis. The filler helps improve the appearance and increase the size of the penis and is often used as a penis enlargement procedure. The average cost of non-surgical procedures for penis enlargement ranges from $1,000 to $5,000 depending on how many injections are needed to achieve the desired result. 

 

**Facial Fillers**

Dr. Emer highlights that many men are dissatisfied with their facial appearance and "want to improve their complexion, get rid of dark circles under the eyes, remove fine lines and wrinkles, and improve the neck and jawline." The needs of male patients often differ from females, as they desire attention to slightly different features to achieve a more chiseled, classically masculine look.

Dr. Emer commonly uses short term dermal fillers to address these concerns. Restylane®, a type of dermal filler which contains hyaluronic acid, is used to reduce the appearance of fine lines and wrinkles, improve skin tone, and generally create a more youthful appearance. The effects are likely to last around 2-3 months. Restylane® syringes cost in the region of $620 each, although in some cases they can be as much as $750 each. 

Bellafill® is made with polymethylmethacrylate (PMMA) and is another type of facial filler used to enhance the facial skin's appearance, create a youthful look, and define jawlines. It can also be used to reduce the appearance of scars such as those from acne. The effects of this type of filler can be permanent and there are a number of risks associated, including infections, swelling, and lumps. Bellafill® costs around $800 per syringe.

 
**What Else Can the Cosmetic Industry Offer Men?**

Men, it seems, want the same thing from their cosmetic procedures as women do: to appear more youthful, healthy, and attractive. “Men want to look masculine, but want lifted, not lateral, cheekbones," says Dr. Emer. "They want implants in the jawline, hair rejuvenation, and chin augmentation with fillers." Other popular procedures for men include eyelid surgery,  Botox® (or ‘brotox’ as it is now affectionately known to male patients), neck lifts, tummy tucks, laser hair removal, and Coolsculpting.







Women aren’t the only ones who can feel the pressure to live up to an aesthetic ideal. More men are seeking to make changes with the help of cosmetic procedures.

The Best Cosmetic Surgery Procedures for Men

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When considering a cosmetic procedure, it is so important to find the right doctor for you. This is a procedure that can last you a lifetime, and you want to be completely confident in the doctor you choose to work with. Throughout the entire research process, you should maintain a healthy dose of skepticism as you vet prospective doctors. As the number of people choosing plastic surgery procedures has increased over the years, unfortunately so has the number of unqualified physicians claiming to be experts in the aesthetics procedure industry. Follow the seven steps below to ensure you are selecting the right doctor for your procedure.

### 1. Confirm credentials
For a plastic surgeon, a board certification is critical. Unknown to most, in the United States, state medical boards do not require the surgeon to be specifically trained in the surgical procedure he or she offers. In other words, if a general surgeon one day decides he or she wants to start practicing cosmetic surgery instead of general surgery, he or she can! The board certification guarantees that the surgeon has been trained specifically in cosmetic or reconstructive surgeries. When consulting with potential surgeons, ensure they are board certified in plastic surgery as a first step. They should be board certified and members of either The American Academy of Facial Plastic and Reconstructive Surgery, The American Society of Plastic Surgeons (ASPS), The American Academy of Dermatology, The American Board of Plastic Surgery (ABPS), or The American Society for Dermatologic Surgery. 
 
Similarly, a certificate from the American Academy of Dermatology for Dermatologists and accreditation from the American Academy of Cosmetic Dentistry (AACD) ensure that doctors have received specialized training in the field dermatology and cosmetic dentistry, respectively.

*Ask: Are you board certified and a member of any professional organizations?*
 
### 2. Make sure the physician is skilled in the procedure you want
Once you have confirmed credentials, the next step is to inquire about the doctor’s experience with specific procedures. If you are looking to get a nose job, you want to make sure that the plastic surgeon you work with has plenty of experience performing [nose jobs](https://aedit.com/procedure/rhinoplasty-nose-job). While some of the knowledge is transferable, each feature has unique properties, requiring a completely different set of skills. For instance, facial plastic surgery would require the cosmetic surgeon to work with bone, cartilage, and potentially breathing passages whereas breast reconstruction is mostly soft tissue. The surgical techniques a plastic surgeon would use on soft tissue vary significantly from those used on bone or cartilage.

Take a step back for a second. If you (or a friend or child) needed a tutor to prepare for a history exam, would you hire an English teacher or a history teacher? While they are both teachers, the history teacher is an expert in the subject whereas the English teacher is less familiar. Opt for a doctor who is a specialist or has substantial experience in the procedure you are considering. A physician who names specific treatments, like Botox, [veneers](https://aedit.com/procedure/veneers), or [breast augmentation](https://aedit.com/procedure/breast-augmentation-with-implants), will likely be a better fit compared to someone who claims to do all procedures equally as well.
 
*Ask: What did your training entail for the procedure I am considering?*
*How long have you been performing this procedure?* 
*How many times have you performed this procedure?*
 
### 3. Choose a doctor whose past work appeals to you
You found a doctor with top credentials and who is skilled in the procedure you are considering, but do you like his or her aesthetic? It is so important that both you and the physician you are aligned on what a successful procedure will look like. For instance, some plastic surgeons may like more turned up noses whereas others may not. Once you have an idea of what your ideal outcome will look like, begin browsing the before and after photos on doctors’ websites. If available, pay close attention to the before and after photos of patients with similar features to yours. This will give you good insight on the doctor’s consistency and how you may look after the procedure.
 
*Ask: In addition to what is online, do you have any before and after photos of patients with similar features to me?*
 
### 4. Inquire about the operating facility
One factor that should not be overlooked is the safety of the surgical facility. When undergoing a cosmetic surgery, you are not only working with the plastic surgeon but also an entire operating team and anesthetist. Accredited surgical centers adhere to strict standards, such as sanitation, staff, and equipment, to maximize patient safety. Accreditation is granted by passing regular inspections and submitting thorough records of the facility’s policies. With an accredited operating facility, you can expect qualified staff, a sterile operating room, anesthesia monitoring devices, and the up to date equipment for emergency situations and patient care. Look for facility accreditation certificates, such as AAAASF or AAAHC, and for an anesthetist who is either a Certified Registered Nurse Anesthetist (CRNA) or an anesthesiologist who is board certified in Anesthesiology. Additionally, when discussing the operating facility, you will want to see if the prospective plastic surgeon has hospital privileges to perform the considered procedure. If the plastic surgeon is only able to do the procedure in the surgeon’s office then that can be a red flag.
 
*Ask: Where do you perform surgery and what is the facility’s level of accreditation?*
*What is the anesthetist/anesthesiologist’s level of training?*
*Have you and your team handled emergency situations in the past?*
*Are you affiliated with a hospital and/or do you do surgery at one?*
 
### 5. Assess bedside manner and personality fit
Aside from poor results, the last thing you want is a pushy or rude physician. With such a life-changing procedure, it is essential you feel comfortable enough to express concerns or ask questions. A good plastic surgeon, cosmetic dentist or dermatologist will allow you to take your time as you absorb all of the new information and will lay out all of the pro’s and con’s of each procedure type so you can make the most informed decision. Realistically, there is not one perfect procedure and doctors must be open about the potential drawbacks of each option.
 
As you start scheduling consultations, take note of the doctor’s availability. If the schedule is wide open, that could be a negative sign. Typically, Mondays and Tuesdays are the busiest days for cosmetic physicians. If your schedule allows it, try to book your consultation for a Monday or Tuesday to gauge how much demand the doctor has. More so, speak to other patients in the waiting room about their experience with the doctor to get candid and honest feedback. If you are unable to get in-person insight, you can also read online reviews and forums, like AEDIT’s.

A certificate through the American Board of Medical Specialties (ABMS) is another positive indicator as you research doctors. ABMS certifies that doctors carry responsibilities safely and ethically as well as demonstrate empathy towards patients to provide optimal health care.
 
*Ask: What are some risks associated with this procedure?*
*What should I be most concerned about?*
 
### 6. Consider location
While it is important to work with a professional you trust, you want to ensure that the location is convenient as well. This is particularly important for invasive procedures, like a breast augmentation or tummy tuck. With larger surgeries, you want to make sure that you will be near a family or friend who will be able to pick you up from the surgery and act as a caregiver. Discuss with your doctor ahead of time what post procedure and recovery time will look like.
 
*Ask: Will I need a family member or a friend to pick me up from the procedure afterwards?*
*How long can I expect the recovery time to be?*
 
### 7. Review pricing
Expenses certainly matter, but this is not an investment to be stingy on. Keep in mind that “inexpensive” surgeries can turn costly if the end result is unsatisfactory. If the outcome is not right, reconstructive surgery may be needed, which can quickly increase the overall cost. That is why it is critical to get the results right the first time. 

Discuss pricing with the physician ahead of time and ask for a breakdown of all charges. In addition to the surgeon’s fee, you can expect fees for the operating room, anesthesia, and other services. Compare prices among different doctors to gauge what is reasonable for your desired procedure.
 
*Ask: Are there any additional charges to the surgery fee?*
*What can I expect as the total cost for the procedure?*

The most important thing to remember is to take your time in making a decision. While it can be a lengthy and labor intensive search, do not settle. Keep looking until you find a well-respected and board certified doctor that has the exact aesthetic you desire and has proper bedside manner. Cosmetic procedures can be absolutely transformative and life-changing when done properly, so remember not to rush!



When considering a cosmetic procedure, it is so important to find the right doctor for you.

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