Get­ting It Done

A new crop of min­i­mally in­va­sive treat­ments are an al­ter­na­tive to surgery, of­fer­ing vis­i­ble re­sults and less pain. Here, the ones top docs are en­dors­ing.

SHAPE (USA) - - Contents - By Kate San­doval Box

Top doc­tors weigh in on the skin pro­ce­dures that make the most im­pact

Im­prove your skin tone The treat­ment: lasers Let ’s say you have a lit­tle acne, along with some dark spots. Maybe melasma or pso­ri­a­sis too. Plus, you’d love firmer skin. Rather than treat each sep­a­rately, tackle them all at once with the new Aero­lase Neo (a 1064 nm Nd: YAG laser). “It tar­gets the color red, the color brown, and water in the deep lay­ers of your skin, so it zaps red acne and brown spots, and it pro­motes col­la­gen pro­duc­tion, which tight­ens and smooths skin,” says der­ma­tol­o­gist Pa­tri­cia Wexler, M.D. While older Nd: YAG lasers were sim­i­larly mul­ti­pur­pose, this new ver­sion has a short pulse, mean­ing that the laser zaps on and off in­cred­i­bly quickly. “This makes it less painful and leaves skin pink rather than red and peel­ing,” Dr. Wexler ex­plains. Ex­pect three to four treat­ments at $700 to $1,750 each. How­ever, if you have just one is­sue, you’ll want a spe­cialty laser. For brown spots, that’s the PiQo4, which, just like the Aero­lase, makes quick

pulses but in pi­cosec­onds, which are one-tril­lionth of a sec­ond. This can truly re­duce your sun dam­age, says der­ma­tol­o­gist Ellen Mar­mur, M.D., a mem­ber of the Shape Brain Trust, but it takes up to five ses­sions spaced a few weeks apart. “Many pa­tients with melasma and hy­per­pig­men­ta­tion want per­fect skin in one ses­sion, but that would dam­age it—a slow and steady ap­proach is bet­ter,” Dr. Mar­mur says. Price per ses­sion: $150 for a sin­gle spot to $1,500 for a full face. For red­ness, der­ma­tol­o­gist Jeremy Brauer, M.D., turns to the Vbeam, the gold stan­dard for treat­ing rosacea, port-wine stains, and red scars. “This pulsed-dye laser treats large ar­eas ef­fi­ciently and ef­fec­tively,” he says. Ex­pect three to four ses­sions start­ing at $300 each.

Stim­u­late re­pair and growth The treat­ment: Mi­croneedling + platelet-rich plasma

You may have heard of—or even tried—mi­croneedling: a treat­ment per­formed with a de­vice called a mi­cropen, which has mul­ti­ple nee­dles and is stamped or rolled on your face. It cre­ates con­trolled wounds that rev the body’s col­la­gen pro­duc­tion in an ef­fort to heal. What’s new is cou­pling it with a platelet­rich plasma (PRP) treat­ment. “This com­bi­na­tion is bring­ing shorter down­times and bet­ter out­comes, espe­cially for pa­tients with tex­ture in­con­sis­ten­cies, like acne scars,” says cos­metic sur­geon Sachin Shrid­ha­rani, M.D. Your doc­tor spins 24 cc of your blood in a cen­trifuge. This sep­a­rates the growth-fac­tor-rich plasma, which is ap­plied be­fore and af­ter mi­croneedling. “The mi­croneedling helps ac­ti­vate the growth fac­tors in the plasma, which re­duces heal­ing time to a cou­ple of days,” says der­ma­tol­o­gist Gary Gold­en­berg, M.D. PRP can be com­bined with other pro­ce­dures, like hair restora­tion, to boost ef­fi­cacy, and with laser and filler in­jec­tions to cut heal­ing time. Price starts at $1,500.

Make curves sleeker The treat­ment: BTL EMSCULPT

This new FDA-ap­proved body-con­tour­ing tech­nol­ogy uses high-fre­quency elec­tro­mag­netic en­ergy to con­tract your mus­cles and burn fat. In a 30-minute ses­sion, your mus­cles will do the equiv­a­lent of 20,000 crunches or 20,000 squats, says der­ma­to­logic sur­geon Dendy En­gel­man, M.D. Each time the ma­chine pulses, your mus­cles con­tract. “My pa­tients de­scribe it as an in­tense work­out with­out the sweat,” Dr. En­gel­man says, adding that some of them use the treat­ments to help with di­as­ta­sis recti—a con­di­tion in which the ab­dom­i­nal mus­cles have

separated be­cause of preg­nancy. Stud­ies have shown an 11 per­cent de­crease in di­as­ta­sis recti and a 23 per­cent fat re­duc­tion over a six-month pe­riod, adds plas­tic sur­geon Barry DiBernardo, M.D. He sug­gests four ses­sions in two weeks and two main­te­nance ses­sions every few months. Cost: up to $1,000 per ses­sion.

Add vol­ume to your face The treat­ment: fillers

You can in­ject a bios­tim­u­la­tory filler to in­crease the body’s col­la­gen pro­duc­tion rather than use a re­place­ment filler to, say, in­stantly triple the size of the cheek­bones. That new think­ing is lead­ing to re­mark­ably nat­u­ral and long-term re­sults, says plas­tic sur­geon Z. Paul Lorenc, M.D. Sculp­tra Aes­thetic (starts at $1,000), poly-L lac­tic acid beads of­ten in­jected into cheeks, smile lines, and tem­ples, dis­solves in months but stim­u­lates col­la­gen so well that ar­eas stay vo­lu­mi­nous for up to three years. Bel­lafill (starts at $800), ap­proved for smile lines and acne scars, uses poly­methyl methacry­late mi­cro­spheres to pro­mote and sup­port col­la­gen, with ef­fects last­ing up to five years. There are also new tech­niques: Dr. Wexler per­forms mi­croin­jec­tions in the lines around the mouth and crow’s-feet with Belotero Bal­ance (around $1,000), a struc­tural filler that she says “pushes on the skin cell’s fi­brob­lasts to cre­ate col­la­gen.” Dr. Shrid­ha­rani likes to do mi­cro­droplet in­jec­tions in the fore­head and cheeks and around the mouth with Ju­vé­derm Vol­bella XC (starts at $950), a hyaluronic acid filler that locks water near the top of the der­mis to give skin a dewy, be­liev­ably youth­ful qual­ity.

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