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Plastic surgery is a big business. The American Society of Plastic Surgeon’s (ASPS) [annual report](https://www.plasticsurgery.org/documents/News/Statistics/2020/plastic-surgery-statistics-full-report-2020.pdf) found that some $20 billion was spent in 2020, with 15.6 million cosmetic procedures and nearly 7 million reconstructive procedures performed. When we speak about the cosmetic end of the spectrum, we are usually dealing with out-of-pocket expenses because the treatments are generally considered elective and not medically necessary. When we talk about the reconstructive side of the industry, however, [health insurance coverage](https://aedit.com/aedition/insurance-coverage-for-plastic-surgery-cosmetic-procedures) may come into play.

In June 1989, the American Medical Association (AMA) adopted definitions of ‘cosmetic surgery’ and ‘reconstructive surgery’ that are used by insurance providers to determine coverage:

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

If you clicked on this article, it’s probably because you are considering a breast surgery of some kind. So, what does the ‘cosmetic’ versus ‘reconstructive’ distinction mean to you? If you are simply looking to up your cup size, you can pretty much count on paying for your [breast augmentation](https://aedit.com/procedure/breast-augmentation-solutions) yourself. But there are certain reasons why breast implants and other enhancement procedures may fall into the ‘reconstructive’ category. Additionally, [breast reduction](https://aedit.com/procedure/breast-reduction-and-revision-solutions) is one of the most common procedures insurance might cover.

To better understand what factors into whether or not a [breast surgery](https://aedit.com/concern/breast-shape-and-size) is covered by insurance, we’re breaking down some of the key criteria you need to know to make your case.

## **Why Breast Surgery May Be Covered By Insurance**
The fact of the matter is that there are no guarantees when it comes to insurance coverage. “Nobody knows what will qualify, as there are no guidelines that say, ‘if you have this, you qualify,” says [Richard J. Brown, MD](https://www.richardjbrownmd.com/), a board certified plastic and reconstructive surgeon in Scottsdale, AZ. “It is totally at the discretion of the insurance company.” Even so, there are some circumstances that, with proper documentation, may mean a procedure is eligible for coverage.

### **1. Post-Mastectomy Reconstruction**
Perhaps the most straightforward situation on the list, the 1998 [Women’s Health and Cancer Rights Act](https://www.cancer.org/treatment/finding-and-paying-for-treatment/health-insurance-laws/womens-health-and-cancer-rights-act.html) mandated that group health plans that cover [mastectomy](https://aedit.com/aedition/what-to-expect-before-during-after-mastectomy-breast-cancer) (for both breast cancer prevention and treatment) must also cover [breast reconstruction](https://aedit.com/aedition/comprehensive-guide-to-breast-reconstruction-nipple-reconstruction-after-breast-cancer). It should be noted that Medicare covers bilateral breast reconstruction in post-mastectomy patients, too. Reconstruction can be performed in a variety of ways depending on the anatomy and aesthetic goals of the patient, and prostheses (i.e. [breast implants](https://aedit.com/procedure/breast-augmentation-with-implants)) are an option. Whether it is a unilateral or bilateral mastectomy, insurance providers must cover reconstruction for both breasts. 

In these cases, surgeons do not need to document symptoms or trials of alternative treatment. “For breast cancer, I do not have to document, as they already have a diagnosis,” Dr. Brown explains. “If it is for revision reconstruction, I document what I feel I can do to make the reconstruction better, if that is possible.”  

### **2. Shoulder, Neck, & Back Pain**
Anyone that suffers from back, neck, or shoulder pain knows just how debilitating it can be. Whether the pain is attributed to injury, [poor posture](https://aedit.com/aedition/how-to-improve-your-posture), or breast size, treating the pain can be a challenge. This is especially true if the discomfort is caused by a large chest. [Research](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3322448/) has found a correlation between breast size and chronic back pain, and it is believed it may have to do with the curvature of the spine due to the weight of the breasts. As a result, insurance companies may cover a breast reduction to improve quality of life. 

### **3. Inability to Exercise**
Exercising is challenging enough as is, but, for some women, it is made even more difficult by large breasts. As you move, so do your breasts and that can be very painful while doing high intensity – or even low intensity – workouts. Finding sports bras that are supportive and containing enough may not be possible, with some even doubling up on them. Some women with large breasts are not able to get the health benefits associated with fitness, which can help create the case for a medically necessary breast reduction.  

### **4. Significant Asymmetries**
From head to toe, [asymmetry](https://aedit.com/aedition/cosmetic-procedures-for-body-asymmetries) is inevitable. No body – literally or figuratively – is perfect, and most females find that their breasts are uneven. For the large majority of people, correcting breast asymmetry is not a medical necessity. But for certain cases of asymmetry as a result of trauma, disease, infection, tumors, or genetic conditions that cause large size discrepancies, there may be a conversation to be had with your insurance company. 

### **5. Rashes** 
Chronic rashes under the breasts can be a reason for insurance to cover a reduction surgery. Because large breasts often droop and cover other areas of the chest, it can cause skin-to-skin friction (intertrigo) and/or make it difficult for sweat to evaporate. In normal circumstances, sweat produced in the inframammary fold (i.e. the breast crease) evaporates on its own, but, for women with larger breasts, the damp environment can cause irritation and rashes. 

### **6. Bra Strap Grooves**
Ever notice indentations on your shoulders when taking off your bra at the end of the day? It’s usually a sign that the undergarment was overburdened or ill-fitting. While this nuisance is usually a once-in-a-while thing for most, some bigger-busted ladies have permanent grooves from their bra straps because the breasts are simply too heavy to be properly supported. Alone, these markings may not be enough of a reason to warrant a reduction, but they can be supporting evidence (pun intended) when building a case. 

### **7. Headaches**
Can large breasts be headache-inducing? According to [research](https://pubmed.ncbi.nlm.nih.gov/20048598/), the answer is yes. Studies show a link between chronic headaches and macromastia (large breasts), and women who previously suffered from headaches or migraines reported improved wellbeing post-breast reduction. The exact connection between the two isn’t fully understood, but it is believed that the weight of the breasts can be a stressor to the muscles in the head, just like in the back, neck, and shoulders. 

### **8. Faulty Breast Implants**
Just as insurance companies will cover breast implants for mastectomy patients, they may cover the removal of said implants if it is determined to be medically necessary to do so. ‘Medically necessary’ reasons can include: 

- Implant rupture
- Severe [capsular contracture](https://aedit.com/aedition/capsular-contracture-breast-implants)
- Infection
- Chronic breast pain
- Breast implant-associated anaplastic large cell lymphoma ([BIA-ALCL](https://aedit.com/aedition/heres-what-you-need-to-know-about-the-allergan-breast-implant-recall))

Even for reconstruction patients, coverage for [breast implant removal](https://aedit.com/procedure/breast-implant-removal) or [replacement](https://aedit.com/aedition/guide-to-replacing-breast-implants) is not a given. “Beyond initial reconstruction, insurance is not obligated to cover any breast reconstruction revisions,” Dr. Brown shares. But “the fact of the matter is they pretty much cover it all,” he adds. With that said, insurance companies rarely, if ever, cover revision if the primary surgery was for cosmetic purposes.

## **How to Build a Case for Insurance**
So, how do you get insurance to cover your breast surgery? The reality of the situation is that it takes time and patience. With the exception of post-mastectomy breast reconstruction patients, evidence must be submitted to your insurance provider and pre-authorization must be gained before moving forward with the procedure. Insurance companies aren’t going to just pay for anyone’s breast surgery. In the case of [reduction mammaplasty](https://aedit.com/aedition/best-questions-to-ask-before-a-breast-reduction) (a.k.a. breast reduction), you need documentation that demonstrates why you need the procedure, including some or all of the following:

- **Photography**: Standardized photography of the breasts taken by a medical professional is usually required to visualize the breast hypertrophy, or overgrowth of breast tissue.
- **Symptoms**: Chronic symptoms, like many of those listed above, must be experienced for at least six months (though usually a year or more) before building a case.
- **Alternative Treatment**: Proof of unsuccessful non-surgical treatments, including visits to a physical therapist, chiropractor, or orthopedist, supervised weight loss, or the inability for rashes or other skin conditions to be cleared up by a dermatologist, must be submitted.
- **Surgical Plan**: Your board certified plastic surgeon will need to share the approximate amount of tissue they plan to remove from each breast based on your weight and height. Insurance companies have specific parameters for how much needs to be excised in order for the reduction to be considered medically necessary.
- **Surgeon’s Statement**: Additionally, your medical team will need to share their opinion on why your symptoms are best treated with breast reduction surgery.

Not all health insurance companies will require all of these criteria be met, but, according to a [2020 paper](https://journals.lww.com/plasreconsurg/Abstract/2020/08000/Insurance_Denials_in_Reduction_Mammaplasty__How.6.aspx) published in *Plastic and Reconstructive Surgery*, pre-authorization denial rates for breast reduction surgery have increased steadily over the last five years. The researchers note that the factors for precertification “are used arbitrarily, without scientific evidence, and are inconsistent with clinical practice,” making it difficult for patients and providers alike. 

These discrepancies are why Dr. Brown always tries to manage expectations. As he explains, “neck pain, back pain, bra strap grooves, headaches, rashes under the breast, [and] inability to exercise because they need several bras” are all legitimate reasons to consider breast reduction surgery, but these symptoms “do not guarantee” coverage by insurance. “They still can be denied,” he shares. “And often insurance wants proof of PT [physical therapy] and OT [occupational therapy] to avoid surgery.”

Needless to say, building a case for preauthorization isn’t something you do on your own. Your primary care physician, PT or OT specialists, and board certified plastic and reconstructive surgeon will all be part of the process. Dr. Brown’s approach? “I just tell the story,” he notes. “I describe the symptoms, and what is going on, and make comments on whether I feel it is medically necessary or not.” 

In addition to the symptoms described above, insurance providers usually use the controversial [Schnur Sliding Scale](https://pubmed.ncbi.nlm.nih.gov/30557179/) to calculate how much breast tissue should be removed. “[It] is a formula that based on height, weight, and other factors predicts how much they should have removed, and it is so imperfect,” Dr. Brown cautions. “They use that against how much the surgeon says they think they can remove, and, if those numbers are off by too much, they may deny.”  Some insurance companies will also require the surgeon performing the procedure is in-network, so be sure to clear that up early on.

### **Next Steps**
If your breast reduction case gets approved, insurance will cover the cost of the surgery – with some stipulations. You will need a post-operative report that shows the procedure was carried out in accordance with the pre-authorized plan. That includes being operated on by an in-network surgeon at an accredited facility (usually a hospital) and having the mandatory amount of tissue removed. 

## **The Takeaway**
Unfortunately, there are no ‘sure things’ in insurance, but there are steps you can take to improve your chances of coverage. In addition to careful documentation, one of the best things prospective patients can do is work with a board certified plastic surgeon who specializes in the procedure they are interested in. They will likely have a lot of experience navigating the pre-authorization process, and they should also be expert in delivering the most medically and cosmetically pleasing result for your anatomy and aesthetic goals.

Aesthetics

From breast reduction to post-mastectomy reconstruction, here’s what you need to know.

A Guide To Insurance Coverage For Breast Reduction And Breast Reconstruction

Thinking About Breast Surgery? Insurance Might Cover It

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We talk a lot about [sun damage and how to correct it](https://aedit.com/aedition/cosmetic-procedures-treatments-to-correct-sun-damage), but that conversation is not complete without a discussion about skin cancer. May is Skin Cancer Awareness Month, which serves as an annual opportunity to shed light on the most common type of cancer in the United States. You (hopefully!) know to wear sunscreen year round and limit your exposure to ultraviolet (UV) rays as much as possible, and you may be keeping an eye on suspicious moles or visiting your dermatologist for skin cancer screenings. But there is still a lot to know about skin cancer that can be hard to keep track of even for those with a family history of it. 

With education in mind, we’re breaking down some of the most important things you might not know about [skin cancer](https://aedit.com/aedition/category/skin-cancer). Read on to expand your sun safety knowledge and be sure to give us a ‘thumbs up’ at the end of the article if you learned something new.

## **1. There Are Multiple Types of Skin Cancer**
Generally, skin cancers are usually discussed in two categories: melanoma and non-melanoma. Within those groups, there are three main types that present in different ways:

- **Basal Cell Carcinoma (BCC)**: The most common form of skin cancer with about 3.6 million cases in the U.S. every year, BCC usually develops after years of sun exposure.
- **Squamous Cell Carcinoma (SCC)**: Ranking as the second most common skin cancer with nearly two million cases diagnosed annually, SCC can grow deep into the skin and cause disfigurement.
- **Melanoma**: The most dangerous form of skin cancer due to its ability to spread, the Skin Cancer Foundation [estimates](https://www.skincancer.org/skin-cancer-information/skin-cancer-facts/) there will be 197,700 cases diagnosed in 2022.

If you commit to regular skin checks with your dermatologist and practice safe sun, however, skin cancer is very treatable. From [Mohs surgery](https://aedit.com/procedure/mohs-surgery) to [non-ablative laser therapy](https://aedit.com/aedition/nonsurgical-laser-treatment-for-skin-cancer), there are more treatment options than ever.

## **2. Skin Cancer Is Common – But Preventable**
One in five Americans will develop some sort of skin cancer during their lifetime, making it the [most common](https://www.aad.org/media/stats-skin-cancer) form of cancer in the U.S. But even the sobering statistics don’t tell the whole story. According to the American Cancer Society, the [actual number](https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2020/cancer-facts-and-figures-2020.pdf) of non-melanoma basal cell and squamous cell (i.e. the two most common types of skin cancer) cases are difficult to estimate because they are not required to be reported to cancer registries. Invasive melanoma, meanwhile, only accounts for about one percent of skin cancer cases, but it is responsible for the majority of skin cancer deaths. 

It is estimated that some 10,000 people are diagnosed with skin cancer every day, with more than one million Americans living with melanoma at any given time. If there is any good news to be had, it is this: Skin cancer is the most preventable form of cancer. Unlike cancers that have ambiguous origins or can’t be seen, we know exactly where skin cancer comes from: exposure to UV rays from the sun and artificial sources (read: tanning beds). 

You can play an active role in skin cancer prevention and protection with healthy habits. They include: 

- Monthly at-home skin checks (more on that below)
- Daily use of a broad spectrum sunscreen with a minimum of SPF 30 
- Reapplication of said sunscreen every two hours or immediately after swimming
- Staying in the shade between 10 a.m. and 4 p.m.
- Wearing a wide-brim hat, polarized sunglasses, and UPF clothing
- Avoiding indoor tanning

## **3. No One Is Immune From Skin Cancer**
There is a dangerous misconception that [skin of color](https://aedit.com/aedition/bipoc-skin-cancer-awareness) doesn’t burn or can’t develop skin cancer. It is true that people with lighter skin — types I through III on the [Fitzpatrick scale](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types) — are at a higher risk of developing skin cancer than types IV, V, and VI. But people with darker skin have a higher risk of being diagnosed with skin cancer at a later stage. This means the cancer is often more aggressive and has a lower survival rate.

The most common form of skin cancer for BIPOCs is basal cell carcinoma, specifically on the palms of the hands and soles of the feet. Melanoma most often affects non-Hispanic whites, but people of color have higher rates of acral lentiginous melanoma (ALM), or melanoma of the palms, soles, and nail beds. 

And then there is the age factor. While rare, pediatric melanoma should be on every parent’s radar. According to the National Cancer Institute, nearly 500 children are [diagnosed](https://www.cancer.gov/types/skin/hp/child-melanoma-treatment-pdq) with pediatric melanoma each year. This is why it is so important for *everyone* to apply sunscreen properly and to conduct skin checks regularly.

## **4. Skin Cancer Can Develop Anywhere**
The skin is the body’s largest organ, and there is a lot of it. Skin cancer can develop anywhere, so you should be protecting and checking from the top of your head to the tips of your toes – though certain parts of the body are more overlooked than others. These include the fingers and toes (including under the nails) and the bottoms of the feet. The eyelids, scalp, and genital area are also easy to forget. Last but not least, don’t neglect your lips. Whether you realize it or not, they are part of your skin — a very sensitive one at that – and need protection. We’ve already rounded up the [best lip balms with SPF](https://aedit.com/aedition/best-lip-balms-with-spf) to eliminate any excuse not to protect.

## **5. Skin Cancer Screenings Save Lives**
All forms of skin cancer are treatable, but early detection is key. The five-year survival rate for melanoma is 99 percent, which is why committing to regular skin cancer screenings – both at-home and with your dermatologist – is vital. According to the American Academy of Dermatology (AAD), half of reported melanomas are [self-detected](https://www.aad.org/media/stats-skin-cancer). Just like you do a monthly [self breast examination](https://aedit.com/aedition/what-to-do-if-you-find-a-lump-in-your-breast-breast-cancer-awareness), skin checks should be a part of your routine, too. 

As you know, skin cancer can develop anywhere on the body, so you have to be thorough in your exam. If you’re wondering how you are going to check your scalp or your back – we have an [expert guide to conducting at-home skin cancer screenings](https://aedit.com/aedition/how-to-conduct-at-home-self-examination-skin-cancer-screenings). As it relates to melanoma specifically, the ‘ABCDE rule’ should be considered. The ABCDEs include:

- A – Asymmetry: Growth is asymmetrical
- B – Border: Rough or jagged edges
- C – Color: Various shades of brown, tan, black, red, white, or blue
- D – Diameter: Larger than six millimeters (think: a pencil eraser)
- E – Evolving: Changing, growing, bleeding, etc.

BCC and SCC do not necessarily follow the same pattern, but, generally speaking, you want to be mindful of spots that are growing asymmetrically, evolve in size or color, or suddenly start bleeding, itching, or burning. At the end of the day, self-exams are all about monitoring the skin for changes — whether it’s the evolution of an existing mark or the advent of a new one.

At-home skin checks are a must, but they do not replace a [professional skin cancer screening](https://aedit.com/aedition/dermatologist-skin-cancer-screenings-mole-checks) with a dermatologist. It's usually recommended to start these checks annually around the time you turn 18, though, depending on you and your family's medical history, more frequent visits may be needed. Consulting with a board certified dermatologist is the best way to determine the ideal cadence.

## **6. Sun Damage Is Cumulative**
Having five or more sunburns doubles your risk of developing melanoma, but skin cancer can form from repeated sun exposure over time regardless of if there’s a [sunburn](https://aedit.com/aedition/dermatologist-tips-for-soothing-sunburn) or not. We’re sorry to tell you that the sun damage we see in adulthood is the result of years of damage – often, the cumulative sun exposure we experienced before age 18. That chronic exposure to UV rays can lead to visible signs of aging (i.e. unwanted pigmentation, fine lines and wrinkles, crepiness, etc.), skin cancers, and potentially problematic pre-cancers.

[Actinic keratoses](https://aedit.com/aedition/guide-to-actinic-keratosis) (also known as solar keratoses) are the most common pre-cancers. According to the Skin Cancer Foundation, 58 million Americans have one or more AK and five to 10 percent of those spots become cancerous. They present as scaly patches on the skin – most commonly on the face, lips, ears, neck, scalp, and hands – and are the direct result of UV damage. If left untreated, they can turn into squamous cell carcinoma. Dermatologists can freeze off actinic keratoses with liquid nitrogen. Alternatively, topical chemotherapy or anti-inflammatory agents may be prescribed. In addition to sun protection, regular resurfacing treatments (think: [chemical peels](https://aedit.com/aedition/guide-to-superficial-medium-deep-chemical-peels) and [lasers](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing)) may actually help treat pre-cancers by removing the top layer of the skin.

## **7. Sun Care & Skincare Are Critical Parts of Prevention**
We’ve said it several times before, and we’ll say it again: The best way to prevent skin cancer is to protect yourself from harmful UV rays. One of the easiest ways to do that is to apply sunscreen every single day (rain or shine) and reapply regularly. While any sunscreen is better than no sunscreen, the AAD recommends using a broad spectrum sunscreen with a minimum sun protection factor (SPF) of 30. ‘Broad spectrum’ means the formula provides protection against both UVA and UVB rays. The former cause sun damage, while the latter are responsible for sunburns. 

Whether you use a [chemical or physical formula](https://aedit.com/aedition/difference-between-chemical-sunscreen-physical-mineral-sunscreen), the key is to apply the right amount and not miss a spot ([we’ve got expert tips for both](https://aedit.com/aedition/how-to-apply-sunscreen-and-not-miss-a-spot)). Today’s sunscreens are infinitely easier to incorporate into your routine than ever before. If you are in the market for a new formula, we have [a list of dermatologist-approved options](https://aedit.com/aedition/dermatologist-approved-sunscreen-for-face-body), [a crop that is lightweight to wear indoors](https://aedit.com/aedition/best-lightweight-non-greasy-sunscreens-to-wear-indoors), [a group that’s great for guys](https://aedit.com/aedition/best-sunscreens-for-men), and [a host that double as makeup](https://aedit.com/aedition/best-sunscreens-that-act-as-makeup). 

When it comes to [layering](https://aedit.com/aedition/how-to-apply-layer-skincare-products), apply sunscreen as the last step of your skincare routine but before any makeup. Speaking of skincare, what you put under your SPF can actually make it work harder. [Research shows](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3673383/) that pairing your SPF with antioxidants like [vitamin C](https://aedit.com/aedition/facts-about-vitamin-c-in-skincare) can better protect the skin from the sun and free radical damage. You can learn more in our [deep dive into how skincare can treat sun damage](https://aedit.com/aedition/best-skincare-to-treat-sun-damage).

And if the thought of a summer without a sun-kissed glow is too much to bear, consider a sunless alternative (no, we’re not talking about equally damaging tanning beds). [Self-tanners](https://aedit.com/aedition/how-to-make-your-self-tan-last-longer) are a cost-effective and safe way to glow – sans sun. Just remember that self tanner is not a substitute for sunscreen.

## **The Takeaway**
As long as the sun keeps burning, skin cancer is a risk. The best precaution is to avoid excessive sun exposure and to protect your skin with sunscreen or protective clothing. Early detection is key to a favorable prognosis, so get into the habit of conducting regular at-home skin checks and scheduling visits with your dermatologists. We may all be susceptible to skin cancer, but we have the knowledge and tools to prevent it.

Wellness

The most common type of cancer in the United States is also the most preventable.

Skin Cancer: Facts, Statistics, Treatment, Prevention

7 Skin Cancer Facts That May Surprise You

shutterstock 1059728453

Starting your aesthetic journey is a learning process that requires a lot of research. Not only do you need to narrow down your provider options, but you also have to think about what type of procedure will provide the outcome you desire. Take, for instance, augmentation mammaplasty (a.k.a. [breast augmentation](https://aedit.com/procedure/breast-augmentation-solutions)). Generally speaking, there are three types of breast augmentation: breast implants, [fat transfer](https://aedit.com/procedure/breast-augmentation-with-fat-transfer), and a combination of the two. 

If you are interested in [breast implants](https://aedit.com/procedure/breast-augmentation-with-implants) or [hybrid breast augmentation](https://aedit.com/procedure/hybrid-breast-augmentation) (which combines implants with fat transfer), part of your consultation and pre-op process will involve [deciding on what type of implant](https://aedit.com/aedition/how-to-choose-the-right-breast-implants) is best for you. It’s not just about size — you and your plastic surgeon will also discuss material, shape, and texture. 

The vocabulary can be confusing, but you don’t need a medical degree to sort it all out. To break down the terminology and what should factor into your decision-making process, we tapped the man who quite literally wrote the book on implants, [Gregory Buford, MD](https://aedit.com/provider/gregory-buford-md-1015), a Colorado-based board certified plastic and reconstructive surgeon and author of *[The Boob Job Bible: Your Ultimate Guide To Breast Surgery](https://www.beautybybuford.com/the-boob-job-bible-guide-breast-enhancement/)*. Read on for a masterclass on breast implants. 

<BeforeAfterModule
  title={Before & Afters: Breast Implants}
  procedureId={1013}
/>

## **Types of Breast Implants**
Once you’ve established that you are a candidate for breast implants, the next step is choose the material from which the implant is made. “The two main types of breast implants currently available in the United States are those filled with saline and those filled with silicone gel,” Dr. Buford notes. Here’s how they differ:

### **Silicone Gel Breast Implants**
- **What**: A silicone outer shell that is filled with silicone gel.   
- **Pros**: Used in both primary and secondary (read: [revision](https://aedit.com/aedition/guide-to-replacing-breast-implants)) breast augmentation and [reconstructive](https://aedit.com/aedition/comprehensive-guide-to-breast-reconstruction-nipple-reconstruction-after-breast-cancer) surgeries, Dr. Buford says silicone breast implants are the most popular in the U.S. “They not only look and feel more natural, but they also move more naturally, giving a far more optimal appearance,” he explains. At his practice, he specifically uses Allergan’s Natrelle INSPIRA™ implants because he likes the “individual styles, sizes, and gel structure that Allergan has.” 
- **Cons**: Dr. Buford notes that saline implants are not approved by the U.S. Food and Drug Administration (FDA) for people under the age of 22, and they can be more expensive. In the event of a rupture, the danger of silicone implants is that they do not reabsorb into the body. The so-called ‘silent rupture’ requires an MRI scan to diagnose. Additionally, inserting this type of implant requires a larger [incision](https://aedit.com/aedition/minimizing-scars-after-surgery), which may factor into the decision-making process for some. 

### **Saline Breast Implants**
- **What**: A silicone outer shell that is filled with saline (i.e. saltwater).
- **Pros**: Unlike silicone gel implants, saline-filled implants are FDA-approved for patients 18 and older. Another advantage? “They can be preferentially filled with a range of fluid (saltwater), which allows better customization of size,” Dr. Buford adds. Because they aren’t pre-filled, a smaller incision is needed. “This allows them to be rolled (like a cigar) into a much smaller profile and inserted through a much smaller incision,” he notes. If saline implants rupture, the saltwater is harmless and reabsorbed by the body.
- **Cons**: Rupturing is a big concern for many breast implant patients, and, if a saline implant ruptures, Dr. Buford says it will leave you “with what we lovingly refer to as the ‘flat tire’ look.” The breast will have a visible deflated appearance that requires surgery to correct. Additionally, saline implants can have a wrinkled or rippled appearance under thinner skin.

## **Breast Implant Shape**
Now that you know the difference between silicone- and saline-filled implants, it’s time to talk about shape. “There are really only two different shapes of implants: round and anatomic (a.k.a. teardrop),” Dr. Buford says. This impacts the profile of the breast once the implant is inserted.

### **Round Breast Implants**
- **What**: Round implants are circular and have a uniform circumference.
- **Pros**: In the event of a rotation, the round shape does not appear to have moved the same way a teardrop might. Round implants can be filled with silicone or saline and housed in a textured or smooth casing. 
- **Cons**: There are few notable cons to round-shaped breast implants. Depending on their aesthetic goals, some patients may express dissatisfaction based on individual preference. 

### **Teardrop Breast Implants**
- **What**: Anatomic or teardrop breast implants have more volume at the bottom.
- **Pros**: Because teardrop breast implants are tapered, they theoretically better mimic the shape of a natural breast. To minimize the risk of rotation and asymmetry, they have a textured exterior (more on that below).
- **Cons**: “The early buzz of anatomic implants was that they would give a more natural result,” Dr. Buford recalls. The theory, however, did not bear out. “When blinded observers compared results, this was not the case,” he says. Instead, “the big disadvantage of the teardrop-shaped implants is their ability to rotate,” Dr. Buford notes. In order to maintain the shape, teardrop implants can only be saline-filled.

## **Breast Implant Texture**
As we started to discuss above, the texture of the implant also matters. Implant texture refers to how the outer shell feels (think: smooth or textured). There are pros and cons to both:

### **Smooth Breast Implants**
- **What**: The exterior of the implant has no texture. 
- **Pros**: Without any texture to the shell, the implant may have a softer look. Without the texture to lock it in, smooth implants can move around more freely, which allows it to feel more natural. 
- **Cons**: This style can be more prone to inflammation around the implant and may not be the right fit depending on your medical history. Additionally, there is more of a chance of rotation, though it’s not usually very noticeable in round-shaped implants.

### **Textured Breast Implants**
- **What**: The shell has a rough exterior that is comparable to sandpaper. 
- **Pros**: “Texturing is thought to potentially reduce the risk for capsular contracture, but it is also used when the implant is shaped — instead of round — to avoid rotation,” Dr. Buford explains.
- **Cons**: For the implant to have a textured exterior, it requires a thicker shell that may lead to a less [natural-looking](https://aedit.com/aedition/how-to-get-the-most-natural-looking-breast-implants) appearance. Additionally, you may [remember the recall](https://aedit.com/aedition/heres-what-you-need-to-know-about-the-allergan-breast-implant-recall) involving textured implants from a couple years ago. “These implants have been tied to the risk for a very rare cancer called anaplastic large cell lymphoma (ALCL) — a form of Non-Hodgkin's Lymphoma,” Dr. Buford notes. For these reasons, he prefers smooth implants.

## **Additional Factors**
So, you’ve got a good sense of breast implant filling, shape, and texture. Here are the remaining factors for you to think about:

### **1. Sizing**
Cubic centimeters (a.k.a. CC) is the sizing system for implant volume. Implants usually begin at 100 CC and can go up to 800 CC, depending on the manufacturer. To help you visualize this, it is estimated that 150 CC to 200 CC equals a full cup size — though it is important to remember that the way an implant looks ultimately depends on the patient’s measurements. This is why surgeons tend to [focus less on specific sizes](https://aedit.com/aedition/why-women-are-getting-smaller-breast-implants) and more on look and feel. Because no two breasts are the same (think of them as sisters, not twins), implant sizes can be mixed and matched to create a more [symmetrical appearance](https://aedit.com/aedition/cosmetic-procedures-for-body-asymmetries). 

### **2. Profile**
Not to be confused with size, the profile or dimension of the implant will dictate the protrusion of the breast. “Given the same amount of volume, we have implants that are wider and flatter and we have implants that are narrower and more projectes,” Dr. Buford explains. “[This allows] for even further [customization](https://aedit.com/aedition/combining-breast-augmentation-with-breast-lift) of a specific look for your patients.” A lower profile implant, for example, will only protrude a little, whereas the high profile option will appear fuller. While that’s the general rule, the exact outcome depends on the individual's anatomy — meaning the size and shape of the chest wall and breast envelope.

### **3. Incisions**
“Most plastic surgeons these days are placing implants through either a periareolar or an inframammary approach incision,” Dr. Buford explains. The former involves incisions around the areola, while the latter goes through the base of the breast. The size and nature of the incisions will depend on the type of implant used. Silicone gel implants tend to require larger incisions than their saline counterparts because they are pre-filled. Regardless, good [scar care](https://aedit.com/aedition/scar-minimizing-skincare-to-use-after-surgery) should minimize the appearance of postoperative marks.

### **4. Shelf Life** 
What does Dr. Buford believe is the biggest misconception about breast implants for patients and providers alike? “That you need to change out all breast implants every 10 years,” he says. While observing the implants for possible rupture is part of long-term post-op maintenance, [implant replacement](https://aedit.com/procedure/breast-implant-removal) does not happen on one set timeline. “At 10 years, there is an increased risk for complications associated with implants,” he admits. “But, if it ain't broke, don't fix it.”

## **The Takeaway** 
All plastic surgery is personal, and [breast augmentation with implants](https://aedit.com/aedition/breast-augmentation-recovery-healing-process) is no exception. As Dr. Buford explains, your ‘after’ will be more impacted by your ‘before’ than by the implant itself. “Your tissue quality, degree of symmetry (or lack thereof), and the overall appearance of your breasts are far more important than the specific style of implant used,” he shares. Consider that all the more reason to ensure you [find a plastic surgeon](https://aedit.com/aedition/finding-the-right-plastic-surgeon-dermatologist-or-cosmetic-dentist) who understands your aesthetic goals.

You’re curious about breast augmentation with implants but don’t know the difference between silicone or saline, round or teardrop, textured or smooth. We’re here to help. 

Guide To Breast Implant Type, Shape, Texture, Size, And More

Breast Implants 101: Your Guide To Type, Shape, Texture, And More

shutterstock 1799310610

If you’ve been to a cosmetic dermatology or plastic surgery practice lately, you may have noticed a licensed aesthetician (or two) on the team — and it’s for good reason. Even the best aesthetic procedures and surgeries cannot make up for poor skin quality, and that is where the expertise of aestheticians comes into play. “It is important to have synergy between surgical and non-surgical treatments for patients, especially those undergoing facial procedures,” [Shay Moinuddin, RN, MS, CANS](https://www.fewinstitute.com/about/shay-beauty-rn/), senior aesthetic nurse and clinic director at [The Few Institute](https://www.fewinstitute.com/) in Chicago. 

The relationship between the services medical professionals offer and what aestheticians can provide is often what ends up giving patients the most comprehensive *and* lasting results. Case in point? “When our [facelift](https://aedit.com/aedition/popularity-of-facelift-cosmetic-surgery-for-aging-sagging-neck) patients maintain the health of their skin by undergoing medical-grade skincare procedures, it not only enhances and prolongs the results of their surgery, it assists in maintaining the health of their skin,” Moinuddin notes.  

We often talk about the importance of [credentials](https://aedit.com/aedition/finding-the-right-plastic-surgeon-dermatologist-or-cosmetic-dentist), [specialities](https://aedit.com/aedition/how-to-find-a-plastic-surgeon-who-specializes-in-cosmetic-procedures-for-men), and [board certification](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) as it relates to doctors and surgeons, but it’s equally important for you to understand the value and role of aestheticians. In honor of National Aesthetician Day on October 15, we’re breaking down everything you need to know about the role these skin experts play in aesthetic medicine with the help of some top providers.

## **So, What Is an Aesthetician?**
Regardless of which way you spell it (with or without the ‘a’), the crux of the role remains the same. “Aestheticians are skincare technicians,” says [Sandra Peraza](https://pfrankmd.com/sandra-peraza/), master aesthetician at [PFRANKMD by Dr. Paul Jarrod Frank](https://pfrankmd.com/) in New York City. 

In that role, Peraza and her peers are laser-focused on the health of clients’ complexions both when they are in the office and when they are tending to it themselves at home. “As an aesthetician, I perform skincare treatments for patients who have minor problems on the skin’s epidermal layer,” she explains. “I also design the best [skincare routine](https://aedit.com/aedition/best-skincare-routine-products-ingredients-for-20s) for balance, radiance, maintenance of the skin’s health and vitality, and improving its overall look.”

Aestheticians, especially those that work within a larger aesthetics practice, are able to assess a client’s entire professional and at-home regimen and develop a treatment plan accordingly. “During my initial consultation with a patient, I spend about 30 minutes discussing goals, prior aesthetic history, medical history, and current products being used,” says [Emily Mariscal, LE](https://www.fewinstitute.com/about/tfi-staff/), senior medical aesthetician at The Few Institute. “I focus on educating a patient on what the skin really needs and ways I can incorporate our skin services in that mix.” 

As it relates to education, sometimes a bit of tough love is in order. “I also provide my professional recommendations to tweak their regimen,” Mariscal shares. “To be frank, most people are using way too many active acids on their skin these days causing redness, irritation, and inflammation.” Righting those wrongs is a big part of the role. “My job is to go over key [active ingredients](https://aedit.com/aedition/safely-trying-new-skincare-products-ingredients) in their skincare, why they shouldn’t over-exfoliate with too many anti-aging products, and just help simplify their regimen,” she adds.

As Peraza notes, the [facials](https://aedit.com/procedure/facials) and treatments aestheticians offer “are meant to be corrective and preventative.” But that doesn’t mean they are short on ambiance. “I perform a mix of corrective treatments tailored to each individual's particular skincare needs all within the confines of a relaxing experience,” says Danielle Gamble, an aesthetician at [The Spa at Fifth Avenue Aesthetics](https://www.mariehayagmd.com/) in NYC. “My clients leave refreshed with their skin glowing.” 

In fact, it’s that mix of form and function — delivering high-quality, visible results in a less clinical environment — that helps keep clients returning again and again.

## **The Relationship Between Aestheticians & Healthcare Providers**
Aestheticians are the skin whisperers who keep your complexion healthy and happy so that it is properly prepped and ready to go for any additional treatments or procedures you have planned. As such, they are, as Peraza describes, a “natural ally” to healthcare providers. 

She says her “main role” is to “focus on the longevity and maintenance of treatment results in between cosmetic procedures to improve efficacy,” which is very much a team effort. “I work with my aesthetician to create a synergy to treat and maintain skin’s health,” explains [Paul Jarrod Frank, MD](https://pfrankmd.com/), a board certified dermatologist and founder of PFRANKMD. “Patients have customizable treatments with our aesthetician, who is familiar with their cosmetic treatments performed in the office.”

Collaboration is a hallmark of care at The Few Institute, too. “We find the right fit for the given person’s goal and are an advocate for their best interest and results,” says [Julius Few, MD](https://aedit.com/provider/julius-few-md-15580), a board certified plastic and reconstructive surgeon and founder of The Few Institute. “We offer an integrated approach to patient care and coordinate all aspects of our approach.” As a result, Moinuddin says she works “very closely with aestheticians to create short- and long-term treatment plans” that are efficacious and budget conscious. “It makes patient continuity of care much more efficient when patients receive their skincare, injectable treatments, and minimally invasive skincare treatments in the same practice setting,” she notes. 

In some cases, doctors and surgeons refer patients to aestheticians for additional care, but the referral process can work in the other direction, too. “I advise my patients to the various skincare facials and medical-grade devices the aestheticians utilize that best suit their needs based upon my assessment and/or the cosmetic procedure performed,” explains [Marie Hayag, MD](https://www.mariehayagmd.com/), board certified dermatologist and founder of Fifth Avenue Aesthetics in NYC. “Likewise, many of my aestheticians have their own clientele that, based upon their assessment, will have me visit after a treatment for my medical assessment.”

That constant communication is all for the client/patients’ benefit. “This holistic skincare approach allows for the best possible patient outcome to meet their skincare goals and needs,” Dr. Hayag shares. “It is a wonderful thing for physicians and aestheticians to work together as a team to provide the ultimate beauty plan for each client.”

## **The Role of Aestheticians in Aesthetic Medicine**
At this point, you’ve likely gleaned that aestheticians play a key role in aesthetic medicine. “Patients can have the best facial plastic surgery outcomes, but, if their skin is wrinkled, sun damaged, etc., their surgical results won't shine through as well,” Moinuddin says. “A good aesthetician will put his/her patient on a consistent in-office skincare regimen that alternates exfoliation, energy-based skin tightening, laser therapy, and [medical-grade skincare products](https://aedit.com/aedition/maintaining-skin-with-devices-skincare-products-between-cosmetic-procedures).”

As technology continues to advance, so too does the capability of aestheticians. “When a licensed esthetician has at their disposal the latest devices, we can tailor a regular skincare regimen and treatment plan corresponding to the procedure performed and concern identified by the board certified dermatologist,” Gamble explains. “This synergy leads to optimal patient satisfaction and outcomes.” 

Dr. Hayag describes the role of Gamble and the other aestheticians at The Spa at Fifth Avenue as “complementary” to the work she does. “The treatments they provide improve medical cosmetic treatment outcomes,” she says. “Interaction between cosmetic procedures and medical-grade spa skincare treatments absolutely produce a combined effect greater than an individual procedure alone.” 

For example, she usually recommends that patients who undergo [cosmetic laser treatments](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing) schedule an [LED therapy session](https://aedit.com/procedure/led-light-therapy) with one of her certified lead aestheticians for the same day. “This light therapy device immediately reduces redness and inflammation and soothes the affected area while also boosting collagen production,” Dr. Hayag shares. Additionally, she suggests “regular” radiofrequency (RF) and [microcurrent](https://aedit.com/aedition/difference-between-professional-at-home-microcurrent-facials) treatments to “increase collagen and elastin production.” [RF microneedling](https://aedit.com/procedure/microneedling-with-radiofrequency), meanwhile, can “reduce fine lines, [acne scarring](https://aedit.com/concern/acne-scars), and sun damage.” “This comprehensive approach leads to better sustained outcomes and a superior overall patient experience,” she adds.

And let us not forget the [preventative nature](https://aedit.com/aedition/i-was-practicing-prejuvenation-before-it-was-a-trend) of these skincare treatments. “Many patients are realizing that quarterly or even monthly treatments from a licensed aesthetician utilizing the latest in skincare devices under a physician’s guidance are part of a routine that will greatly enhance their skin’s appearance and health,” Dr. Hayag says. The sooner you start, the more likely you are to successfully slow the effects of skin aging.

## **What Your Aesthetician Wants You to Know**
Before we let you go, here are three things that Mariscal, Gamble, and Peraza say you should know about what they can (and cannot) do for your complexion:

### **1. They Aren’t Doctors**
“Some people may not understand the level of education and experience aestheticians have, especially those who work in a medical setting,” Moinuddin says. “They usually have undergone extensive training and truly are experts in skin health.” With that said, they did not go to medical school. “We aren’t doctors,” Mariscal emphasizes. “I’m happy to assist patients with the wealth of knowledge that I’ve obtained over the years for certain skin issues, but I always recommend seeking medical attention for serious skin conditions like [eczema](https://aedit.com/aedition/best-skincare-products-to-treat-eczema-flare-ups-in-the-winter), [psoriasis](https://aedit.com/aedition/what-its-like-to-live-with-and-treat-psoriasis), dermatitis, or [possible allergic reaction](https://aedit.com/aedition/difference-between-sensitive-vs-sensitized-skin) they’ve gotten from use of a product.”

### **2. They Aren’t Just Putting Products on Your Face**
“There is, at times, a misunderstanding of the importance and long-term benefit a licensed aesthetician can add to a person's overall skincare health and beauty,” Gamble laments. The skincare treatments aestheticians offer can go a long way towards defending against premature signs of aging. “Many of the treatments I provide can reduce [inflammation](https://aedit.com/aedition/guide-to-inflammaging), aid in the healing and prevention of [acne](https://aedit.com/concern/acne), and increase [collagen](https://aedit.com/aedition/guide-to-collagen-in-skincare-supplements-aesthetic-medicine) production,” she says. But that’s not all.  “A reputable aesthetician has a vast knowledge of skincare products and their ingredients to recommend for a customized [at-home regimen](https://aedit.com/aedition/best-mens-skincare-routine-products-ingredients-for-20s) for their clients,” she adds. The net-net: “A [facial](https://aedit.com/aedition/what-its-like-to-get-a-hydrafacial-for-clear-glowing-skin) is so much more than putting creams on the face,” Gamble emphasizes.

### **3. They Work on the Skin in a Specific Way**
In keeping with lesson number one, there is a limit to what aestheticians are qualified to do. “While aestheticians serve an important role in the health and maintenance of the skin, they cannot perform treatments such as [Clear + Brilliant®](https://aedit.com/procedure/clear-brilliant), [Ulthera®](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy), and other types of lasers commonly offered in medspa settings,” Peraza cautions. “Such treatments must be performed by a healthcare provider.” The reason? “As an aesthetician, we work mainly on the epidermis, while more aggressive treatments, such as lasers, work beneath this layer,” she explains. Consider this yet another illustration of the importance of the relationship between medical providers and aestheticians in aesthetic medicine.

## **The Takeaway**
If you have your dermatologist or plastic surgeon on speed dial, it’s high time to add an aesthetician to your rolodex as well. “[Aestheticians] complement the in-office treatments I perform by helping to manage issues such as pigmentation, moisture, acne, etc.,” Dr. Frank says. As Peraza puts it, she brings her “skills and experience on how to care for skin” as she “guides patients how to take care of their skin at home and as they undergo any medical cosmetic procedure.” 

At the end of the day, aestheticians are the advocate your complexion craves. “Contrary to popular belief, you don’t need a 13-step skin regimen to have glowing skin,” Mariscal shares. “Being a [minimalist](https://aedit.com/aedition/skinimalism-skincare-trend) with products, treatments, and injectables is our mantra for youthful, glowing, natural-looking results.”

In honor of National Aesthetician Day, we are breaking down the important part these skin experts play in the aesthetic journey.

The Role Of Aestheticians In Aesthetic Medicine, Skincare, Skin Health 

The Role Of Aestheticians In Aesthetic Medicine

feeh-costa-JYm-kkXE f8-unsplash

In case you haven’t heard, September 6 is National Read a Book Day. And while we are so grateful for the time you spend reading the content we create here on The AEDITION, we’d be remiss not to let you in on a few of our favorite topical tomes that were written by some of our go-to experts. From the secrets of Park Avenue plastic surgery to the history of makeup, we’re rounding up the best books about aesthetics, beauty, and wellness from some of the foremost thought leaders in the industry.

### **For the Pre-Op Phase**: The Boob Job Bible: Your Ultimate Guide to Breast Surgery
![AEDIT-DrBuford](//images.ctfassets.net/zw35sfestf1t/3dsNebxQRu92B9f3YnD2EQ/2ab2bbc1f476c7ef7d61ff1b0c432539/AEDIT-DrBuford.jpg)
Perfect for the patient who is considering going up a few cup sizes, Denver-based board certified plastic and reconstructive surgeon [Gregory Buford, MD](https://aedit.com/provider/gregory-buford-md-1015), has assembled the ultimate guide to breast augmentation. From choosing the right implants and timing for your procedure to ensuring a safe and healthy recovery, Dr. Buford dispenses expert tips and insights gleaned from his 20 years in practice. *download your copy at* [beautybybuford.com](https://www.beautybybuford.com/the-boob-job-bible-guide-breast-enhancement/)  

### **For the Skincare Savant**: Heal Your Skin: The Breakthrough Plan for Renewal
![AEDIT-DrShamban](//images.ctfassets.net/zw35sfestf1t/3oVxMr0CjXfoyNIdj86TAs/5b6f145de981a8eba9fead59f32c6eae/AEDIT-DrShamban.jpg)
Consider this book the next best thing to a consultation with Beverly Hills-based board certified dermatologist [Ava Shamban, MD](https://aedit.com/provider/ava-shamban-md-2325). Since the prescription for a happy, healthy complexion is anything but one-size-fits-all, Dr. Shamban offers an array of skincare, nutrition, and fitness tips with specific regimens tailored to age, skin type, and concerns. Basically, there is something for everyone. $32, [barnesandnoble.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.barnesandnoble.com%2Fw%2Fheal-your-skin-ava-shamban%2F1100259724%3Fean%3D9781630260989) 

### **For the History Buff**: Face Paint: The Story of Makeup
![AEDIT-LisaEldridge](//images.ctfassets.net/zw35sfestf1t/75I2oipPQ82EkrP7YPyFHi/d10081cabc5930d3dace838a8c6b3cc8/AEDIT-LisaEldridge.jpg)
Makeup, as we know it today, has only come about in the last century or so, but the concept of decorating one’s face has dates back to ancient times. Here, celebrity makeup artist [Lisa Eldridge](https://www.instagram.com/lisaeldridgemakeup/?hl=en) explores the history of makeup as an art form and how the products themselves have evolved. You don’t have to be interested in cosmetics to appreciate its cultural significance, which is exactly what Eldridge’s tome uncovers. $27, [bookshop.org](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fbookshop.org%2Fbooks%2Fface-paint-the-story-of-makeup%2F9781419717963) 

### **For the Prospective Patient**: The Real Beauty Bible: Navigating Your Journey Through Plastic Surgery
![AEDIT-DrBrown](//images.ctfassets.net/zw35sfestf1t/2oIUFeeOoJasgbzLuO5l7d/7ac345581677348b87ffd80f2c525f36/AEDIT-DrBrown.jpg)
Interested in cosmetic procedures but not sure where to start? [Richard Brown, MD](https://www.richardjbrownmd.com/), a board certified plastic and reconstructive surgeon in Scottsdale, AZ, has assembled a comprehensive manual to guide patients from research through recovery. Discover treatments, get advice on how to find the right provider, and learn more about what to expect pre- and post-op. Consider this a must-read prior to having a procedure. $25, [barnesandnoble.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.barnesandnoble.com%2Fw%2Fthe-real-beauty-bible-richard-j-brown-md%2F1131663282) 

### **For the Best Tressed**: True Color: The Essential Hair Color Handbook
![AEDIT-TraceyCunningham](//images.ctfassets.net/zw35sfestf1t/7E40r40CAIuK2VRpYLOZ5F/89bd5d9ade23e4eb4450ccbb6db658ab/AEDIT-TraceyCunningham.jpg)
It may sound counterintuitive to hear a celebrity hair colorist advocate for minimalism, but that is precisely what [Tracey Cunningham](https://www.instagram.com/traceycunningham1/?hl=en) does in her new book. If you are in search of a look that requires minimal effort to pull together, she says embracing your original shade — which she calls your [“true color”](https://aedit.com/aedition/tracey-cunningham-true-color-hair-tips) — is your best bet. To prove her point, the pages are filled with childhood pics of stars like Jessica Biel and Maria Sharapova that illustrate how she has been able to honor their, well, roots. Oh, and she also offers tons of healthy hair tips along the way. $27, [barnesandnoble.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.barnesandnoble.com%2Fw%2Ftracey-cunninghams-true-color-tracey-cunningham%2F1137392850) 

### **For the Wellness Guru**: Beauty from the Inside Out: Makeup, Wellness, Confidence
![AEDIT-BobbiBrown](//images.ctfassets.net/zw35sfestf1t/43IbDIZ4n6XRMFr5y5wrMQ/52d139aff47e9a7b9babbafa213d667c/AEDIT-BobbiBrown.jpg)
No one knows their way around a your-face-but-better beauty look better than celebrity makeup artist [Bobbi Brown](https://www.instagram.com/justbobbidotcom/?hl=en), but her most recent writing makes the case that true beauty comes from within. The book pairs makeup tutorials and skincare advice with healthy recipes and fitness inspo from leading wellness experts and Brown herself for a holistic guide to beautifying your life. $25, [bookshop.org](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fbookshop.org%2Fbooks%2Fbobbi-brown-beauty-from-the-inside-out-makeup-wellness-confidence-modern-beauty-books-makeup-books-for-girls-makeup-tutorial-books%2F9781452161846) 

### **For the Aesthetically Curious**: The Park Avenue Face: Secrets and Tips from a Top Facial Plastic Surgeon for Flawless, Undetectable Procedures and Treatments
![AEDIT-Jacono](//images.ctfassets.net/zw35sfestf1t/6I5jKHImXII6xks0b6Okeh/dd0693d933db4583148e336ad7d2e942/AEDIT-Jacono.jpg)
If you’ve ever wondered how the ladies and gentlemen of the Upper East Side age gracefully, look no further than this piece from [Andrew Jacono, MD](https://www.newyorkfacialplasticsurgery.com/), a double board certified facial plastic and reconstructive surgeon in NYC. The man behind [Marc Jacobs’ facelift](https://aedit.com/aedition/marc-jacobs-facelift) sheds light on his natural approach to aesthetic medicine, so you too can tap into the fountain of youth. $30, [bookshop.org](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fbookshop.org%2Fbooks%2Fthe-park-avenue-face-secrets-and-tips-from-a-top-facial-plastic-surgeon-for-flawless-undetectable-procedures-and-treatments%2F9781946885975) 

### **For the Francophile**: Ageless Beauty the French Way: Secrets from Three Generations of French Beauty Editors
![AEDIT-ClemenceVonMueffling](//images.ctfassets.net/zw35sfestf1t/68mcaSC1RTzW10Uo3ebVpT/6b87a498b5c46473f1c2d34ad1df7d93/AEDIT-ClemenceVonMueffling.jpg)
If a year and a half of staying close to home has you yearning for a trip abroad, this read from Parisienne beauty expert [Clémence von Mueffling](https://www.instagram.com/beautyandwb/?hl=en) is just what the doctor ordered. With a mother and grandmother who were both beauty editors at *French Vogue*, von Mueffling dispenses three generations worth of skincare, beauty, and wellness secrets that will have you well on your way to capturing that certain je ne sais quoi French women embody — no passport required. $28, [barnesandnoble.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.barnesandnoble.com%2Fw%2Fageless-beauty-the-french-way-clemence-von-mueffling%2F1127173959%3Fean%3D9781250151605) 

### **For the Makeup Maven**: Making Faces
![AEDIT-KevynAucoin](//images.ctfassets.net/zw35sfestf1t/5L9EFhrVQBBIW5RN7qjFtO/887e1e9658c72f701f64267fa81b61fc/AEDIT-KevynAucoin.jpg)
First published in 1997, this *New York Times* bestseller by the legendary [Kevyn Aucoin](https://kevynaucoinbeauty.com/) stands the test of time. With some 200 photos and sketches, the late makeup artist shares the secrets behind his iconic looks while also offering a masterclass on application techniques that will help even the most novice familiarize themselves with the fundamentals. Consider this the OG makeup tutorial. $22, [bookshop.org ](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fbookshop.org%2Fbooks%2Fmaking-faces%2F9780316286855)

### **For the Prejuventor**: The Pro-Aging Playbook: Embracing a Lifestyle of Beauty and Wellness Inside and Out
![AEDIT-DrFrank](//images.ctfassets.net/zw35sfestf1t/5STPmx75Th2pyVlsnuXgHU/bce07792c85f98c5dfdb99a7fb0394e6/AEDIT-DrFrank.jpg)
Because it is far easier to prevent signs of aging than it is to correct them, NYC-based board certified dermatologist [Paul Jarrod Frank, MD](https://pfrankmd.com/), has compiled his 360-degree approach to healthy — and youthful — living. From cosmetic treatments and products to lifestyle and wellness habits, Dr. Frank offers outside-in *and* inside-out techniques that will transform your perspective on beauty and aging. $27, [barnesandnoble.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.barnesandnoble.com%2Fw%2Fthe-pro-aging-playbook-paul-jarrod-frank-md%2F1136471809)

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

Expert Opinion

In honor of National Read a Book Day, we are rounding up the best books about beauty, wellness, and aesthetics from some of the foremost thought leaders in the industry.

The Best Books About Plastic Surgery, Makeup, Beauty

The 10 Best Books For The Beauty And Aesthetics Obsessed

shutterstock 736667047

One trend that doctors are seeing — and it’s not a positive one — is so-called [doctor hopping](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3552465/). The practice involves patients constantly bouncing amongst different cosmetic providers in hopes of achieving their aesthetic goals for as little money as possible and with little to no regard for the skill-level or certification of the doctor. “I wish I had a concrete answer as to why so many patients jump from doctor to doctor to doctor, but there are various reasons why it happens,” says [Michele Green, MD](https://aedit.com/provider/michele-green-md-34642), a board certified dermatologist and clinical instructor at Mount Sinai Hospital in New York City.
 
As more people get work done and talk about it, conversations around aesthetic medicine have, in many ways, normalized. “The number of people seeking aesthetic treatments continues to increase,” says [Farhad Ardesh MD](https://aedit.com/provider/farhad-ardesh-md-19202), a double board certified facial plastic and reconstructive surgeon in Beverly Hills. “Patients see celebrities, friends, and even family members receiving treatments, and they want to look their best, too.” But what these prospective patients often underestimate is the time, cost, and safety precautions involved. Here, top dermatologists, plastic surgeons, and psychologists reflect on the dangerous trend.

## **The Reasons for Doctor Hopping**
As [Julius Few, MD](https://aedit.com/provider/julius-few-md-15580), a board certified plastic and reconstructive surgeon in Chicago, explains “most patients jump around between doctors to get the outcome they want independent of the advice they may have received from a trusted authority.” This can quickly spell T-R-O-U-B-L-E. “There are countless ads out there for the impossible, often posted by individuals who are not adequately trained,” he says. 

It’s not just advertising that lures consumers to partake in doctor shopping. [Social media](https://aedit.com/aedition/march-2020-study-shows-relationship-between-social-media-cosmetic-surgery) is a culprit, too. “Instagram, TikTok, and other forms of social media contribute to the desire for everyone to want to look their best,” Dr. Ardesh notes. “Some want to look like their favorite influencers or celebrity and are willing to go to any extreme to achieve that goal.” The problem with social media is that what you see is rarely what you get. “Remember, social media is full of tricks, like great lighting, body positioning and editing with filters and photo editing apps,” he cautions. “These factors create [unrealistic expectations](https://aedit.com/aedition/how-plastic-surgeons-balance-patients-cosmetic-surgery-desires-and-safety) that followers try to achieve.” 
 
Another motive for doctor hopping? [Being told no](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6679752/). Dr. Few says that if a patient does not like the advice or recommendation given (even if that suggestion is *not* to do a procedure), they’ll go ahead with it anyways. “I have had hundreds of cases over the past 20 years where a patient will ask for surgery or a cosmetic procedure, and I give them a clear, scientific reason as to why I am not willing to do the procedure; yet, they will go to someone much less experienced who believes they can deliver magic,” he shares. More often than not, he sees those patients again. “In the end, the patient comes back to me wanting to undo or fix what the other surgeon did,” he says. 

Similarly, Dr. Green performs a lot of revisions. “Half of the time, I end up fixing the work of another doctor or injector who screws up the patient because the patient — for whatever reason — came to me, then went to see someone else who they’re unhappy with, and then ends up back in my office,” she explains. “It can be a vicious cycle.”
 
Then, of course, there are the bargain shoppers. “Many of these treatments can be expensive and patients want to find the best deal,” says [Roseann Capanna-Hodge, EdD](https://drroseann.com/), a psychologist and integrative medical health expert in Ridgewood, CT. “Unfortunately, most of the discounted prices and deals are offered by less experienced providers, and they come at a cost (think: a lack of skills to properly evaluate, plan, and perform the treatment).” The psychological power of a sale runs deep. “Plenty of people hear of a deal or see a promo and, even if they aren’t due for a treatment or really need it, get it done anyway because they can’t pass up the savings,” Dr. Green adds. 

## **The Risky Business of Doctor Hopping**
“Those who are desperate to fix their physical appearance often make poor decisions,” says Dr. Capanna-Hodge. “There is a false belief that you can bargain shop for everything — including low-cost medical procedures from unqualified or inexperienced providers.” That desire for a discount often outweighs safety concerns. “Many would rather cut corners instead of investing in a provider that is not only experienced but provides safe quality care,” she notes.
 
Doctor shopping is more common with noninvasive procedures simply because patients believe it is easier to dupe their provider. But that doesn’t mean it doesn’t apply to surgery as well. And, as Dr. Few explains, the onus is on the doctor to do their due diligence. “Doctors need to play the role of investigative reporter before agreeing to treat these types of patients,” he says. “Often, I insist the patient give me their records from other places of treatment.” Over the years, he’s also learned some telltale signs of prior work. “Even if the patient does not share that they doctor shop, a trick to figure it out is to ask them to lift their brows and squint for signs of Botox®,” Dr. Few explains. “If they have signs of Botox® or previous surgery, I ask why they are not seeing the person who did their original work.” 

It's not just the lack of patient-provider honesty that makes doctor hopping problematic. It’s a slippery slope because of the large number of unqualified providers out there. While It’s difficult for patients to categorize an unqualified provider as the real deal, it’s also tricky to distinguish between authentic products, knockoffs and watered-down versions of the original. Any time anything is injected into your face or body, ask to see the bottle and verify that the product is in fact what it is supposed to be. “Usually, someone willing to do this type of thing is cutting corners,” Dr. Few warns. “It’s common for the person claiming to perform Botox® or Xeomin® for $5 a unit (less than the cost of the product) is likely getting it from an illicit place or watering it down so that it does not work as well or for as long as it should.”

Even if a patient is not well-versed in what to look for in a provider, dermatologists and surgeons know what red flags to look for in patients. “I question the ones that see a half-dozen different doctors and say, ‘no one is good,’” Dr. Green says. “Why has one patient been to so many doctors in a short time? What is the underlying reason why they can’t stick to a single doctor?” 

Dr. Few also keeps an eye on patients who talk about all the various places and doctors who have treated them. “This is a red flag,” he cautions. For some, doctor hopping is a way of life, but it’s like playing Russian roulette. “When doctors and services are treated as commodities such as purchasing groceries or gas, you may not receive the best outcome,” Dr. Ardesh says. “Aesthetics is still a part of medicine and it should be treated as such.”

## **The Dangers of Doctor Hopping** 
There are serious consequences — some even life-threatening — that can result from doctor shopping. “One little mistake and your life can be in danger and the damage will be permanent,” Dr. Capanna-Hodge says. “When it comes to cosmetic procedures, it’s best to think about why you’re getting the procedure, what it will do for you in terms of happiness, confidence, etc., and research the most qualified provider.” While finances will obviously play a role in the decision making process, don’t let [budget](https://aedit.com/aedition/how-much-cosmetic-surgery-costs) be *the* deciding factor. “If money is an issue, then reconsider your options and revisit when you have the funds to do so,” she suggests.

Here is just a sampling of the things that can go wrong when patients choose to crowdsource their care or see unqualified providers:

### **1. An overfilled face that appears distorted**
The entire face is fair game for overfilling, though the lips and cheeks usually take center stage. Some patients chase an overly plump aesthetic and seek out multiple doctors and rounds of treatments to obtain their ideal look. Poor technique is also often apparent. “Recently, I saw a patient who had her temples injected by another provider,” Dr. Green shares. “One side of her face looked injected, the other looked hollow. Needless to say, she wasn’t happy, and I had to correct it.” 

### **2. A blue-ish tint to the under-eye skin** 
Injecting [filler under the eyes](https://aedit.com/procedure/under-eye-filler) can erase hollowness and give an instant refresh, but, if the product is placed too superficially or the wrong filler is used, the skin can appear blue. Known as the Tyndall effect, the only way to reverse the pigment is by dissolving the hyaluronic acid-based filler with an enzyme called hyaluronidase. 

### **3. Excessive scarring**
Scars are an expected part of any surgery, but abnormal [scarring](https://aedit.com/aedition/minimizing-scars-after-surgery) (think: those that are painful, extremely thick, and easily infected) are not the norm and require patience, time, and TLC to correct.

### **4. Hard-to-fix lumps and nodules**
Here’s another reason why you shouldn’t let just anyone inject you, and why you should only do what is necessary, when it’s necessary: lumps and nodules. An overabundance of product (or the wrong product) can cause asymmetries, lumps, bumps, and nodules. If hyaluronic acid is used, it can usually be reversed. But with [biostimulatory injectables](https://aedit.com/aedition/everything-you-need-to-know-about-dermal-fillers) or products like silicone that are not approved by the United States Food and Drug Administration (FDA), there’s little to nothing that can be done to correct the issue. 

### **5. Painful hematomas & seromas**
Although hematomas only occur in about 1 percent of [breast augmentation](https://aedit.com/procedure/breast-augmentation-solutions) surgeries, they can develop from any type of cosmetic surgery. [Hematomas](https://academic.oup.com/asj/article/37/10/1175/3112265), which are pockets of blood that collect outside of the blood vessels, resemble a large, dark bruise, are painful and require additional procedures to remedy. Seromas, which are a pooling of fluid under the skin, can also form when surgery is performed by an unqualified surgeon. 

### **6. Skin that displays signs of hyperpigmentation**
It’s not just injectables and fillers that can cause problems — [lasers](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing), in the wrong hands and without proper understanding of the patient’s skin tone, can be dicey, too. If the wrong setting is used on [darker skin tones](https://aedit.com/aedition/best-laser-skin-hair-removal-treatments-for-darker-skin-tones) or those that have certain undertones, hard-to-fix hyperpigmentation and melasma can easily ensue. “A patient may be of Asian or Mediterranean descent, but they may not look it, or they have darker undertones in their skin,” Dr. Green explains. “If a patient’s true skin type isn’t considered when it should be, the wrong device is used or the setting is placed too high for their skin, they will pigment.” When that happens, there is no easy remedy. “Some patients end up with [melasma](https://aedit.com/concern/melasma), which isn’t an easy fix,” she says. “Correcting pigment takes a very long time and a series of peels, lots of topicals, and other treatments to rectify the discoloration.” 

### **7. Loss of mobility**
Although it is rare, permanent loss of mobility, both to the face and body, can occur after surgery. “I have seen patients who are not candidates for blepharoplasty have surgery and, in the end, are unable to close their eyes because the surgeon did not have enough experience to know better,” Dr. Few recalls. “It is critical to always ask what the risks and the benefits are.” The way he sees it, the onus is on board certified surgeons to properly assess prospective patients. “If someone the doctor hops, it’s the doctor’s responsibility to slam on the brakes and make sure you know what is going on,” he says.

### **8. Permanent disfigurement**
Perhaps the most severe and debilitating side effect is permanent disfigurement, which can be a complication of both surgical *and* non-surgical procedures. Nerve damage, permanent numbness, and tingling that doesn’t subside can be serious long-term effects, and there’s also the rare complication of blindness if filler is injected into an artery.

## **The Takeaway**
We get one body, and aesthetic treatments to enhance it are not a place to cut corners. While there is always a chance that complications can arise from any procedure — invasive or non-invasive — even in the most qualified hands, [finding a board certified doctor or surgeon](https://aedit.com/aedition/finding-the-right-plastic-surgeon-dermatologist-or-cosmetic-dentist) who specializes in the treatment(s) you are interested in and understands your aesthetic goals is the best way to minimize risk. At the end of the day, there is little to gain but a whole lot to lose from rolling the dice with your care.

For those that think visiting numerous doctors for fillers and injectables in a short period of time is the way to go, we are here to tell you it does more harm than good. Four experts explain why it's never a good idea.

The Dangers Of Doctor Hopping For Cosmetic Procedures

Why Doctor Hopping Is A Major No-No

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All scars form for the same reason — a [surgery](https://aedit.com/aedition/minimizing-scars-after-surgery), [burn](https://aedit.com/aedition/how-to-treat-first-second-third-degree-burns), cut, [acne spot](https://aedit.com/concern/acne-scars), or trauma of some sort occurs, which signals a dermal healing response that recruits inflammatory cells. “Living animals all have a natural ability to attempt restoration of function and repair damage to the body after an injury.” explains [James Beckman, MD](https://aedit.com/provider/james-beckman-md-34641), a board certified plastic and reconstructive surgeon and founder of [Therapon Skin Health](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Ftheraderm.net%2F). “Whether it is skin, other tissue, or even entire organs, scar formation is the first step.” The purpose? “It serves to cover open areas, preventing bacteria from entering and keeping tissues from drying out,” he says.

When you consider the state our bodies would be left in without the ability to scar, it’s a pretty remarkable phenomena. “If our skin would not scar, we would be walking around with big open wounds, which is why scarring is a necessity,” says [Gregory Buford, MD](https://aedit.com/provider/gregory-buford-md-1015), a board certified plastic and reconstructive surgeon in Englewood, CO. “It’s just that society has determined that it’s not pretty.” He likens scars to a kind of biological glue. 

With that said, there is no rhyme or reason to how the body responds to injury, which means you can be left with some pretty [unique scars](https://aedit.com/concern/scars). If you are unhappy with the appearance of a scar — no matter where it came from — there are ways to minimize it. Read on for both at-home and in-office [scar solutions](https://aedit.com/procedure/scar-solutions).

## **What Determines the Appearance of a Scar**
Even on the same person, no two scars heal the same. As [Jessica Weiser, MD](https://aedit.com/provider/jessica-weiser-md-34640), a board certified dermatologist in New York City, explains, there are several reasons why scars settle uniquely, including: 

- Extent of the injury
- Location of the wound
- Genetics
- Body’s collagen response (i.e. how much of the protein, which is like the building block of skin, is made)

“When new collagen forms, the bundles fill in a wound in the dermis (the second layer of skin),” she says. When just the right amount of collagen is produced, the scar is flat; too much collagen leads to thick, rope-like raised scars and keloids. All scars start red and, as they mature, transform to pink and then white. 

Like a good piece of real estate, the end result is all about location, location, location — certain parts of the body are better equipped to handle the formation of a scar than others. “Luckily, on the face, there is a good blood supply, so the area tends to heal more readily there,” says [Amanda Doyle, MD](https://aedit.com/provider/amanda-doyle-md-31526), a board certified dermatologist at Russak Dermatology Clinic in New York City. The same cannot be said the further south you go. “As you get towards the waist and further down, the blood supply is farther from the heart, so it takes a lot longer to heal because of the location,” she shares. 

Another factor that affects scarring is tension. “In areas like the shoulder or the back, there is a lot of pulling and tugging, and that can lead to a wider-looking scar because of constant tension in that location,” Dr. Doyle adds.

## **Types of Scars**
Scars are like snowflakes — no two are identical. At the most macro level, scars can be classified into two categories:

1. **Sunken (a.k.a. atrophic)**: “Sometimes, there is an absence of fat or other underlying structures that the body cannot fill in and scars end up atrophic or indented,” Dr. Doyle explains. 
2. **Raised (a.k.a. hypertrophic)**: “In other circumstances, the body stimulates an overly exuberant response that causes excess scar tissue clinically appearing as raised or keloid-type scars, which are typically the most challenging ones to treat,” she says. “Even with treatment, they may recur or may not respond as readily.” 

Moving to a more micro level, there are specific types of scars within those initial classifications:

### **Atrophic Scars**
- **Ice Pick Scars**: Deep and narrow but small, ice pick scars almost always have a tie to [nodular or cystic acne](https://aedit.com/concern/acne). Resembling a puncture wound of sorts, ice pick scars are commonly categorized as indented skin and occur on the cheeks.
- **Boxcar Scars**: Rounder in shape and resembling more of a crater, boxcar scars are wider than an ice pick scar but not as wide as rolling scars. They are often due to acne, and the deeper they are, the harder they are to treat. 
- **Rolling Scars**: Reminiscent of a pit but with undefined edges, the more common rolling scars give the area an almost wavy texture and can worsen with age due to a loss of elasticity and collagen in the skin. 

### **Hypertrophic Scars**
While not all hypertrophic scars are keloid scars, keloids are perhaps the best known raised scars. They are also considered among the most difficult to treat. Keloids tend to be wide, large, and puffy and occur after a surgery, cut or wound, or even piercing. As Dr. Buford explains, keloids grow outside of the boundaries of the scar and are technically tumors (tumors, by definition, are a growth in the skin and can be noncancerous). 

Keloids tend to be more common in people with darker skin (but any [skin tone](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types) can develop them). “Although keloid scarring generally tends to happen in Asians and African Americans, we don’t fully know why it affects certain skin tones,” Dr. Doyle says. “It’s related to the whole inflammatory process and collagen being re-formed in those areas of injury.” For whatever reason, some people experience that inflammatory response a little more robustly than others, and, “particularly in those two populations, we see it more frequently,” she adds.

## **At-Home & In-Office Scar Treatments**
Scars don’t subscribe to a one-treatment-fixes-all method. Each class of scar responds differently to treatment, which is why picking the right procedure is important. To get the best result, Dr. Doyle recommends an in-person evaluation so your doctor can fully evaluate the size, color, and texture of the scar. Most scars can show improvement, even if that means taking a mix-and-match approach. “There’s no silver bullet or monotherapy that makes scars look perfect,” Dr. Buford cautions. “We can’t always remove a scar in its entirety, but we can take the red out, modulate the scar, and make it thinner.” 

Whether your scar is fresh or more mature, the [first rule of scar care](https://aedit.com/aedition/scar-minimizing-skincare-to-use-after-surgery) is to make sure to always protect it from the sun with [sunscreen](https://aedit.com/aedition/best-sunscreens-of-2021) to prevent discoloration and improve its appearance. From there, below are the most effective treatment options for each scar type:

### **1. Topical Scar Gels** 
- **Best For:** Scars that are less than six months old
- **The 411:** If a scar is newer, faint, and pretty small, you may be able to treat it with a cocktail of over-the-counter topical ingredients like [vitamin C](https://aedit.com/aedition/guide-to-topical-vitamin-c-in-skincare), [retinol](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare), and hydroquinone or a specifically formulated [scar cream](https://aedit.com/aedition/scar-minimizing-skincare-to-use-after-surgery), which contains a cocktail of effective ingredients.
- **Find It In:** [Avène Cicalfate+ Scar Gel](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.dermstore.com%2Fproduct_Cicalfate%2BScar%2BGel_85402.htm) & [Visha Skincare Advanced Correcting Serum](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.vishaskincare.com%2Fproducts%2Fadvanced-correcting-serum-with-illuminotex)

### **2. Silicone Gel Sheets** 
- **Best For:** Minimizing closed, raised surgical scars
- **The 411:** These specially designed self-adhesive sheets (they’re somewhat reminiscent of a mega bandage) work well for pretty much all types of scars. Not only do they act as an occlusive dressing (read: seals in moisture by creating a barrier), but they also regulate pressure on the scar. Dr. Beckman says that silicone gel sheets have an unexplained effect to keep both the scar and skin surfaces from becoming raised, unsightly, or painful.
- **Find It In:** [Embrace Scar Sheets](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.embracescartherapy.com%2Fshop-by-product) & [Aroamas Professional Silicone Scar Sheets](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.walmart.com%2Fip%2FAroamas-Professional-Silicone-Scar-Sheets-Soften-Flattens-Scars-Resulting-Surgery-Injury-Burns-Acne-C-section-more-Soft-Strips-3-1-57-8-Sheets-4-Mont%2F696436019)

### **3. Polyurethane Dressing**
- **Best For:** Hard, red, & raised scars
- **The 411:** A flexible, waterproof pad of sorts, “polyurethane dressings, while initially used for wound healing, have been shown in a [few smaller studies](https://pubmed.ncbi.nlm.nih.gov/19440173/) to positively impact the scar surface, improve the microcirculation and improve scar color, firmness, and thickness,” Dr. Weiser says. As she explains, polyurethane is “an alternate ingredient to silicone but behaves in the same way as an occlusive dressing.”

### **4. Steroid Injections**
- **Best For:** Keloids & thick, raised, itchy, or painful scars that are fully healed 
- **The 411:** Performed by your dermatologist or plastic surgeon, steroid injections use cortisone to take down scar thickness. Some even contain very small amounts of 5-fluorouracil (5-FU), a cancer drug that reduces fibroblast activity and, in turn, hinders the progression of scar tissue. There is the potential for the injection site to darken, but, when cortisone is injected into a keloid, Dr. Beckman says that the steroid softens and weakens the scar.

### **5. Hyaluronic Acid & Biostimulatory Fillers**
- **Best For:** Sunken & indented scars, like ice pick acne scars
- **The 411:** For the past few years, doctors have been [injecting fillers](https://aedit.com/procedure/acne-scar-treatment-dermal-fillers) like Juvéderm® and Belotero® Balance to treat scars. “Dermal fillers help add volume to level a sunken scar with the surrounding tissue,” Dr. Weiser says. Depending on the patient’s preference, “hyaluronic acid fillers can be used for immediate improvement or biostimulatory fillers can be used to stimulate collagen production around the scar like a scaffold,” she adds. Some doctors, like Dr. Buford, pair hyaluronic acid filler with platelet-rich plasma (PRP) to level up the scar and change the character of the overlying skin. Just like using filler in the face for aesthetic and anti-aging purposes, the results are not permanent and need to be repeated.

### **6. Neurotoxins**
- **Best For:** Surgical scars & scars that occur in a bony area
- **The 411:** One of the newer ways to correct scars is with [neurotoxin](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) (think: Botox® or Dysport®), which can be injected into the scar to reduce muscle tension on scar tissue. “Using Botox® or other neuromodulators to reduce or eliminate muscle contraction in and around the scar has been shown to reduce hypertrophy and also to decrease fish-mouth or spread scars,” Dr. Weiser shares. Dr. Buford agrees. “Botox® is effective in a variety of scars,” he says. “When I place it in fresh scars all over the body, the scars tend to heal a little nicer.” But that doesn’t relegate the off-label use of Botox® just to body scars — it works on facial scars, too. “We know one thing that is consistent about scars is that they heal best under as little tension as possible,” he reiterates. “So, if you inject Botox®, you can relax the area to some degree. It’s a little trick, and it only works on certain areas.” 

### **7. Laser & Light Treatments** 
- **Best For:** Acne scars, keloids, raised or flat scars, red & discolored scars
- **The 411:** Light-based and [laser](https://aedit.com/procedure/acne-scar-treatment-laser-resurfacing) therapies stimulate new collagen to lessen the look of the scar. Light-based treatments, like [IPL](https://aedit.com/procedure/ipl) (intense pulsed light) and [BBL](https://aedit.com/aedition/benefits-of-bbl-hero-for-sun-damage-hair-removal) (broadband light), work well on scars on lighter skin. [Pulsed dye lasers](https://aedit.com/procedure/pulsed-dye-laser) (these target blood vessels in the skin) are best for reducing redness in scars, while [resurfacing lasers](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing) can soften the scar’s appearance and coloration. “These lasers involve the creation of controlled microscopic wounds in a specified percentage of the skin, which induces a wound healing response,” Dr. Weiser explains.

### **8. Microneedling**
- **Best For:** Superficial surgical & acne scars
- **The 411:** Perhaps the treatment du jour for unwanted scars, particularly acne scars, [microneedling](https://aedit.com/procedure/microneedling) (a.k.a. collagen induction therapy) creates microscopic wounds in the skin to stimulate new collagen that, in turn, smooths out the skin and the surrounding scar. It can also be [coupled with PRP](https://aedit.com/procedure/microneedling-with-prp) to further enhance the results. “Microneedling — especially with PRP — does work, and there are [studies](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4509584/) that show its efficacy,” Dr. Buford says.

### **9. Subcision** 
- **Best For:** Acne scars
- **The 411:** One of the most reliable ways to pull a deep scar out from under the skin and make it more flush with the surface is with [subcision](https://aedit.com/procedure/acne-scar-treatment-subcision). “This classic technique requires inserting a hypodermic needle into the skin directly beneath the scar to loosen and break the fibers that connect the scar to the tissue underneath it,” Dr. Weiser explains. “While this primarily helps to lift indented scars, it can also be helpful to release the collagen at the site of needle insertion to trigger a further healing response.”

### **10. Radiation Therapy**
- **Best For:** Stubborn keloids
- **The 411:** One of the more under-the-radar scar treatments is radiation therapy, which, [although promising](https://www.ncbi.nlm.nih.gov/books/NBK499973/), is strictly reserved for keloid improvement. “It’s used as a last resort for very challenging keloids,” Dr. Weiser says. If you are wondering how this therapy relates to cancer treatments, it is similar. “Radiation treatments entail the use of ionizing radiation — used for cancer/tumor treatment — usually externally applied to destroy existing collagen-producing cells and limit production of new ones,” she explains.

### **11. Scar Relaxation**
- **The 411:** Performed using a digital rotary tattoo machine to safely injure the skin and then repair it, this unique scar reduction method gives up to 80 percent improvement over six to 12 months and transforms almost every type of scar into soft, smooth skin. Scar expert Linda Dunn Carter, who invented [The DC Method](https://lindadunncarter.com/) over a decade ago, first abrades the skin down to the dermal layer to create new tissue while simultaneously forcing any dark pigment to purge. The tattoo machine breaks the bands of connective tissue that make up the scar to incite new, healthy tissue formation.

### **12. Scar Revision Surgery**
- **The 411:** Usually performed as the result of a poor surgical scar (think: [after a C-section](https://aedit.com/aedition/invasive-non-invasive-procedures-to-fix-appearance-of-c-section-scar)), surgical scar revision works best when a piece of the original scar is excised. But here’s the kicker: anytime you treat a scar with surgery, it will result in another scar — albeit a potentially thinner and flatter one. “Remember, the only way to erase a scar is to cut it out and replace it for another scar,” Dr. Bufford cautions. “But, sometimes, we can replace the old scar with a better-hidden one.”

## **The Takeaway**
Scarring is like a young child that you want to control but can’t. While scarless procedures sound promising, they’re far from reality, and you can’t do much to prevent occasional nicks and scratches. Fortunately, there are more treatment options to choose from than ever before for virtually every type of scar. 

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

They say that every scar tells a story, but not every story needs to be retold. Here’s everything you need to know about improving that stubborn scar — no matter the cause.

How To Treat Every Type Of Scar

Scar Wars: How To Treat Every Type Of Scar

shutterstock 1650779743

The beauty industry is notoriously ugly on the planet. Although the market is working on improvements, there are still a lot of blurred lines in eco-messaging and strategy. It’s estimated that personal care and beauty items make up a [third of the landfill waste](https://www.theguardian.com/sustainable-business/2014/nov/18/online-shopping-holidays-packaging-waste-recycling), and the harsh reality is that many beauty products have a short lifespan that leads to a landfill finish. But that’s not to say all is lost. Consumers (i.e. you!) are more educated than ever before and are expecting more from the brands you purchase from, and we’re here to shed light on the steps you can take to clean up your beauty routine and make it [more sustainable](https://aedit.com/aedition/guide-to-sustainability-and-recycling-beauty-products) — without feeling overwhelmed by the process.

## **5 Tips Towards Sustainability**
As we mentioned, there is a new generation of beauty brands to go along with a new generation of buyers that is taking action. Take [Taos Aer](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Ftaosaer.com%2F). The personal care brand was co-founded by Kristine Keheley, a formulator and expert in anhydrous products, who is working to offer more earth-friendly deodorant. “We use a waterless formulation to create the cleanest product possible and use minimally processed ingredients,” she explains. Working in an anhydrous way allows for [water conservation](https://www.un.org/waterforlifedecade/scarcity.shtml). Below, Keheley shares her tips for what to look for from brands and how to refine your own beauty habits.  

### **1. Do Your Research**
The landscape of sustainable beauty can be hard to navigate with so-called greenwashing being a prevalent issue. Some brands utilize fear-based tactics in their marketing to position their products as non-harmful alternatives, but a lack of clarity around verbiage is often what causes the most confusion. As we’ve covered, there are [no formal definitions](https://aedit.com/aedition/what-clean-green-natural-mean-for-beauty-makeup-skincare-products) of what terms like ‘green,’ ‘clean,’ or ‘natural’ mean, and a product doesn’t necessarily need to be free of synthetics or waterless to be environmentally conscious. Instead, the entire manufacturing and production process needs to be taken into account to ensure a truly eco-friendly outcome. 

Wondering whether the brands you are purchasing from practice what they preach? Do your homework. Dig deeper into their ethos and strategy when it comes to farming or ingredient sourcing to understand if they align to your values. More often than not, all it requires is an online search. Brands like [Thrive Natural Care](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fthrivecare.co%2F) and [True Botanicals](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Ftruebotanicals.com%2F), for example, are finding ways to sustainably grow and replenish resources through regenerative farming. 

And, if you are curious about the use of water in products (a quick look at the ingredient list will show that it often comes up first), Keheley offers this explanation: “Water is where bacteria can grow, so, by removing water, you can help create a safe space and reduce microbial growth. Waterless products will contain more of the ingredients you want with less filler.”  

### **2. Use Only What You Need**
It’s easy to be tempted by a sale or the innovation of a new product (we’re all guilty of it!), but nobody needs an expansive routine if the products they currently use are working. It’s also worth noting that [all beauty products have a shelf life](https://aedit.com/aedition/shelf-life-of-makeup-mascara-lipstick-foundation) that dictates how long they are stable and effective after opening. Lasting anywhere from three to 24 months (depending on the type of product), certain makeup, serums, sunblocks, and creams should be used consistently so that they don’t expire before you finish them. Try using each product as it is intended and only replacing it once it’s empty — you’ll be cutting down on waste *and* ensuring you’re using them at the peak of their effectiveness.

### **3. Reduce Packaging**
It’s not just the paper, glass, or plastic that your skincare comes in but the manufacturing systems in place to produce everything from the ink to the glue that makes for a large carbon footprint. “What’s been lagging in the 20 years of my career is interest on behalf of the packaging companies to offer sustainable options – they haven’t come up with good solutions yet,” Keheley explains. 

Fortunately, there have been some recent improvements in this sector that have her hopeful, though it’s a process that requires effort from both manufacturers and consumers. Limiting the need for single-use products (more on that below) will allow for a longer lifespan and decrease demand. [Plus](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fcleanwith.plus%2Fpages%2Fsustainability), a new personal care brand, is attempting to take packaging out of the equation all together. Its biodegradable body wash is waterless and comes in fully dissolvable packaging that breaks down into water, carbon dioxide, and organic matter.  

### **4. Opt for Reusable Products**
Perhaps the best way to get the most from your products and to reduce the cycle of repurchasing is to find ones that are reusable. Common of many [Asian skincare and makeup brands](https://aedit.com/aedition/best-skincare-brands-products-from-asia), companies around the globe are increasingly offering refillable solutions that allow you to replace part of the product instead of the whole thing. 

Rihanna’s Fenty Skin, for example, only makes you purchase the outer packaging of her cult-favorite [Hydra Vizor Invisible Moisturizer Broad Spectrum SPF 30 Sunscreen](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.sephora.com%2Fproduct%2Ffenty-skin-hydra-vizor-moisturizer-broad-spectrum-spf-30-sunscreen-P467249%3Ficid2%3Dproducts%2520grid%3Ap467249) once. When you run out of the product, you can simply purchase a refill at a reduced price. Dior, meanwhile, updated the tubes of its iconic [Rouge Lipstick](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.sephora.com%2Fproduct%2Fdior-rouge-dior-lipstick-P467760) to be refillable across 45 matte, metallic, and satin shades. And then there are brands like L’Occitane that offer convenient refills for household staples that have been in particularly heavy rotation this past year, [hand soap](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.loccitane.com%2Fen-us%2Fverbena-jumbo-duo-666876.html).

### **5. Recycle**
Recycling isn’t as easy as placing a used bottle into a bin. Despite our best intentions, many items never find their way to a recycling plant, and a [recent study](https://advances.sciencemag.org/content/3/7/e1700782) showed that only nine percent of the world's plastic was recycled. But that doesn’t mean beauty brands aren’t stepping up to help tackle this issue. Retailers like [Credo](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fcredobeauty.com%2Fblogs%2Fclean-scene%2Frecycle-your-empties-with-credo) and [Detox Market](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.thedetoxmarket.com%2Fpages%2Fclean-beauty-recycling) offer programs to help patrons recycle properly and diminish ‘wish-cycling.’

If you’re keen on recycling from home, there are a few factors to keep in mind — especially when it comes to the components of your used products. “Most products are made with mixed material, which makes them harder to process by recycling plants,” Keheley notes. Mirrors and magnets, for example, often interfere with the recycling process, and Luxe Botanics has a great [video](https://www.youtube.com/watch?v=uW0E7uJsMGI) that is worth watching to understand more about taking bottles apart for easier disposal. 

## **Eco-Minded Beauty Products to Try** 
If you’re interested in reducing your reliance on single-use products, making your eye creams last longer, or getting the most from the skincare you already have, check out the products below that can help clean up your beauty routine. 

### **Taos AER Deodorant** 
![AEDIT-Taos](//images.ctfassets.net/zw35sfestf1t/5g5P7afdHGpWSAI2sYrKt8/4fa87c7007af1f5061a99ff7cccdcff1/AEDIT-Taos.png)
Long-lasting and genderless, this deodorant not only keeps you smelling fresh, but it is also kind on the planet. Great for sensitive skin, it is made without water and with ethically sourced ingredients. $19, [taosaer.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Ftaosaer.com%2Fcollections%2Fall%2Fproducts%2Fdeodorant-lavender-myrrh) 

### **Dieux Skin Forever Eye Mask** 
![AEDIT-Dieux](//images.ctfassets.net/zw35sfestf1t/7s9brWUJLmNNm3EPOSuN4p/34c6d1fc6e86908116b8a39de6f4af18/AEDIT-Dieux.png)
These darling eye patches not only make for fun selfies — they can also help you get the most out of your eye creams. Decreasing the evaporation of product and locking in moisture in an area that needs it, the reusable silicone patches are meant to stand the test of time. $25, [dieuxskin.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.dieuxskin.com%2Fproducts%2Fforever-eye-mask)  

### **Common Heir Vitamin C Serum** 
![AEDIT-CommonHeir](//images.ctfassets.net/zw35sfestf1t/2QgoHOo7efooUdGrWemjV4/6d04a3abbd1b22c72bfb8d7d02e61fd0/AEDIT-CommonHeir.png)
Vitamin C is a finicky ingredient to formulate with, and it requires just as much attention once it enters your home (be wary of light and oxidation!). Common Heir is working to reduce waste of spoiled product and useless packaging with these biodegradable vegan capsules that brighten the complexion and are good for the planet. $88, [commonheir.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fcommonheir.com%2Fproducts%2Fvitamin-c-serum) 

### **Izzy Zero Waste Beauty Zero Waste Mascara**
![AEDIT-Izzy](//images.ctfassets.net/zw35sfestf1t/01sKaTHI06stFn2Xs1zXjN/63a5ee3552a5a068bdf1bdd0094f0c4f/AEDIT-Izzy.png)
Zero-waste, carbon-neutral, and 100 percent recyclable, this is the first-of-its-kind beauty innovation that will change the way you purchase mascara. No more throwaway tubes, every component is made to be reused or recycled by the professionals (just send the mascara back in the mailer it came in). Opt-in for a membership to receive a high-quality mascara on a regular basis or try it out once – the entire process is simplified and your lashes will love it. $39, [yourizzy.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fyourizzy.com%2Fpassword) 

### **Nurse Jamie Face Wrap**
![AEDIT-NurseJamie](//images.ctfassets.net/zw35sfestf1t/GtVZ6gFw6wxOmJ5lBKXOO/1e4dadd829b7fa5141ecaf0be340824b/AEDIT-NurseJamie.png)
Say ‘goodbye’ to single-use sheet masks and ‘hello’ to a reusable face mask that lets you look good and feel good. Allowing for easy and comfortable absorption of product, this mask enhances the efficacy of your existing skincare, which means less waste and more improvements in your skin. After you’re done, simply wash it and leave it out to dry for your next self-care Sunday. $30, [dermstore.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.dermstore.com%2Fproduct_FaceWrap%2B_74773.htm)  

### **Beautyblender Biopure Sustainable Makeup Sponge**
![AEDIT-Beautyblender](//images.ctfassets.net/zw35sfestf1t/2QCGfvM2zVd8U5UNQuQ05T/77ad1f62e5a9ab25eb903f5ba948740f/AEDIT-Beautyblender.png)
The brand’s new BioPlush foam is 60 percent plant-based thanks to renewable sugarcane that boasts the same cushion and coverage of the OG sponge — but with more eco-friendly production. The updated process includes less synthetics, minimal water, and more post-consumer recycled materials (for the outer packaging) at the same price point as the original. $20, [sephora.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.sephora.com%2Fproduct%2Fbeautyblender-biopure-sustainable-green-makeup-sponge-P468345) 

### **KVD Good Apple Skin-Perfecting Foundation Balm**
![AEDIT-KVD](//images.ctfassets.net/zw35sfestf1t/1Sfw7eDJEz6GbcdVVzX98d/663847d5a10d64fb8a25ab6a602d09f5/AEDIT-KVD.png)
It made waves on social media for its flawless finish, but the real beauty of this vegan foundation balm is its revolutionary design. Made without a mirror, magnet, or metal (components that are not recyclable), the compact is fully recyclable and does not require any disassembly. $38, [kvdveganbeauty.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.kvdveganbeauty.com%2Fface%2Ffoundation%2Fgood-apple-skin-perfecting-foundation-balm%2F20050.html) 

### **Plus Body Wash** 
![AEDIT-Plus](//images.ctfassets.net/zw35sfestf1t/3pNxC8llbXYrSd0V9FcF81/25612bea955c3af9e2a1e8e32810c002/AEDIT-Plus.png)
As we mentioned, packaging is a major pollutant, so Plus decided to forego it altogether with these biodegradable papers. The dissolvable wrap is made from wood pulp and the body wash itself requires only a little water to transform into a scintillating lather. Available in scented and unscented options, it’s a great option for both travel and at-home use. $17, [cleanwith.plus](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fcleanwith.plus%2Fcollections%2Fall) 

### **Oui The People The Single** 
![AEDIT-OuiThePeople](//images.ctfassets.net/zw35sfestf1t/6RqmWZbuPx1p59JWWrTsbV/f11092049751f5a392616f78dde9c91c/AEDIT-OuiThePeople.png)
Want to avoid the pink tax and having to constantly repurchase a new razor once the old one loses its edge? This rose gold safety razor provides a smooth shave, reduces razor burn, and comes with 10 replacement blades that can be easily disposed of. $75, [ouithepeople.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.ouithepeople.com%2Fproducts%2Frose-gold-safety-razor)  

### **Clean Circle Reusable Bamboo Velour Skincare Pads**
![AEDIT-CleanCircle](//images.ctfassets.net/zw35sfestf1t/58u1vdW9XVwLVTC4SXaEp6/430c85681ccbfcc39c0dc8784dc8ff0c/AEDIT-CleanCircle.png)
At this point, we know that single-use makeup remover wipes are one of the most wasteful items in a beauty routine, so why not swap them out for a more sustainable option? These 100 percent bamboo velour rounds also come with a drawstring pouch to ensure they don’t get lost in the wash. $22, [clean-circle.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fclean-circle.com%2Fproducts%2Freusable-bamboo-velour-skincare-pads) 

### **Fenty Beauty Day + Night Moisturizer Refill Bundle** 
![AEDIT-FentySkin](//images.ctfassets.net/zw35sfestf1t/5mt2PEy9AlGTaLmqLhWDyC/cd821608a4427b890c311b6bd18c0a71/AEDIT-FentySkin.png)
Let’s be honest, we all love cute packaging. But, what can make it harmful is that it’s often not refillable and goes to waste. Enter: Rihanna’s Fenty Skin. The brand offers a few refillable options (including this A.M./P.M. duo) in its skincare collection for guilt-free shopping. $56, [fentybeauty.com](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.fentybeauty.com%2Fday-night-moisturizer-refill-bundle-spf-moisturizer-night-cream%2Fam-pm-moisturizer-duo-refill.html) 

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

Beauty

In honor of Earth Day, we’re breaking down sustainable ways to clean up your beauty routine and the products that can make it more eco-friendly.

How To Make Your Beauty Routine More Sustainable

shutterstock 795630103

You found out that you need to have a medically necessary procedure. You and your provider have submitted all of your necessary documentation and insurance has approved your case. While you’re not necessarily thrilled about going under the knife, there just so happen to be a few cosmetic tweaks that you’re interested in making to that same part of the body you already scheduled to have surgery on. So, can you blend functional and aesthetic surgeries? We asked the experts.

## **Functional vs. Aesthetic Procedures**
First things first, you may be wondering what the difference is between functional and aesthetic procedures? The best way to understand it is to look at these two definitions from the [American Medical Association (AMA)](https://www.ama-assn.org/): 

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

Another way to put it? A functional procedure is one that you probably *need* to have, whereas an aesthetic procedure is one that you *want* to have. As you may have guessed, functional procedures are more likely to be [covered by insurance](https://aedit.com/aedition/insurance-coverage-for-plastic-surgery-cosmetic-procedures) than cosmetic ones. 

While it may sound straightforward enough, there is actually quite a bit of gray area. Many procedures have dual purposes and can treat both functional *and* aesthetic concerns. For example, patients who have [trouble breathing](https://aedit.com/concern/breathing-issues) due to a deviated septum (medically necessary) and are also unhappy with the appearance (aesthetic) of their [asymmetrical or crooked nose](https://aedit.com/concern/nose-angle) could address both concerns with the [same rhinoplasty surgery](https://aedit.com/aedition/difference-between-cosmetic-rhinoplasty-vs-functional-rhinoplasty).

## **Blending Functional & Aesthetic Procedures**
Rhinoplasty isn’t the only procedure that has functional and aesthetic benefits though. And, if you are curious as to what other plastic surgery fits the bill, we’re breaking down six of the most common: 

### **1. Rhinoplasty (a.k.a. nose job)** 
While we often think of rhinoplasty as a way to improve the appearance and [shape of the nose](https://aedit.com/concern/nose-shape), it also can help with breathing problems. “It is a very well understood scientific fact that the nose is the primary organ for delivery of oxygen to the body,” explains [Oren Friedman, MD](https://aedit.com/provider/oren-friedman-md-1609), a double board certified facial plastic and reconstructive surgeon and director of facial plastic surgery at the University of Pennsylvania. “The nose humidifies, filters, and warms the air we breathe, so that, when the air reaches the lungs, it is primed for gas exchange, allowing for oxygen to reach important functional regions of our bodies and brains.” Needless to say, the proper function of the nose is medically necessary. “It is essential that people be able to breathe through their noses, and, as such, insurance companies should cover surgery to correct a patient's nasal breathing surgery,” he adds.

How does this relate to aesthetic concerns a patient may have? If a patient has a major nasal shape deformity that is directly contributing to their inability to breathe through the nose, the surgeon will correct it as part of the functional rhinoplasty procedure. According to Dr. Friedman, nasal deformities that need to be corrected in order to improve the breathing function include cleft lip nasal deformities, nasal defects following cancer removal, and traumatic defects as with a dog bite.  

### **2. Abdominoplasty (a.k.a. tummy tuck)** 
For patients with a [body mass index (BMI)](https://www.dukehealth.org/treatments/weight-loss-surgery-candidate) of 35 or higher, [weight loss procedures](https://aedit.com/aedition/what-its-like-to-get-plastic-surgery-after-bariatric-surgery-weight-loss) (e.g. gastric sleeves, lap gastric bands, gastric bypass, etc.) are often covered by insurance. This is especially true if it is coupled with medical complications, like diabetes, heart disease, or pulmonary hypertension. Procedures like an [abdominoplasty](https://aedit.com/procedure/abdominoplasty) (to remove [excess fat](https://aedit.com/concern/excess-fat) and skin) and panniculectomy (to address extra skin) may also qualify as medically necessary in certain patients, though it is not as common as the weight loss treatments. 

But complementing a significant weight loss isn’t the only functional benefit of abdominal surgery. “[Body contouring](https://aedit.com/procedure/body-contouring-solutions) procedures such as a tummy tuck often provide much more than aesthetic outcomes and may actually improve function,” explains [Gregory Buford, MD](https://aedit.com/provider/gregory-buford-md-1015), a board certified plastic and reconstructive surgeon in Englewood, CO. “When we tighten the abdominal muscles, the overall core is made more functionally competent.” 

As a result, he says patients “will often report improvement in chronic back pain” and has also seen patients comment that “bladder function has improved.” While these benefits will probably not qualify the procedure for insurance coverage, Dr. Buford notes that a good number of his tummy tuck patients experience health improvements in addition to the cosmetic benefits. 

### **3. Blepharoplasty (a.k.a. eyelid surgery)** 
Eyelid surgery is another procedure that can be performed for cosmetic or functional reasons — and, in some cases, both. [Lower](https://aedit.com/procedure/lower-eyelid-blepharoplasty-transconjunctival-approach) and [upper eyelid blepharoplasty](https://aedit.com/procedure/upper-eyelid-blepharoplasty) surgeries can treat loose or sagging skin, under eye bags or puffiness, and eyelid droopiness.

Functionally, a blepharoplasty may be medically necessary when excess skin impedes vision. Dr. Friedman says that when the degree of eyelid droop is so extensive that it obstructs a patient's ability to see, insurance usually covers the eyelid surgery. “Failure to see well is a hazard to the patient and to those around the patient, and, as a result, functional surgery should be performed for health reasons,” he explains. 

If vision is not impaired, don’t expect the procedure to be classified as functional. “At times, patients do not like the heavy appearance of their eyelids and may want to have skin removed from the upper eyelids,” Dr. Friedman notes. “In such cases of cosmetic dissatisfaction, insurance should not cover the procedure.” Depending on the patient’s goals, a blepharoplasty can help with [rejuvenation](https://aedit.com/procedure/eye-rejuvenation-solutions) or [reshaping](https://aedit.com/procedure/eyelid-correction-solutions) the eyes.

### **4. Breast Surgery**
No, your standard [breast augmentation](https://aedit.com/procedure/breast-augmentation-solutions) — be it with [implants](https://aedit.com/procedure/breast-augmentation-with-implants), [fat transfer](https://aedit.com/procedure/breast-augmentation-with-fat-transfer), or some [hybrid](https://aedit.com/aedition/hybrid-breast-augmentation-with-implants-fat-transfer) of the two — is not functional. But breast surgery encompasses a wide range of procedures, some of which are considered medically necessary. Mastectomy, breast reconstruction, and breast reduction are three such treatments. 

As per the [1998 Women’s Health and Cancer Rights Act (WHCRA)](https://www.cancer.org/treatment/finding-and-paying-for-treatment/understanding-health-insurance/health-insurance-laws/womens-health-and-cancer-rights-act.html), health insurance plans that cover [mastectomy](https://aedit.com/aedition/what-to-expect-before-during-after-mastectomy-breast-cancer) (whether it’s for breast cancer prevention or treatment) must also cover [breast reconstruction](https://aedit.com/aedition/comprehensive-guide-to-breast-reconstruction-nipple-reconstruction-after-breast-cancer) — in the form of prostheses (like breast implants) — for both breasts. In these cases, providers do not need to document health problems or trials of alternative treatment as is usually custom in insurance cases. 

In the case of [breast reduction](https://aedit.com/procedure/breast-reduction-and-revision-solutions), addressing the size of the breasts can have a true impact on the patient’s quality of life. “When we reduce a woman's breasts, our goal is not only to achieve functional improvement (e.g. less weight and, so, less pressure on the lower back and neck) but to also create an aesthetic outcome that is attractive,” Dr. Buford says. “In this sense, breast reduction is likely one of the best examples in plastic surgery where form meets function to achieve an endpoint that creates benefit for our patients on multiple levels.”

### **5. Otoplasty (a.k.a. ear surgery)**
In order to understand the functional benefits of [otoplasty](https://aedit.com/procedure/otoplasty), it’s important to understand the functional benefits of the outer ear. “The external ear serves the primary function of funneling sound to the middle and inner ear in order to aid in hearing,” Dr. Friedman explains. “Repair of deformities that cause poor hearing should generally be covered by insurance.” 

[Cosmetic ear surgeries](https://aedit.com/aedition/otoplasty-ear-pinning-benefits-for-large-prominent-ears), as you may have guessed, are usually paid for out of pocket. “Aesthetic ear deformities often present as children and adults expressing that their ears protrude from their heads too far, making their ears stand out,” he says. “Patients sometimes come in stating ‘I get bullied for my funny looking ears’ or ‘my ears look like dumbo ears.’” Despite the mental health component to such concerns, Dr. Friedman shares that “otoplasty to correct these types of cosmetic deformities are generally not covered by insurance.”

There are, however, certain exceptions. “At times, children are born with excessively small ears [or] with no identifiable ears at all,” he notes. “These ear deformities require reconstruction of the missing ear and should be covered by insurance.” 

### **6. Botox®**
While it’s not a surgery, we’d be remiss not to mention the therapeutic benefits of a certain cosmetic injectable. As you likely know, [Botox®](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) is a form of botulinum toxin type A (BoNT-A) that is used in aesthetic medicine to reduce the appearance of fine lines and wrinkles caused by facial expressions (think: forehead lines and [crow’s feet](https://aedit.com/procedure/periorbital-botox)). But the neurotoxin is approved by the United States Food and Drug Administration (FDA) to treat medical conditions as well. 

Therapeutic uses for Botox® include the treatment of [migraines](https://americanmigrainefoundation.org/resource-library/botox-for-migraine/), [hyperhidrosis](https://aedit.com/procedure/botox-for-hyperhidrosis) (read: excessive sweating), and eye spasms (to name a few). “I treat a good number of patients with Botox® who report additional benefits such as reduced local sweating and an overall reduction in migraines,” Dr. Buford shares. “For these patients, the additional benefits often vastly outweigh the cosmetic improvements and are literally life changing.” In such cases, insurance may cover the cost of routine Botox® treatments.

## **How to Find the Right Provider**
The most important part of any procedure — functional or aesthetic? [Finding the right provider](https://aedit.com/aedition/finding-the-right-plastic-surgeon-dermatologist-or-cosmetic-dentist) to ensure you receive the best and safest treatment for your needs. “Choosing the right surgeon is always the most important predictor of success for a surgical procedure,” Dr. Friedman says. During the research and [consultation](https://aedit.com/aedition/questions-to-ask-your-doctor-during-plastic-surgery-consultation) process, be sure to inquire about how often they perform the procedure(s) you are interested in and ask to see [before and after photos](https://aedit.com/aedition/importance-of-before-and-after-photos-in-plastic-surgery). 

No matter what area you are looking to treat, it is important that the surgeon has extensive knowledge of anatomy and how the body works. “A surgeon who understands the functions of the facial sense organs — the nose, the eyes, the ears — is well suited to safely and comprehensively achieve the best possible surgical outcomes,” Dr. Friedman says. “Knowing the nose, eyes, and ears inside and out allows us to insure success in both form and function.”

In choosing a [board certified](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) plastic surgeon, you are often, well, blending the best of both worlds. “The beauty of plastic surgery is that it is essentially an art,” Dr. Buford concludes. “And, when form meets function, art is ultimately achieved.”

When you think ‘plastic surgery,’ you probably don’t think ‘medically necessary.’ But there are certain procedures that can provide dual functional and aesthetic benefits. Here’s what you need to know.

Blending Functional And Cosmetic Procedures In Plastic Surgery

What It Means To Blend Functional And Aesthetic Procedures

haley-lawrence-6ugQ978v-zg-unsplash

From facial thirds (and fifths!) to the infamous golden ratio, pop culture has been seeking facial harmony’s magic formula for millennia. Between the ancient Greeks, Renaissance artists like Leonardo da Vinci, and [today's social media set](https://aedit.com/aedition/march-2020-study-shows-relationship-between-social-media-cosmetic-surgery), there's no shortage of hypotheses about what constitutes a well-balanced countenance. But the whopping number of requests for Kate Middleton’s nose (once deemed to be the “world’s most perfect”) proves that many people still don’t have an accurate grasp of the concept.

In a nutshell, facial harmony is about [ideal proportions, not perfection](https://aedit.com/aedition/plastic-surgery-results-are-about-proportion-not-perfection). “It’s not so much about direct measurement; proportions are way more important,” says [Jason Roostaeian, MD](https://aedit.com/provider/jason-roostaeian-md-449), a board certified plastic and reconstructive surgeon and associate clinical professor at UCLA. “When we’re evaluating a face, you’re really looking at that face relative to itself.” In other words, the measurements of individual facial features are less important than the interaction between those features, and we’ve gone straight to the experts to better understand what that means for facial aesthetics.

## **What Is Facial Harmony?**
When we think of facial harmony, most of us think about beauty — but it’s really much more basic (in every sense) than that. “It really comes down to the fact that the most attractive faces are those where everything falls into the average,” Dr. Jason explains. “Philosophically speaking, when one part falls out of the norm, it’s alarming for potential disease.” If a person has a deficient jaw, for example, it’s an indication of certain ailments, he adds.

And, when it comes to attraction, it’s all about survival of the species. “If, in essence, what we’re doing is looking for a partner to mate with, the ideal mating partner is somebody who seems ‘normal’ across the board,” he says. In the most primal sense, we’re programmed to gravitate toward facial symmetry and harmony because they convey good health.

As it relates to aesthetic medicine and plastic surgery, providers have — no surprise here — a very precise understanding of facial proportion. “We mean balance and a subjective sense of normalcy,” explains [Jacob Unger, MD](https://aedit.com/provider/jacob-unger-md-2649), a Nashville-based board certified plastic and reconstructive surgeon and assistant professor of plastic surgery at Vanderbilt University. “If you overly highlight a feature or ignore a feature in the face, it will draw the eye negatively.” 

Sure, a surgery or procedure may focus on one part of the face, but the goal of said treatment is balance. “We aim for improvement in facial aesthetic surgery, but the key to doing it well is understanding facial anatomy and relationships,” Dr. Unger says.

### **Facial Harmony vs. Beauty**
Before we move on, you might be wondering: is facial harmony the same as beauty? According to our experts, the basic tenets of facial harmony have remained largely unchanged. Beauty standards, on the other hand, are infamously ever-changing. “Harmony is less subjective than beauty,” Dr. Unger shares. As he explains it, beauty evolves with the times and trends, but harmony and proportion are less beholden to what is en vogue. “Balance, harmony, and the golden ratio has indicated what is naturally aesthetically pleasing to the human eye and mind since it was first described — and that was thousands of years ago,” he says.

But how do modern beauty trends (think: super plush pouts) fit in with the idea of facial harmony? “There are certain features that you may want to augment compared to average because they have some underlying innuendo with them,” Dr. Jason explains. “But it’s very clear to see that, when it gets too out of proportion, you lose the attractiveness again.” In other words, cosmetic surgery can push certain boundaries to meet beauty standards, but only to the point where the enhancement or augmentation is not disrupting the overall harmony of the face.

## **How Does Plastic Surgery Achieve Facial Harmony?**
“We, as plastic surgeons, must take a holistic approach towards facial beauty and harmony,” Dr. Unger explains. And that often requires a bit of patient education. “We have to make sure we are not just improving the one item that may be the focus for the patient, but explaining how the structures of the face are interrelated,” he continues. As such, candidates must understand that “gentle adjustments in the surrounding areas” may be needed in order to ensure the desired results of more refined shape will look, as he describes, “elegant and balanced.” 

That holistic view ensures facial features remain proportional to each other. “Within a structure like the nose, any expert will explain that just because you don’t like something — a [dorsal hump](https://aedit.com/procedure/nose-bump-solutions), for instance — doesn’t mean that correcting that one issue will look good,” Dr. Unger says. “In fact, it will probably look very unnatural, unbalanced, or not harmonious if you impact one particular concern. This is because everything is interrelated.”

If you’re getting the sense that facial plastic surgery is like aesthetic Tetris, you’re on the right track. “Once you make one move, it may change the proportions and, therefore, you have to make the other move to make the two meld together better,” Dr. Jason says. Essentially, it's all about finding the sweet spot between enhancement (whether it's highlighting or downplaying a feature) and rejuvenation. “This deep understanding of the face is what sets [board certified plastic surgeons](https://aedit.com/aedition/difference-between-plastic-surgeons-and-cosmetic-surgeons) apart from untrained practitioners who do not have deep training or experience in overall facial shape, anatomy, and symmetry,” Dr. Unger adds. That lack of expertise is what leads to “many of the strange looking faces, lips, and cheeks we see walking around all the time,” he says.

The net net: When it comes to finding facial harmony, the whole is indeed much greater than the sum of its parts. Below, we break down some of the most common surgical combos that achieve a more balanced facial appearance:

### **NOSE + CHIN**
Evaluating patients for [rhinoplasty surgery](https://aedit.com/aedition/reinventing-rhinoplasty-whats-different-about-modern-nose-jobs) provides a perfect example of how surgeons consider facial harmony on both a macro level (how a feature relates to all of your other features) and micro level (how a feature’s individual elements relate to each other). “When you fine-tune or reshape a feature that the patient does not like, it will likely require changes to the related parts of the nose or face to ensure everything is balanced and looks appropriate together,” Dr. Unger notes. An example? “A big dorsum, when reduced, will likely expose a too broad nasal tip or too full tip because the relationship will be off,” he says.

Changing the nasal proportions can also [highlight the eyes](https://aedit.com/aedition/popularity-of-eyelid-surgery-cosmetic-eye-procedures-during-covid-19) and make the [chin appear more prominent](https://aedit.com/aedition/best-chin-augmentation-enhancement-procedures). It may happen naturally — “sometimes, adjustments to the nose alone are sufficient to meet a patient’s aesthetic goals,” Dr. Jason says — or it may require a bit more refinement. “Other times, we also need to perform a [chin augmentation](https://aedit.com/procedure/chin-enhancement-solutions) to get the results they want,” he adds. “A nose looks more or less prominent based on where the facial plane sits relative to it, so bringing the chin forward can also make the nose look less prominent.”

### **EYES + BROWS**
Another common area where proportions are particularly important? The eyes. [Blepharoplasty](https://aedit.com/procedure/upper-eyelid-blepharoplasty) (a.k.a. eyelid surgery) is one of the most popular surgical procedures for both women and men seeking to restore a more youthful, awake appearance. But removing eyelid skin isn’t always the best (or sole) solution. “Some patients who come in thinking they want blepharoplasty don’t actually have much excess eyelid skin,” Dr. Jason explains. “Instead, what they have is a sagging brow that’s making the lids look heavy.” If the surgeon simply cut away the skin without elevating the brow, the results will not be optimal, he says. As a result, [eye rejuvenation](https://aedit.com/procedure/eye-rejuvenation-solutions) often involves pairing eye and brow procedures.

### **UPPER + LOWER FACE**
The term ‘facelift’ can be confusing because the procedure focuses on restoring the lower to midface and jawline (i.e. the dreaded jowls) — not the entire face. [Facelift surgery](https://aedit.com/aedition/popularity-of-facelift-cosmetic-surgery-for-aging-sagging-neck) alone works well for patients whose concerns are relatively isolated to those areas. But, for those who also have significant signs of aging in the upper face (think: above the cheekbones, the eyes, and brows), a facelift by itself may leave them looking unbalanced. 

As Dr. Jason explains, if you’re getting a facelift, a [brow lift](https://aedit.com/aedition/theres-more-to-a-brow-lift-than-meets-the-eye) often makes sense, too. “You don’t want to make it look piecemeal or unharmonious because you lifted one part and left the rest,” he shares. Patients with a sagging brow, for example, may end up looking, as he describes, “squished in the middle” without the complementary treatment. 

## **Is AI the Future of Evaluating Facial Harmony?**
[Artificial intelligence](https://aedit.com/aedition/study-shows-how-artificial-intelligence-is-bringing-objectivity-to-aesthetics) (read: machine learning) is emerging as a compelling tool for objectively evaluating the elusive trifecta of beauty, youth, and proportion in the human face. But, according to our experts, automated facial analysis still can’t replace the eye of an expertly trained plastic surgeon — and it maybe never will. 

“It is still an analog approach that is honed with education, training, and experience to create shapes and contours that highlight and accentuate without overly stylizing and, thus, looking artificial,” Dr. Unger says. So, while he admits AI may help us better articulate what experts create with their eye and technique, he maintains that we are “likely very far away from a complete algorithmic or pre-planned approach that can be easily enacted on an actual human created from a computerized map.”

At the end of the day, the ‘art’ of plastic surgery cannot be underestimated. “This is what I tell my patients all the time — especially with rhinoplasty — it truly is art, and it doesn’t really matter what anybody else says,” Dr. Jason explains. “At the end of the day, only you can decide what you think looks good.” Regardless of how far the technology comes, honestly portrayed [before and after results](https://aedit.com/aedition/importance-of-before-and-after-photos-in-plastic-surgery) are still the most important factor when [choosing the right plastic surgeon](https://aedit.com/aedition/finding-the-right-plastic-surgeon-dermatologist-or-cosmetic-dentist) and, by extension, the right aesthetic for you.

Facial harmony is about proportion, not perfection, and we’ve gone straight to the experts to better understand what that means for your next plastic surgery consultation.

Importance Of Facial Harmony And Proportion In Plastic Surgery

The Importance Of Facial Harmony In Aesthetic Medicine

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It’s estimated that around 20 percent of the population has some degree of needle phobia. Known medically as trypanophobia, fear of needles comes in different forms — ranging from a fear of the pointy object itself to anxiety around being injected. For people with trypanophobia, the prospect of getting [Botox®](https://aedit.com/aedition/everything-you-need-to-know-before-getting-botox-for-the-first-time) or [fillers](https://aedit.com/aedition/what-to-know-before-getting-lip-filler-for-the-first-time) or even considering a surgery that involves [intravenous (IV)](https://aedit.com/aedition/iv-nutrient-drip-therapy-for-skincare-wellness) medication can be overwhelming. But this doesn’t make the results of these procedures any less attractive, so finding ways to make the thought of treatment less stressful may be helpful. 

Uncertainty around what kind of needles are used, how [painful](https://aedit.com/aedition/how-much-plastic-surgery-really-hurts) a procedure will be, and what to expect during the injection process can all increase anxiety levels for any patient but especially for those with needle phobias. Here at AEDIT, we know that knowledge is power, and we’ve consulted with plastic surgeons and patients alike to better understand the different needles used in aesthetic medicine and how to manage fears.

## **Injectable Needles 101**
When you’re looking into having a cosmetic surgery or treatment, you will come across a lot of procedure-specific medical jargon. As it relates to needles, ‘injectables’ is an umbrella term that refers to procedures that inject a product into the skin or body (think: [neurotoxins](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin), [filler](https://aedit.com/aedition/everything-you-need-to-know-about-dermal-fillers), [Kybella®](https://aedit.com/procedure/kybella), [Qwo™](https://aedit.com/aedition/qwo-cellulite-injectable-treatment-fda-approved), etc.). “There are different types of needles used for cosmetic injectables, and there are different brands, too,” says [Kian Karimi, MD](https://aedit.com/provider/kian-karimi-md-17458), a double board certified facial plastic and reconstructive surgeon in Los Angeles. Below, a quick vocabulary lesson:  

- **Needle**: A hollow, slender, sharply pointed instrument used for injection.
- **Gauge**: A needle’s gauge refers to the size of its opening. The higher the gauge, the smaller the diameter.
- **Syringe**: The syringe is the plastic pump that is attached to a needle to perform an injection. In the case of dermal filler, syringes often come pre-filled and your practitioner will choose which gauge of needle to use depending on your specific needs.
- **Cannula**: A cannula is a thin, flexible tube that is inserted via needle to administer medication or product. When a cannula is placed, the needle used to insert it is removed.

As Dr. Karimi explains, injectables come with needles in an array of sizes (usually ranging from 27-gauge to 30-gauge), and he says some providers will further customize treatment. “Some injectors like to transfer filler into even smaller syringes with 31- or even 32-gauge needles,” he notes. “But it really comes down to the thickness of the filler to determine which needle would be most appropriate.”

Neuromodulators like Botox®, for example, can often be injected with some of the tiniest needles on the market (a 31- or 32-gauge), which minimizes discomfort. Thicker and more viscous fillers (think: Juvéderm® and Restylane®), meanwhile, may require a larger 30-gauge or 27-gauge needle. As such, dermal filler injections are generally considered to be a bit more uncomfortable than neurotoxins.

### **Needle Alternatives**
As defined above, cannulas can serve as an alternative to needles. “Using a microcannula is different from using a needle,” says Dr. Karimi, who specializes in using DermaSculpt microcannulas. “The difference between a needle and a microcannula is that only one poke is made through the skin with a needle, then the blunt-tip microcannula is used to artistically place the filler in different tissue layers.” 

He has been teaching microcannula use for some 10 years now and estimates he has educated thousands of providers. “Overall, there are many advantages to using the microcannula,” he notes. They include less [bruising](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox) (a typical side effect of facial fillers) and less chance of injecting into a blood vessel, which can cause serious complications. “Although using a microcannula to inject fillers does not eliminate the risk of complication, it does decrease it to a very significant degree,” Dr. Karimi says. They also allow for a more “artistic” result, he adds.

## **Overcoming a Fear of Needles**
“Fear of needles is completely normal, although in some cases it can be quite extreme,” Dr. Karimi admits. To combat it, he and his team employ a variety of calming tactics — beginning the moment someone enters the practice — to make patients more comfortable. “We use great customer service, hearing the patient’s fears and anxieties, nice music, and friendly injectors,” Dr. Karimi shares. He’s also developed his own line of [CBD wellness](https://broadway.aedit.com/aedition/use-of-cbd-cannabinoids-products-in-wellness-fitness-recovery) products, [HealMD](https://www.healmd.us/), which he says has “significantly reduced anxiety in our patients before the procedure.”

Once it comes time for treatment, Dr. Karimi has a few go-to distraction techniques. “We often recommend patients not look at the needle or think about something else while the injections are being performed,” he says. What’s more? “We use distraction methods such as having an assistant tap the shoulder of our patients while the injections are being performed or other [vibration mechanisms](https://aedit.com/aedition/everything-you-need-to-know-before-getting-botox-for-the-first-time) that can help distract from the discomfort,” he adds.

In the case of more invasive procedures (think: combining filler with a [thread lift](https://aedit.com/procedure/thread-lift) or [laser treatment](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing)), minimal sedation may be offered. “When we are performing more significant combination therapies, we offer nitrous oxide gas inhalation during the procedure, which is a 50-50 mix of nitrous oxide and oxygen,” Dr. Karimi explains. “[It] can really help the patient get through the procedure without any lasting intoxicating effects as the gas wears off in just a few minutes.”

## **Patient Perspective**
Jessica conquered her needle phobia and now has regular appointments to top-off her fillers and Botox®. She tells us how [hypnotherapy](https://aedit.com/aedition/hypnotherapy-for-cosmetic-surgery-sedation-recovery-pain) and exposure therapy helped her to overcome her fear of needles and improved her life for the better.

<Dialogue>
  <Question party={The AEDITION}>
    When did your needle phobia start and how did it affect you?
  </Question>
  <Response party={Jessica}>
    It started when I was a pre-teen. I was having a series of medical tests and went from being a little uneasy about having needles near me — I mean, who isn’t?! —  to having severe panic attacks before having my blood drawn or having any other procedure that involved needles.
  </Response>
  <Question party={The AEDITION}>
    How did you overcome your fear?
  </Question>
  <Response party={Jessica}>
    My motivator for combatting my fear was my desire to become a nurse. Of course, I couldn’t be a nurse who was too scared of needles to be in the same room as anyone having an injection. So, I looked into my options and found an incredible therapist who, over a series of sessions, worked on finding the root of my phobia and practicing hypnosis to help me combat it. As I progressed, I went from being able to hold a needle to being able to give blood without feeling any more than some nerves just as anyone else would. As I’ve gotten older, the shift in my approach has also meant that I have been able to take full advantage of cosmetic injectables to keep my face looking nice and youthful.
  </Response>
  <Question party={The AEDITION}>
    Do you have any advice for anyone who is struggling with the same phobia?
  </Question>
  <Response party={Jessica}>
    For me, the most important step was facing the fact that I needed to do something about the problem. After that, being referred by a friend to a great therapist was nothing short of life-changing. Finding a therapist you connect with and who has experience treating phobias is important. I think having an end goal was key for me. If that end goal is [having your lips done](https://aedit.com/aedition/what-to-know-before-getting-lip-filler-for-the-first-time) or getting those frown lines seen to, then more power to you! Injectables are amazing, and I’m so glad I’m able to have them as a happy side effect of working to combat my phobia in the past.
  </Response>
</Dialogue>

## **The Takeaway**
It’s perfectly normal to feel some nerves prior to a cosmetic procedure, but, if you have a fear of needles, this can be exacerbated. Depending on your level of concern, methods ranging from meditation and therapy (talking and/or exposure) to even anxiety medication may be recommended to help manage your fears. Another tact? [Consult with your aesthetic provider](https://aedit.com/aedition/questions-to-ask-your-doctor-during-plastic-surgery-consultation) — they are often equipped with tips and tools to both educate and empower patients. “All in all, we assess each patient to see what level of anxiety they have about the procedure or procedures and discuss all the options with them,” Dr. Karimi shares.

About 20 percent of the population has some degree of needle phobia. Since knowledge is power, we’re breaking down the different needles used in aesthetic medicine and how to manage fears.