The AEDITION team covers Compounded vs. Branded GLP-1s: What’s the Difference & Is It Safe?

Compounded vs. Branded GLP-1s-pexels-darina-belonogova

If you’ve spent time scrolling social media, talking to friends, or researching weight loss medications online, chances are you’ve come across terms like “compounded semaglutide” or “compounded Ozempic.” You may have heard that these alternatives are often less expensive compared to brand-name [GLP-1](https://aedit.com/aedition/a-comprehensive-guide-to-semaglutide-the-current-skinny-on-the-worlds) drugs, like [Ozempic](https://aedit.com/procedure/ozempic) and [Wegovy](https://aedit.com/procedure/wegovy), and offer similar benefits. But what exactly does “compounded” mean and, more importantly, is it safe? Let’s break it down so you can make the most informed decision for your health (and wallet).

# **What is a compounded GLP-1?**

A compounded GLP-1 refers to a medication that has been custom-made by a licensed pharmacy rather than manufactured by a pharmaceutical company. Compounding pharmacies can mix, alter, or combine active ingredients to create a medication tailored for a patient’s specific needs. With GLP-1s, this often means preparing [semaglutide](https://aedit.com/aedition/a-comprehensive-guide-to-semaglutide-the-current-skinny-on-the-worlds) formulations when brand-name drugs are too expensive or unavailable for the patient. Unlike branded drugs, compounded medications are not FDA-approved. In other words, they don’t undergo the same rigorous clinical trials or quality checks before reaching patients.

# **What is a branded GLP-1?**

So, what is a branded GLP-1? They’re the FDA-approved versions you’ve probably heard of: [Ozempic](https://aedit.com/procedure/ozempic), [Wegovy](https://aedit.com/procedure/wegovy), Rybelsus, and [Mounjaro](https://aedit.com/procedure/mounjaro). Unlike compounded GLP-1’s, branded versions are manufactured by major pharmaceutical companies under strict regulatory oversight. Each batch must meet specified safety, efficacy, and purity standards. Their efficacy is also rigorously tested and backed by large-scale clinical trials.

# **What is the difference between compounded and branded GLP-1s?**

The biggest difference between compounded and branded GLP-1s comes down to regulation, safety, and consistency. Branded GLP-1s are FDA-approved, mass-produced, and subject to ongoing monitoring. Compounded versions, on the other hand, are produced in small batches and can have more variability in quality and formulation. This makes compounded drugs less predictable in terms of safety, dosing, and effectiveness. That’s why it’s so important to work with an experienced board-certified doctor and pharmacy.

# **Why are compounded GLP-1 medications available?**

When there’s a shortage of a commercially available drug or when a patient requires a different formulation, pharmacies will compound the medication. Because demand for Ozempic and Wegovy has far outpaced supply in recent years, insurance providers have offered compounded semaglutide as an alternative for patients unable to access brand-name products. In certain cases, AEDIT Founder and [Board-certified facial plastic and reconstructive surgeon Dr. William Kennedy](https://aedit.com/provider/william-kennedy-md-26292#google_vignette) shares, “Compounded GLP-1 formulations may be combined with additional agents like Vitamin B12 to ease gastrointestinal discomfort, low-dose naltrexone to combat cravings, and metformin to improve insulin sensitivity. These adjustments are tailored to the patient and can help support individual needs.”

# **Are compounded weight loss drugs legal?**

Yes, compounded medications are legal when prepared by a state-licensed pharmacy or FDA-registered outsourcing facility. That being said, there have been instances of pharmacies not having strict protocols or standards and distributing improper dosing and/or impurities. Whenever starting a new medication, always consult with a reputable board-certified doctor.

# **Is compounded semaglutide safe?**

Safety is the biggest concern with compounded versions of semaglutide. Because these medications don’t go through FDA approval, patients may face risks of impurities or incorrect dosing. While there are a number of telehealth services online that can prescribe compounded GLP-1, it’s essential that patients work with a trusted board-certified doctor to ensure the drugs are coming from a reliable pharmacy.

# **Why is compounded Ozempic so much cheaper?**

Without insurance, branded GLP-1 prescriptions can cost more than $1,000 per month. Compounded versions, on the other hand, are often a fraction of that price—sometimes just a few hundred dollars a month. "Brand-name medications like Ozempic undergo FDA approval and extensive quality control, which adds significantly to their price. On the other hand, compounded versions avoid these costs, which is why they’re more affordable, but the level of testing can vary between pharmacies. It’s important for patients to use a reputable source," says [board-certified facial plastic and reconstructive surgeon Dr. William Kennedy](https://aedit.com/provider/william-kennedy-md-26292#google_vignette).

# **Has the FDA warned about compounded GLP-1s?**

Unfortunately, yes, the FDA has issued multiple [warnings](https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss) cautioning patients and prescribers about compounded GLP-1s. Concerns are mainly around fraud, improper dosing, unapproved ingredients, and salt forms. The FDA strongly urges consumers to purchase from [state-licensed pharmacies](https://www.fda.gov/drugs/besaferx-your-source-online-pharmacy-information/locate-state-licensed-online-pharmacy) rather than buying online because there is a heightened risk of counterfeit drugs, impurities, and dosing errors.

# **Can you get Wegovy compounded?**

Some compounding pharmacies do offer compounded versions marketed as “Wegovy,” though technically these are unapproved formulations of semaglutide. Earlier this year, the [FDA](https://www.fda.gov/drugs/drug-safety-and-availability/fda-clarifies-policies-compounders-national-glp-1-supply-begins-stabilize) gave pharmacies notice to cease production, saying the semaglutide shortage is resolved. Patients getting Wegovy compounded should understand that these products are not equivalent to the branded version. If you’re considering this route, it’s critical to ensure the pharmacy is reputable and legally compliant.

# **What are the risks of using compounded semaglutide or tirzepatide?**

When receiving any drug that has been compounded, there is a risk that the formulation doesn’t contain the correct active ingredient or could even be contaminated with other ingredients. There’s also a possibility that the compounded drug has incorrect concentrations, which would mean the person is unknowingly under- or overdosing. These risks can have real consequences for health and weight loss goals.

# **How are compounded GLP-1 medications dosed and delivered compared to brand-name?**

Branded GLP-1s come in pre-filled injection pens with standardized doses. Compounded versions, on the other hand, may be supplied in vials, requiring manual measurement and injection. Because there’s a risk of user error, there is an increased chance of dosing errors.

# **Are there risks of impurities with compounded GLP-1s?**

Yes. Without strict FDA manufacturing requirements, compounded medications carry a higher risk of contamination or impurities. Even small inconsistencies can impact safety and effectiveness, especially for injectable medications like GLP-1s, which is why the FDA has warned consumers about the risks of compounded medications.

# **Are compounded GLP-1s as effective and have the same clinical outcomes as branded ones?**

A GLP-1’s effectiveness will greatly depend on how well formulated it is.  [Dr. Kennedy](https://aedit.com/provider/william-kennedy-md-26292#google_vignette) explains, "When prepared correctly with the same active ingredient, compounded GLP-1 medications can be just as effective as branded versions in terms of clinical outcomes. The key difference is that brand-name drugs are backed by FDA approval and large-scale trials, while compounded formulations depend on the quality controls of the individual pharmacy."

# **Who should not take compounded versions?**

Patients with complex medical histories, underlying health conditions, or those at higher risk of side effects should avoid compounded versions. If a patient is eligible for insurance coverage for weight loss drugs, there’s no need for a compounded version.

# **Where can I get compounded GLP-1s safely?**

If you decide to pursue this option, make sure you are working with a state-licensed compounding pharmacy or an FDA-registered outsourcing facility. Always verify credentials, ask about ingredient sourcing, and confirm whether the pharmacy has experience with sterile injectable medications.

# **Will compounded GLP-1s remain available if brand-name shortages end?**

Probably not. The FDA typically restricts compounded versions once branded supply returns to normal levels. That means compounded semaglutide or tirzepatide may not remain an option forever, especially if the only reason for compounding was a shortage.

# **How should patients or prescribers vet compounding pharmacies?**

- Ask the right questions:
- Is the pharmacy licensed in your state?
- Is it registered with the FDA?
- Where are they sourcing semaglutide or tirzepatide?
- Are sterility and potency regularly tested?
- Do you test your medications for quality and safety?
- Are you following national standards?
- Can you show proof of testing results?

# **The Bottom Line**

Compounded GLP-1s may seem appealing due to lower prices and easier access during shortages, but they come with real safety concerns. Branded medications like Ozempic, Wegovy, and Mounjaro are backed by rigorous research and regulatory oversight, making them the gold standard for treatment. Ultimately, the safest approach is to work closely with a trusted healthcare provider to find the right option for you.


Expert Opinion

Compounded GLP-1s like semaglutide or compounded Ozempic may be cheaper than brand-name drugs like Ozempic and Wegovy, but are they safe? Learn the key differences, risks, FDA warnings, and how to choose a trusted pharmacy for weight loss treatment.

Compounded Semaglutide vs. Ozempic & Wegovy: Safety, Risks, FDA Warnings, and What to Know About Compounded GLP-1 Weight Loss Medications

Compounded vs. Branded GLP-1s: What’s the Difference & Is It Safe?

A woman with surgical markings on her face sits in contemplation, symbolizing cosmetic surgery planning. The image highlights the difference between wanting to “look better” and targeting specific facial features, reflecting expert approaches to aesthetic goals.

How Experts Navigate General Cosmetic Goals-unsplash-joeyy-lee

You walk into a Medspa or a plastic surgeon’s office and say, “I just want to look better.” You’re not pointing to a deep wrinkle, a bump on your nose, or a specific feature you want to tweak—you simply want to feel fresher, more confident, and maybe turn a few heads. You’re far from alone. Many patients approach their dermatologist or plastic surgery consults with general beauty goals rather than specific concerns, which can be challenging for professionals to figure out exactly what “better” means for you… and making sure it’s achievable in a way that leaves you satisfied. So, is it a good idea to get injected or go under the knife when you’re not quite sure what’s “off” to you? We interviewed AEDIT founder [Board-certified facial plastic and reconstructive surgeon Dr. William Kennedy](https://aedit.com/provider/william-kennedy-md-26292#google_vignette) to get his opinion on the matter.

# **Can you get plastic surgery just to look better?**

You’re not feeling comfortable in your skin, we totally get it and can relate. But, is plastic surgery the solution? [Board-certified facial plastic and reconstructive surgeon Dr. William Kennedy](https://aedit.com/provider/william-kennedy-md-26292#google_vignette) says, "The first conversation with a patient should be to uncover what ‘attractive’ means to them personally, how they want to feel, and what aligns with their unique features.” Surgeons and aesthetic specialists want to understand your unique vision of beauty. Sometimes that’s rooted in subtle anti-aging goals, while other times it’s about changing harmony and balance. If you don’t come in with specifics, your doctor should put on his or her detective hat, helping interpret your beauty goals while ensuring the procedure plan is realistic and safe.

# **What are the best cosmetic procedures to look more attractive?**

The best cosmetic procedures for general attractiveness depend entirely on your desired outcome. There are a number of non-surgical treatments that you can get at a Medspa like dermal fillers, [Botox](https://aedit.com/procedure/botox), [skin resurfacing](https://aedit.com/procedure/skin-resurfacing-solutions), and [thread lifts](https://aedit.com/procedure/thread-lift) to rejuvenate the face with minimal downtime. Some surgical options might include eyelid surgery to open up the eyes, [lip lifts](https://aedit.com/procedure/lip-lift) for a youthful smile, or [rhinoplasty](https://aedit.com/procedure/rhinoplasty-nose-job) for profile refinement. When it comes to the body, many doctors turn to [liposuction](https://aedit.com/procedure/liposuction), [breast lifts](https://aedit.com/procedure/breast-lift), or [tummy tucks](https://aedit.com/procedure/tummy-tuck-abdominoplasty) to tone and tighten. The most effective approach is personalized; what looks transformative for one person might be unnecessary for another.

# **Do people get surgery without knowing what they want?**

[Dr.  Kennedy](https://aedit.com/provider/william-kennedy-md-26292#google_vignette) shares, “It’s very common for patients to come in with a clear goal in mind, yet be unsure of which procedure will best help them achieve it.” This is where aesthetic consultations play an essential role. The provider’s job is to listen, ask the right questions, and guide you toward options that align with your anatomy, your lifestyle, and your goals. You don’t have to walk in knowing exactly what you want, but you should be open to honest feedback about what will and won’t work for you. 

# **Is it normal to want plastic surgery but not know why?**

If you’ve been feeling like you need to get plastic surgery without a clear idea, we’re here to reassure you that’s completely normal. It often happens when you’ve been feeling “off” about your appearance but can’t pinpoint the reason. Maybe you’ve noticed you look tired in photos or that your reflection doesn’t quite match how youthful you feel inside. These feelings are valid, but they do require exploration. Good providers will help you unpack whether those feelings stem from a specific facial or body feature.

# **What does “facial balancing” mean in cosmetic treatments?**

Facial balancing treatments are designed to create harmony among your facial features. Instead of zeroing in on one small area, providers look at proportions; how the chin relates to the jawline, or how the cheeks support the under-eye area. Balancing can be achieved with fillers, implants, or surgical adjustments, and the goal is to create an overall effect where no single feature overpowers the others. This approach is especially common when patients come in with general requests to “look better” rather than to fix one thing. From [Dr. Kennedy's](https://aedit.com/provider/william-kennedy-md-26292#google_vignette) experience he shares, “True enhancement isn’t about changing a single feature but rather creating harmony among all the features so that no one element overpowers the others. This might mean using fillers, implants, or surgery, but the end goal is always the same: a natural, proportionate look that feels like the best version of themselves.”

# **What do plastic surgeons recommend if I want to look prettier?**

If you tell your provider you simply want to look prettier, they’ll likely recommend a combination of Medspa treatments to look younger, volume restoration in areas that have hollowed over time, or subtle adjustments to enhance symmetry. The advice will always be based on your individual features, and the goal is to keep the results natural so you still look like yourself—just refreshed and more confident.

# **What procedures make your face more symmetrical?**

Facial symmetry can be improved through a variety of approaches, depending on the underlying cause of imbalance. [Dermal fillers](https://aedit.com/procedure/dermal-filler-and-injectable-solutions) can even out minor volume differences while surgical procedures like [rhinoplasty](https://aedit.com/procedure/rhinoplasty-nose-job) or [chin augmentation](https://aedit.com/concern/chin-augmentation) can address structural asymmetries. In some cases, dental work or orthodontics play a role in balancing the lower face. 

# **What should I ask during a cosmetic consultation?**

When going in for an aesthetic consultation, it’s important to have an open conversation with your doctor. Ask how they would approach your goals, what procedures they recommend, what results are realistic, and what recovery will look like. Additionally, you’ll want to ask to see before-and-after photos of patients with similar procedures and discuss any risks associated. This is also the time to talk openly about your budget, your timeline, and whether you’re looking for a one-time transformation or a longer-term maintenance plan.

# **Can plastic surgery make you more attractive?**

Plastic surgery can enhance your attractiveness when it’s done by an experienced board-certified plastic surgeon. When improvements are subtle and in harmony with your overall look, they can boost your confidence and help you feel more comfortable in your own skin. However, it’s important to keep in mind that attractiveness is subjective, which is why it’s so important to ensure that you and your surgeon are on the same page about your desired outcome.

# **What’s the difference between fixing a feature and enhancing overall beauty?**

Fixing a feature focuses on one specific area, like minimizing a bump on the nose, lifting droopy eyelids, or augmenting the jaw. Enhancing overall beauty takes a holistic view, considering how all your features work together. Many providers find that addressing the face as a whole, rather than in isolated parts, leads to results that feel more natural and long-lasting.

# **Is wanting to “look better” a red flag for plastic surgery?**

We’ll keep it honest: it can be. Vague plastic surgery goals could be a sign that a patient hasn’t fully thought through their expectations. In some cases, wanting to “look better” is perfectly healthy and simply means the patient is open to expert guidance. In other cases, it might indicate a deeper insecurity or external pressure. Since plastic surgery is permanent, a responsible provider will help patients explore this before moving forward.

# **Can vague beauty goals lead to regret after cosmetic procedures?**

Yes, vague requests can sometimes result in plastic surgery regrets, especially if the plastic surgeon didn’t have a good understanding of the patient’s idea of beauty. That being said, sometimes patients are disappointed with their outcomes even when they were treating a specific feature. This is why thorough consultations and realistic goal-setting are so critical. 

# **Is it bad to get cosmetic treatments because of social media trends?**

Trends come and go. Social media also tends to highlight extremes and heavily edited results that aren’t realistic for most people. The safest approach is to choose treatments that align with your personal style and natural features, not just what’s trending online.

# **How do experts handle patients who are chasing beauty trends?**

When providers identify that a patient is chasing a fleeting look, they may steer the conversation toward more timeless and individualized options. This might involve explaining why certain beauty trend procedures won’t age well or showing examples of subtle changes that will still look good years from now. The goal is to help you avoid decisions that could lead to regret down the road. "When patients come in with goals influenced by the latest trend, I encourage them to opt for procedures that will balance and highlight their individuality in a way that feels authentic and stands the test of time,” shares [Dr. Kennedy](https://aedit.com/provider/william-kennedy-md-26292#google_vignette).

# **Do aesthetic procedures impact self-esteem and confidence?**

For many people, the right procedure can boost self-esteem and improve confidence. Feeling good about how you look can have a ripple effect, encouraging you to engage more fully in life. However, if deeper emotional issues are driving your desire for change, surgery alone won’t solve them. That’s why good providers take time to understand the whole picture.


Explore how experts help patients navigate their cosmetic journey from vague beauty goals to specific procedures by defining attractiveness, setting realistic expectations, and creating safe, personalized treatment plans.

Navigating Your Cosmetic Journey: Expert Insights on Vague Beauty Goals, Specific Procedures & Personalized Plastic Surgery Guidance | AEDIT

Wanting to “Look Better” vs. Fixing a Feature: How Experts Navigate Patients' Cosmetic Goals

The AEDITION team covers Are GLP-1's covered by insurance? 

glp1medicationscoveredbyinsurance-pexels-ketut-subiyanto

Just a few years ago, you may have only heard about GLP-1 medications (aka [Ozempic](https://aedit.com/procedure/ozempic), [Wegovy](https://aedit.com/procedure/wegovy), [Mounjaro](https://aedit.com/procedure/mounjaro), etc.) through tabloid headlines or celebrity gossip forums. Fast forward to today, and it’s actually gotten hard to avoid the conversation; we’re constantly bombarded by influencers on Instagram and Tiktok, social media ads, and even our own personal networks.

If you’re thinking about jumping on the [GLP-1](https://aedit.com/aedition/a-comprehensive-guide-to-semaglutide-the-current-skinny-on-the-worlds) bandwagon, you might be wondering if your insurance covers it or how much it would be out-of-pocket. That’s why we’ve broken down exactly how coverage works—from private insurance to Medicare and Medicaid—so you’ll know what to expect and how to get the most out of your consultations.

# **Are GLP-1 drugs covered by insurance?**

When prescribed for FDA-approved uses, many patients can get insurance coverage for weight loss drugs. Each brand (e.g. Ozempic, Wegovy, Mounjaro, etc) has their own specific criteria set by the FDA. If you have type 2 diabetes, a BMI of 30 or higher, or a BMI of 27 or higher with at least one weight-related health condition (e.g. high blood pressure, high cholesterol, etc) then you’ll be more likely to find a GLP-1 drug covered by insurance. If your prescription is considered off-label (i.e. its use is not approved by the FDA) insurance is far less likely to cover it.

# **Is Ozempic covered by insurance for weight loss?**

Ozempic is FDA-approved for type 2 diabetes, not weight loss. While it may help with weight reduction, most insurers will only cover it for diabetes management. Some people with prediabetes, insulin resistance, or certain metabolic disorders may get coverage if their doctor can justify medical necessity, but this is not the norm.

# **Is Wegovy covered by insurance?**

Wegovy contains the same active ingredient as Ozempic but is specifically FDA-approved for chronic weight management in adults with a BMI of 30 or higher or a BMI of 27 or higher with at least one weight-related condition. If the criteria isn’t met, it’s unlikely that the insurance provider will cover the prescription.

# **Will insurance cover Mounjaro for weight loss?**

Insurance will most likely not cover Mounjaro® for weight loss since it is only FDA-approved for type 2 diabetes. If you want to take tirzepatide (vs. semaglutide) for weight loss, consider Zepbound™ which is FDA-approved for chronic weight management. Health insurance still has strict coverage criteria for Zepbound, similar to that of Wegovy.

# **What insurance covers GLP-1 medications?**

Coverage for GLP-1 medications varies significantly depending on the type of insurance plan you have. Some private health insurance plans include benefits for weight-management drugs while others exclude them entirely. Medicare will cover GLP-1 medications when they are prescribed for type 2 diabetes, but federal law currently prohibits coverage of medications prescribed solely for weight loss. Medicaid coverage is determined by individual states, so while some states have begun covering GLP-1s for obesity treatment, others continue to limit their use to diabetes management.

# **How do I get Ozempic or Wegovy approved by insurance?**

The approval process typically involves working closely with your healthcare provider to meet the insurance company’s coverage criteria. You will need to demonstrate that you meet the BMI and health condition requirements, and your doctor will usually have to provide detailed documentation of your medical history, including your weight over time, any past attempts at weight loss, and relevant lab results. This information is submitted to your insurer through a prior authorization request. If your initial request is denied, you can appeal the decision, and many patients do succeed in getting coverage after an appeal.

In [Board-certified facial plastic and reconstructive surgeon Dr. William Kennedy](https://aedit.com/provider/william-kennedy-md-26292#google_vignette)’s experience, he shares "when we prescribe a GLP-1 medication, the process usually begins with a prior authorization request submitted to your insurance company. If the initial request is denied, you have the option to appeal the decision, and many patients do succeed in securing coverage through this process."

# **Why won’t my insurance cover GLP-1s for weight loss?**

One of the main reasons insurers deny coverage is cost; GLP-1 medications can run over $1,000 a month. Many insurance companies still classify weight-loss medications as “lifestyle” treatments rather than medical necessities, despite growing evidence of their benefits for long-term health. For Medicare, there is an additional barrier: federal law currently prohibits the program from covering drugs prescribed solely for weight management.

# **Are GLP-1s covered by Medicare or Medicaid?**

Medicare will cover GLP-1 medications like Ozempic or Mounjaro when prescribed for type 2 diabetes. Medicaid’s policies differ depending on the state. In some states, GLP-1s are available for weight management if strict clinical criteria are met while in other states coverage remains restricted to diabetes treatment only.

# **Does insurance cover compounded semaglutide?**

Compounded semaglutide refers to a version of the medication that is mixed or prepared by a compounding pharmacy rather than manufactured by the original brand-name drug company. Because compounded versions are not FDA-approved, they are typically not covered by insurance. Patients may encounter compounded semaglutide if brand-name products are on backorder or if a prescriber is seeking a very specific dosing option that isn’t offered by the manufacturer. 

While compounded semaglutide can seem like a more affordable option, [Board-certified facial plastic and reconstructive surgeon Dr. William Kennedy](https://aedit.com/provider/william-kennedy-md-26292#google_vignette) reminds us to be cautious. "When it comes to GLP-1 medications, safety should always be the top priority. Unfortunately, there are online sources selling compounded or counterfeit products illegally, and the Drug Enforcement Administration has warned against using them. To protect your health, it’s essential to obtain treatment only through a trusted, licensed medical provider and reliable pharmacy, this ensures you receive authentic medication."

# **How much do GLP-1 drugs cost without insurance?**

Without insurance, GLP-1 drugs can be quite expensive. Ozempic typically costs between $900 and $1,200 per month, Wegovy can range from $1,300 to $1,600, and Mounjaro or Zepbound generally fall between $1,000 and $1,400. The exact GLP-1 prescription cost can vary depending on your pharmacy, location, and any available discounts.

# **What diagnosis is needed for insurance to cover GLP-1s?**

The most reliable path to coverage is a diagnosis of type 2 diabetes, which is the FDA-approved indication for several GLP-1 medications. Some weight-loss versions, like Wegovy or Zepbound, may also be covered if you have a BMI of 30 or higher, or a BMI of at least 27 with an additional weight-related health condition.

# **Can I get Wegovy or Mounjaro covered with a BMI under 30?**

It is possible to get coverage with a BMI under 30 if you have another qualifying health condition. For example, people with a BMI between 27 and 29.9 who also have high blood pressure, high cholesterol, sleep apnea, or type 2 diabetes may still meet the criteria for insurance approval.

# **How do prior authorizations work for GLP-1 prescriptions?**

A prior authorization is essentially your insurer’s way of confirming that you meet all their requirements before they agree to cover the medication. Your doctor will need to provide documentation of your BMI, medical history, and previous weight-loss attempts. The process can take days to weeks, depending on your insurer. If your request is denied, you and your doctor can submit an appeal with additional evidence. 

[Board-certified facial plastic and reconstructive surgeon Dr. William Kennedy](https://aedit.com/provider/william-kennedy-md-26292#google_vignette) elaborates on what this authorization could look like, "When insurers ask for proof of 'prior weight-loss attempts' as part of the prior-authorization process for GLP-1 medications, what they’re really looking for are structured, sustained efforts. This often means documenting three to six months of participation in a formal weight-management program such as medically supervised programs, working regularly with a dietitian or nutritionist, or following a defined exercise. These records, along with your BMI and medical history, are essential to show that lifestyle interventions were made under clinical guidance before moving to prescription treatment."

# **Are weight loss medications like GLP-1s ever covered for aesthetic reasons?**

No, insurance companies will not cover GLP-1 medications for purely cosmetic weight loss. Coverage is reserved for patients who meet specific clinical guidelines and whose health may be at risk without treatment.

# **Can I use a savings card if insurance denies GLP-1 coverage?**

A savings card, sometimes called a copay card or manufacturer coupon, is a discount program offered by the drug’s manufacturer that can lower your out-of-pocket cost if you have commercial insurance. These cards work by reducing your copay at the pharmacy, and in some cases, they can bring the price down to a small fraction of the retail cost. If your insurance denies coverage for a GLP-1, you may still be able to use a savings card, provided you meet the manufacturer’s eligibility requirements. Most programs exclude people on Medicare or Medicaid due to federal regulations, and the discount typically applies only to brand-name medications purchased at participating pharmacies.


Wondering if GLP-1 medications like Ozempic, Wegovy, or Mounjaro are covered by insurance? Learn how private plans, Medicare, and Medicaid handle coverage, what criteria you’ll need to meet, and what to expect with costs, prior authorizations, and appeals.

Are GLP-1 Medications Covered by Insurance? | What You Need To Know

Are GLP-1 Medications Covered by Insurance? What You Need to Know

 Darina Belonogova via Pexels

 Darina Belonogova via Pexels Thumbnail

There’s a solid chance you’ve never heard of Nicotinamide Adenine Dinucleotide—that’s probably because you know it by its widely-used acronym, NAD+. Over the last several years, the naturally occurring enzyme has taken the health and wellness industry by storm. NAD+ has rapidly gained popularity because it’s thought to play an important role in [metabolism, aging, longevity, the immune system, and DNA repair. ](https://www.nature.com/articles/s41392-020-00354-w)

In this 101 piece, we interview industry experts to understand the background of NAD+, its benefits, the different ways to get the treatment, and suggested guidelines for optimal results. If you’re new to NAD+ or just curious to learn more about it, you’ll want to read on. 

## **The Background and Celebrity Influence** 

While most of us are just learning about NAD+, [researchers](https://pmc.ncbi.nlm.nih.gov/articles/PMC6342515/#R82) have actually been studying the enzyme for over a hundred years. However, it wasn’t until 1999 that researchers started to uncover that the molecules play a major role in cellular function regulation. A little over a decade later, the first NAD+ supplements were brought to market. But, the rise of NAD+ therapies really took off in 2020 when it gained traction among celebrities. Jennifer Aniston referred to them as “the future” in a [Wall Street Journal](https://www.wsj.com/style/jennifer-aniston-morning-show-season-3-59413d2f) interview; Hailey Bieber said “I’m going to NAD for the rest of my life and never age” in an episode of The Kardashians; and Joe Rogan spoke about its immunity, cognitive, and overall wellness benefits on his podcast. With so many influencer endorsements, the [NAD+ market grew to an estimated $184 million in 2022. ](https://www.voguebusiness.com/story/beauty/nad-is-hitting-the-mainstream-and-skincare-brands-want-in)

## **The Benefits of NAD+ Treatments**

We actually all have NAD+ in our bodies already. But, as we age, our [NAD+ stores decline](https://pmc.ncbi.nlm.nih.gov/articles/PMC7442590/). [Amanda Kahn, MD](https://www.dramandakahn.com/), board-certified internist and longevity specialist in New York City, says that we lose about 50% by age 40. Since the coenzyme plays a critical role in anti-aging by supporting mitochondrial function, DNA repair, and optimizing cellular activity, a decline in NAD+ can contribute to oxidative stress, inflammation, and reduced production of cellular energy called ATP, says Kahn. 

“Decreased ATP can accelerate aging and degeneration of all tissues in the body, including and perhaps most visibly, in the skin. Research suggests that NAD+ helps maintain skin elasticity by promoting collagen and elastin synthesis, improving tissue hydration, and supporting adequate nutrient delivery by supporting the skin’s microvasculature,” explains Kahn. “NAD+ also activates the Sirtuin family of longevity-associated proteins that promote cellular repair and reduce inflammation, both of which contribute to slowing down and possibly reversing the aging process.”

In addition to its anti-aging benefits, many report that the popular treatment boosts energy levels and enhances cognitive function. By supporting mitochondrial health and regulating oxidative stress and inflammation, NAD+ can also improve focus, memory, and mental clarity.

AEDIT Founder,[ Dr. William Kennedy, MD](https://aedit.com/provider/william-kennedy-md-26292), also weighed in on the subject saying "Mitochondria are responsible for producing about 90% of our body's energy. If we improve the health and function of the mitochondria in our body,  we will feel more energized. NAD+ has emerged as a vital oxidoreductase cofactor that maintains mitochondrial health and function.  NAD+ acts as a cofactor for various enzymes, including sirtuins, which are involved in regulating cellular metabolism and energy production. By activating these enzymes, NAD+ helps to optimize mitochondrial function, leading to increased energy production in the form of ATP, boosting our energy levels."

And, if all of the benefits above weren't enough to convince you of the magic of NAD+, it’s also thought to improve metabolism, sleep quality, and physical performance.

## **How to Get NAD+ Treatment**

Since its steady incline in popularity, NAD+ is widely available; you can get it at wellness-focused clinics, like Advitamin at Shafer Clinic, luxury hotels and resorts, or even book a treatment in the comfort of your own home. 

- **IV Therapy:** With more immediate benefits and a larger dose of NAD+, many practitioners recommend intravenous NAD+ therapy. However, Kahn points out that IV therapy can be time-consuming, more expensive, may not be practical for long-term maintenance, and may be more than the body physiologically needs in one sitting. It is typically administered in clinics or wellness centers and can take around two to four hours. Depending on the person’s goals, the practitioner may add vitamins or medications to the treatment. Since it’s absorbed more quickly, some people have difficulty tolerating infusions and experience nausea, stomach pain, dizziness, and headaches during the session. 

- **Oral Supplements:** NAD+ supplements are available in capsule and powder form and are marketed for their potential to boost energy and support longevity. While they offer a more convenient option compared to IV therapy, their effectiveness is patient-dependent since they must first be absorbed through the digestive system. Though, Kahn prefers precursors of NAD+, such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN), over direct oral NAD+ supplementation because they are easily accessible over the counter, are bioavailable by mouth, and are efficiently transported into cells. For optimal results, supplements must be taken consistently. As with all supplements, there are potential side effects, such as nausea, headaches, itching, and sweating.

- **Injections and Patches:** While less common than IV therapy and oral supplements, NAD+ can also be administered through intramuscular injections and transdermal patches, either in-office or at home. Intramuscular injections provide a quicker method for NAD+ absorption and are typically administered in a clinical setting. Transdermal patches, on the other hand, deliver a slow and steady release of NAD+ through the skin. 

## **Expert Recommendations for Optimal Results**

Let’s get one thing straight: if you want (good!) results from NAD+ therapies, you absolutely need to work with a licensed professional. Regardless of whether you’re looking to try NAD+ once or just take supplements, it’s critical to work with a knowledgeable team. Because the quality and sterility of internal NAD+ supplementation are critical for safety and efficacy, Dr. Khan urges that NAD+ injections should only be obtained by prescription to ensure medical-grade purity and avoid contamination risks associated with unregulated products.

NAD+ therapies are tailored to each individual, so the best practice is to have a consultation or assessment prior to a prescription. The dose, frequency, and duration of an NAD+ treatment varies from person to person and depends on individual factors like health goals, medical issues, baseline NAD+ levels, and demographics. 

“At Advitam, in order to determine what type of NAD+ treatment is best for our patients we start with a comprehensive consultation including lab tests, biomarkers, and body composition analysis,” [Jamie Gabel, PA-C,](https://www.myadvitam.com/about/providers/) a certified physician assistant at New York’s Advitamin at the Shafer Clinic tells us. And, of course, they can offer abbreviated health screenings for those solely interested in NAD+.

When it comes to taking NAD+ to achieve certain health goals, Dr. Kahn finds it particularly helpful during specific periods in life: while trying to conceive for improved egg quality, during post-partum for a boost in mood and energy, after surgery or athletic injury to accelerate healing or after a seasonal illness for a quicker recovery. 

So, how long does it take to feel the “magic” of NAD+? Though patient-dependent, many notice improvements in energy, sleep, cognitive function, and general well-being within a few weeks of consistent use, says Dr. Kahn. 

## **The Bottom Line**

With rising celebrity endorsement, we expect NAD+ to become even more mainstream in 2025. It’s been marketed as a “miracle molecule,” touted for its benefits in reversing the signs of the skin’s aging, boosting energy, enhancing cognitive function, increasing overall wellness, and so much more. The treatment is available in supplement, IV, patch, and injection forms, making it suitable for all different types of candidates. Regardless of which way you “NAD,” you should always seek professional advice to determine if it’s right for you. It's also important to note, at the end of the day, we think all experts would agree that a consistent skincare regimen (sunscreen!) and healthy lifestyle are a necessity alongside NAD+ treatment to see significant results.

Discover how NAD+ supports cellular health, energy production, and longevity. Our experts break down the science and top treatment options in this essential guide.

Is NAD+ the Key to Longevity? Science & Treatment Explained

All of Your Questions About NAD+ Treatments Answered

Maximize your Botox and Filler

[Botox®](https://aedit.com/procedure/botox) and [soft tissue fillers](https://aedit.com/procedure/dermal-fillersinjectables) have gained immense popularity over the years. The two accounted for nearly 60% of all minimally-invasive cosmetic procedures in 2020 — and there’s good reason for it. Relative to other, more invasive, cosmetic surgeries, [Botox®](https://aedit.com/procedure/botox) and [dermal fillers](https://aedit.com/procedure/dermal-fillersinjectables) are much more affordable, require significantly less downtime, and carry fewer health risks. That being said, there is one major drawback: the results are temporary. Fortunately, there are certain behaviors and habits that we can introduce — or eliminate — to get the most out of our treatments.

So, what can you do to widen the gap between dermatologist visits? Read on for tips and considerations to maximize your [Botox®](https://aedit.com/procedure/botox) and [dermal fillers](https://aedit.com/procedure/dermal-fillersinjectables).

## **How Long Do Injectables Last?**
For better or worse, injectables like Botox® and dermal fillerswear off over time. Botox® typically lasts three to six months and most dermal fillers last around six to 12 months. There are a number of factors that play into the longevity of the injections —  some in our control and others not. The location of the injection is a key factor for how long the injectable will last. In general, muscles that are used more frequently will break down the toxin or filler at a faster rate. Muscles around the forehead, eyes, lips, and mouth are typically more active and, as a result, Botox® and filler may fade away more quickly when targeting those areas. Our metabolisms are another factor that impact injectable lifespan. Having a strong metabolism is a blessing for a number of reasons, but not when it comes to Botox® and dermal fillers. A fast metabolism can break down the toxin and filler  at a higher rate.

“Making sure the patient is the right candidate and accurately determining which injectables to do and where is highly important to ensure best results,” says [Amanda Doyle, MD](https://aedit.com/provider/amanda-doyle-md-31526), a board certified dermatologist at Russak Dermatology in NYC. “Going to a board certified dermatologist and / or plastic surgeon is likely to yield the best outcome. Even with the right doctor and right injections, if you have a fast metabolism, it’s possible that the treatments may not last as long.”

For patients who want longer-lasting results, the release of DAXXIFY™, a new anti-wrinkle injection and Botox® alternative, may be a better option once it’s commercially available in 2023. DAXXIFY™’s effects have been shown to last six to nine months, making it an appealing option for those wanting fewer injections. According to [Dr. Doyle](https://aedit.com/provider/amanda-doyle-md-31526), maintenance for DAXXIFY™ looks similar to Botox® and other neuromodulators like [Dysport®](https://aedit.com/procedure/dysportr) and [Xeomin®](https://aedit.com/procedure/xeomin). Whether it’s DAXXIFY™, Botox® or filler, the following expert advice is sure to help you get the most out of your treatment.

## **Expert tips on how to maximize Botox®  and filler injections**


### **Be extra attentive the first 24 hours**


Given the hefty price tag, the last thing you want to do is disrupt the injections as they make their way through the face. With that in mind, it’s best to leave the targeted area stationary and isolated to prevent the injections from dissipating. NYC-based board certified dermatologist [Brendan Camp, MD](https://aedit.com/provider/brendan-camp-md-34645), warns against lying down for at least four hours post procedure to avoid diffusion of the product. Further, [Dr. Camp](https://aedit.com/provider/brendan-camp-md-34645) says facial massages, exercises with inversions, like yoga, and hats or headbands are all a no-go for at least the first 24 hours. Washing your face within the first day is doctor-approved, but you’ll want to be extra gentle and wait at least a few hours after the treatment. 

### **Avoid sun Damage**

It’s no secret that the sun’s harmful rays can cause skin damage in the form of redness, discoloration, and wrinkles. While it’s always important to protect the skin from ultraviolet (UV) rays, it’s even more pertinent for those undergoing dermal filler treatments. Research has found that the sunlight’s UV rays can degrade the hyaluronic acid found in fillers. [Dr. Camp](https://aedit.com/provider/brendan-camp-md-34645) explains that unprotected sun exposure can stimulate enzymes in the dermis, which contributes to the breakdown of normal skin and injected hyaluronic acid. Not only would unprotected sun exposure decrease the lifespan of the fillers and demand more frequent injections, but [Dr. Camp](https://aedit.com/provider/brendan-camp-md-34645) says it can also continue to cause fine lines and wrinkles and a need for a higher dosage of neurotoxins to relax the skin.

### **Manage Stress**

We know, easier said than done. We’re not suggesting you need to eliminate stress completely, but it’s beneficial to work on stress management — if not for your mental and physical health, then for your Botox® and filler. Increased stress can trigger the release of the hormone cortisol which has been known to sometimes reduce our own body’s ability to produce hyaluronic acid. “When this happens, volume loss may become even more noticeable more quickly even when hyaluronic acid filler is part of the regimen,” says [Dr. Doyle](https://aedit.com/provider/amanda-doyle-md-31526). Further, stress can cause us to inadvertently change our facial expressions and recruit more muscles between our eyebrows and around our eyes. When muscle movement is increased, [Dr. Doyle](https://aedit.com/provider/amanda-doyle-md-31526) explains that the effects of the toxin injections may not last as long. Consider incorporating a stress-relieving activity, like yoga or meditation, into your daily routine. 

### **Skip the high intensity workouts**

High intensity workouts may be good for your overall well-being, but they’re not good for the longevity of your Botox® or filler. Exercise can stimulate your metabolism which, in turn, increases the rate at which the neurotoxins and fillers are broken down. “If someone is committed to making their aesthetic investment last as long as possible, it is recommended to integrate more low and moderate intensity workouts into their routine,” says [Dr. Camp](https://aedit.com/provider/brendan-camp-md-34645). The takeaway? Next time you’re thinking about attending your gym’s HIIT class, consider a long-distance run instead.

### **Keep a healthy wellness routine**
Practicing healthy habits is another critical piece to maximizing Botox® and filler injections. While the treatments help reduce the signs of aging, they have their limitations. Botox® and dermal fillers won’t clear up your skin’s complexion, but maintaining a healthy lifestyle sometimes can. Sugar and unhealthy fats can cause inflammation, breakouts, and uneven skin while inadequate hydration can lead to dry skin, eczema, and discoloration. Maintaining a good skincare routine, refraining from smoking, and limiting alcohol consumption can also lengthen the results of fillers and Botox®.

### **Integrate hyaluronic acid into your skincare routine**

Botox® and dermal filler can do wonders when it comes to smoothing out fine lines and rejuvenating the skin, but to achieve even better results, [Dr. Doyle](https://aedit.com/provider/amanda-doyle-md-31526) recommends pairing with hyaluronic acid serums and Revision Revox. The hyaluronic acid helps support and hydrate the skin and the Revision Revox can mimic the toxin injections by softening fine lines and wrinkles. Adding these two products into the mix can improve the results of the filler injections and make your skin look even more flawless.




What can you do to widen the gap between dermatologist visits for your Botox® and filler injections? Read on for tips and considerations to maximize your results.

How to Maximize Your Botox and Filler Injections

shutterstock 1593164065

From chemical peels to pimple patches, here are expert-approved breakout banishers.

Dermatologist-Approved At-Home And In-Office Acne Treatments

8 Dermatologists Share Their Favorite In-Office And At-Home Acne Treatments

james-barr- U7YytlNunM-unsplash

You’ll be hard pressed to find someone who hasn’t experienced a breakout at some point in their life. According to the American Academy of Dermatology (AAD), acne is the [most common](https://www.aad.org/media/stats-numbers) skin condition in the United States, with upwards of 50 million Americans dealing with it annually. 

Some 85 percent of adolescents and young adults between the ages of 12 and 24 experience at least mild acne, and it’s not exactly like those pesky pimples magically disappear in adulthood. A [study](https://jamanetwork.com/journals/jamadermatology/fullarticle/479093) in the *Journal of the American Medical Association* found that 40 to 54 percent of adults over the age of 25 have some degree of facial acne. Adult acne is considered more common in women than [men](https://aedit.com/aedition/how-to-treat-adult-acne-in-men), though it is increasingly impacting people in their [thirties](https://aedit.com/aedition/best-skincare-routine-products-ingredients-for-30s), [forties](https://aedit.com/aedition/best-skincare-routine-products-ingredients-for-40s), and beyond. 

While there are an array of [professional treatments](https://aedit.com/aedition/best-professional-treatments-for-acne-and-acne-scars) and [at-home skincare](https://aedit.com/aedition/best-skincare-ingredients-to-treat-acne-blackheads-whiteheads) that can treat various aspects of breakouts, dermatologists and plastic surgeons haven’t had a singular [solution](https://aedit.com/procedure/acne-solutions) to offer patients that targets acne at the source without a laundry list of side effects – until now. In March, Cutera received clearance from the U.S. Food and Drug Administration for [AviClear™](https://www.cutera.com/solutions/aviclear/), a first-of-its-kind energy device for the treatment of mild to severe acne, and it is being hailed as the biggest acne breakthrough in decades. Here’s what you need to know.

## **What Is AviClear?**
[AviClear™](https://aviclear.com/) is the first and only FDA-cleared energy device for the treatment of mild to severe acne. “What’s amazing is that it works on all types of acne – whether it’s cystic acne, inflammatory acne, hormonal acne, mask acne,” says [Arash Moradzadeh, MD](https://aedit.com/provider/arash-moradzadeh-md-430), a board certified plastic and reconstructive surgeon in Beverly Hills, CA. “Regardless of what type of acne you have, it’s very effective.”

The laser treatment, which is safe for all [skin tones](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types), uses a 1726-nanometer wavelength to address the source of breakouts. Acne forms when sebum (read: oil), dead skin cells, and bacteria on the skin get trapped in the pores. AviClear™ works by selectively targeting oil glands, so that they produce less oil and, over time, less acne without damaging the rest of the skin. “The laser is actually being absorbed by the sebaceous glands, causing them to be down regulated, or destroyed, so that you then have less acne,” Dr. Moradzadeh explains. 

## **Who Is the Ideal Candidate for AviClear?**
One of the most compelling things about AviClear™ is just how inclusive the treatment is. “Unlike other lasers that you can’t use on [dark skin](https://aedit.com/aedition/best-laser-skin-hair-removal-treatments-for-darker-skin-tones), you can do this on anyone,” Dr. Moradzadeh says. It also doesn’t discriminate against certain types of acne, which means it can treat patients from adolescence through adulthood. Unsurprisingly, “teenagers are one of the main groups that want this treatment,” he says – though it’s not just about short-term relief. Less acne for less periods of time will likely mean less scarring down the road. “They can get treated early and avoid getting acne scars that are then very difficult to treat and cover,” Dr. Moradzadeh shares. 

Additionally, AviClear™ is an in-office, energy-based procedure, which means it doesn’t require prescription or over-the-counter topicals, oral medications, or patients remembering to do anything at home. “You are avoiding chemicals, antibiotics, and difficult regimens that some people can’t stick to and abide by,” he says. “For example, a lot of women don’t want to be on birth control for their hormonal acne, so this is giving them a non-chemical, safe alternative.” 

## **How Does AviClear Treatment Work?**
The treatment protocol for AviClear™ is three sessions, spaced one month apart. Dr. Moradzadeh says each appointment treats the entire face – not just the areas you are prone to breakouts. “When you do the treatment, you are doing it over the whole face,” he shares. “Over the course of your three treatments, you are effectively treating all of the sebaceous glands.”

As Dr. Moradzadeh explains, patients are asked to wash their face upon arriving at the office, before the skin is “degreased” with acetone and “rehydrated” with water to improve contact. After the 15 to 30 minute treatment, he says most patients are “a little bit pink” for about 15 minutes. “There is really no downtime,” he shares. In fact, “most of my patients actually love the way they look after they leave because of that kind of micro-swelling glow in the skin,” Dr. Moradzadeh says. The effect “actually makes their acne look less visible when they walk out,” he adds. Patients can resume activities immediately after treatment.

![AviClear Before & After-2](//images.ctfassets.net/zw35sfestf1t/3iPwQlkdTBNgLWzVCIvgcT/952b4fca323e39b72051fed8e4385809/AviClearBA2.PNG)

If you’ve had a [laser treatment](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing) in the past, you may be wondering about the comfort level. The AviClear™ device features a built-in sapphire cooling technology and sensory controls that work to maintain the skin’s temperature throughout the session. As such, “the treatment itself is relatively comfortable,” Dr. Moradzadeh says. “It feels a little bit hot with a needle-like sensation, but you do not require any pain medication or [numbing cream](https://aedit.com/aedition/numbing-cream-breakouts) at all.”

During the three months of treatment (and the months that follow), Dr. Moradzadeh says patients can carry on with their existing breakout-busting routine – including prescriptions like [Accutane](https://aedit.com/procedure/accutane), [spironolactone](https://aedit.com/procedure/spironolactone-for-acne-treatment), and [tretinoin](https://aedit.com/procedure/tretinoin). “You are not limited like you normally would be,” he explains. “If someone is already on Accutane, they can actually still get this treatment and then transition off their Accutane; if someone is already on spironolactone or an antibiotic or a skincare regimen, they can continue that during this treatment and then taper off.” The net-net: “Nothing has to really change,” he says.

Even so, it’s important to share your current skincare regimen with your provider to ensure you are setting yourself up for success. “I usually just review their protocol and see if there is anything better they could be doing as they get through the first six months to their clearer skin,” Dr. Moradzadeh notes. One non-negotiable during treatment? [Sunscreen](https://aedit.com/aedition/best-sunscreens-of-2022). “In terms of photosensitivity, the only thing we recommend is that you must wear sunscreen every day,” he emphasizes.

## **What Are the Results of AviClear?**
If you are familiar with Accutane, you may know that it is a brand name for isotretinoin, a potent form of vitamin A that was approved by the FDA in 1982 for the treatment of severe, resistant, nodular acne that is unresponsive to conventional therapy. The orally prescribed medication treats acne by reducing the size of oil glands and the amount of oil they produce. The results can be life-changing ([read one patient’s experience here](https://aedit.com/aedition/what-its-like-to-take-accutane)) and lasting, but it is not without a litany of side effects that makes it a difficult choice for many.

What makes AviClear™ so unique is that it treats acne in the same way, but it does so without the additional quality of life impacts. We’re highlighting the similarities between the two because the results of AviClear™ are similar to those of Accutane. “The results that have been seen are equal to Accutane, and you are also avoiding Accutane and the side effects,” Dr. Moradzadeh says. It should be noted that, during clinical testing, no significant adverse effects were observed.

So, what does that mean in practice? “When you first start Accutane, there is this phenomenon called ‘the purge’ where you get a breakout,” he explains. “With AviClear™, it is very similar.” One to two weeks after your first treatment, you can expect to have a purge period. “After your second treatment, you see less of that,” he shares. “And then, three months after your third treatment, you notice a significant reduction in your acne.” About six months after your third treatment, “you will usually love your skin,” he notes.

![AviClear Before & After-1](//images.ctfassets.net/zw35sfestf1t/2rqiD6xjS9dcmiuiUwYV62/3bb0dfffc69bf0995e981e34cbab93b9/AviClearBA1.PNG)

In the clinical studies, 80 percent of patients saw at least half of their acne clear after three treatments, and 87 percent said they were “satisfied” or “very satisfied” at week 12. The results continued to improve over the course of six months. Furthermore, any breakouts patients experienced post-treatment were reported to be shorter with fewer and smaller flare-ups. 

While AviClear™ has not yet been studied for the improvement of [acne scars](https://aedit.com/concern/acne-scars), Dr. Moradzadeh says some patients with “reddish- or pink-colored scars” find that they go away during treatment, while appearance of the remainder of their acne scars is minimized. “We are seeing skin quality improvements as a whole, but we have other treatments that are very specific for [acne scar management](https://aedit.com/procedure/acne-scar-solutions),” he notes.

## **The Takeaway**
As Dr. Moradzadeh says, AviClear™ is a “game changer” because it’s the first true acne innovation in more than 30 years. But it’s not just about the aesthetics of clearer skin. [Research](https://onlinelibrary.wiley.com/doi/full/10.1111/bjd.16099) has found that those diagnosed with acne are at an increased risk (40 to 60 percent greater) of developing major depression, and Dr. Moradzadeh has treated patients who don’t want to leave the house or go to school because of their skin. “Acne has such a strong impact on people’s self esteem and how they feel about themselves, and it hurts to not be able to give them something that is amazing,” he says. “So, to have something now that gives them equal results to Accutane feels good.” For the first time in a long time – or maybe ever – “treating acne is a happy thing,” he notes.

Aesthetics

Medic-Upcoming-Appointments-dashboard image

Medic-Upcoming-Appointments-dashboard-image.png

The 1726nm laser is being called the biggest acne breakthrough since Accutane.

The Benefits Of AviClear Laser Therapy For Treating Acne

Meet The Laser That Is Being Called The Biggest Acne Breakthrough In Decades

joel-muniz-fLhghqC2Jp4-unsplash

If ever there was a beauty, skincare, and wellness buzzword that stands the test of time, ‘[collagen](https://aedit.com/aedition/guide-to-collagen-in-skincare-supplements-aesthetic-medicine)’ would be it. You’ll be hard pressed to research anything related to skin health or aging without coming across the term. When it comes to plump, youthful skin, we know collagen is good and a lack of collagen is not. What’s often left out of conversations about collagen, however, is a deeper exploration of exactly what it is, how it’s produced, and the effect it has on skin quality.

Simply put, collagen gives the skin its structure and natural collagen levels start dropping pretty early in life (think: [mid-twenties](https://aedit.com/aedition/best-skincare-routine-products-ingredients-for-20s)). But all is not lost. There are steps that can be taken to slow the declines and even stimulate new collagen production. Intrigued? Here, top dermatologists and nutritionists break down everything we need to know about the beautifying protein.

## **What Is Collagen?**
Collagen is a protein that is naturally found in the human body. “It is a protein produced by the body that makes up something we call connective tissues,” says [Angela Lamb, MD](https://aedit.com/provider/angela-lamb-md-34643), a board certified dermatologist in New York City. “You can also consume collagen through external sources.” Aside from water and fat, the body is mainly made up of proteins – and collagen is the most ubiquitous of them. 

There are different types of collagen, but type I makes up roughly 90 percent of the collagen in the human body. It is a vital component in bones, muscles, cartilage, and, yes, skin. “Collagen is a structural protein that provides rigidity and firmness to the skin,” says [Brendan Camp, MD](https://aedit.com/provider/brendan-camp-md-34645), a NYC-based board certified dermatologist. 

Basically, collagen is an essential building block of healthy skin. “Collagen is the main component of the skin – in fact, 80 percent of our skin is formed from collagen,” explains [Jennifer Hanway](https://jenniferhanway.com/), a board certified holistic nutritionist. “It is found in the extracellular matrix of the skin, so it plays a pivotal role in the skin's structure and rigidity.” Said another way: “It really is the framework that keeps our skin supple, firm, and lifted,” she adds.

## **What’s the Relationship Between Collagen & Skin?**
“The main role of collagen in the skin is to give it elasticity, bounce, and stretch,” Dr. Lamb says. That’s a lot of responsibility, which is why we’re sorry to say that, once you reach your mid- to late-twenties, natural collagen levels start declining at the rate of about one percent a year. “From the age of around 25, both the types of collagen and the amount of collagen in the skin begins to decrease, leading to dryer, thinning skin,” Hanways shares. Hormonal changes (think: [menopause](https://aedit.com/aedition/cosmetic-procedures-skincare-for-women-in-menopause)) and external forces (i.e. sun exposure, [smoking](https://aedit.com/aedition/impact-of-cigarette-smoking-vaping-on-skin-hair-teeth-health), poor diet, etc.) can speed up the degredation process. “Poor diet, environmental factors, and [stress](https://aedit.com/aedition/impact-of-stress-on-skin-acne-wrinkles-dryness) can all negatively affect the quality and integrity of collagen in the skin,” she says. 

Changes in the quality and quantity of collagen correlate to changes in the skin. “With the loss of collagen, the skin sags and develops the [fine lines and wrinkles](https://aedit.com/concern/fine-lineswrinkles) we associate with age,” Dr. Camp notes. The reason? “Collagen constitutes a large portion of the dermis, one of the layers of skin,” he explains. “Think of it like scaffolding off which other skin structures are supported.” The webbing of collagen, elastin, and [hyaluronic acid](https://aedit.com/aedition/guide-to-hyaluronic-acid-in-skincare-dermal-filler) found in the dermis that makes the skin supple, sculpted, and supported in our younger years, breaks down as we get older and aging fibroblasts (the makers of collagen and elastin) can’t produce enough to offset the loss.

![Aging Skin vs Younger Skin Cross Section Illustration](//images.ctfassets.net/zw35sfestf1t/73J5weI4xxCbfEVQnowdc5/7eb132f953c98475752ebb2dcd4b0bae/aging-skin-vs-younger-skin-cross-section-illustration.jpg)

It’s not uncommon to first notice these changes on naturally fuller areas of the face, like the [cheeks](https://aedit.com/concern/cheek-volume). Then, you may find that the area around your eyes starts to look a little less plump. As for the rest of your body, the texture of your hair could start to change, your nails might become more brittle, and you may find you begin to experience joint pain or a loss of muscle mass.

To put a finer point on the timing, collagen production peaks in the [twenties](https://aedit.com/aedition/best-mens-skincare-routine-products-ingredients-for-20s) and starts decreasing at that annual one percent rate by the mid to latter part of the decade. For females, that continues until [menopause](https://aedit.com/aedition/menopause-specific-beauty-skincare-hair-products), at which point collagen levels have a significant falloff. There is an estimated 30 percent drop in collagen during that phase, before stabilizing to a two percent yearly decline thereafter. 

## **Where Does Collagen Come From?**
As we've been talking about, the body makes its own collagen proteins. Fibroblasts are the cells in the connective tissues that produce collagen and elastin. Your body is constantly replenishing its natural supply to counteract the breakdown that occurs. When we are young and healthy, more collagen is created than lost – hence your firm, elastic, and resilient skin that bounces back quickly and efficiently heals itself. But, with age, that scale tips in the other direction as fibroblast activity slows. 

In order for the body to function optimally and produce collagen in the first place, it requires [proper nutrition](https://aedit.com/aedition/how-food-impacts-skin-aging). “All of the foods that we eat are broken down and absorbed through the process of digestion, then used for cellular growth and repair throughout the body,” Hanway explains. “Collagen is formed via multiple processes that need specific amino acids – the building blocks of protein – combined with vitamin and mineral cofactors.”

While Hanways says the nutrients from a diet high in amino acids, vitamins, and minerals promote collagen repair and growth, the opposite is also true. “If a person’s diet is lacking in these foods, then collagen repair and growth will be compromised,” she notes. But it’s not just what you aren’t eating that will negatively impact collagen production. “A diet high in [sugar](https://aedit.com/aedition/the-impact-of-candy-sugar-sweets-on-teeth-and-skin) and refined carbohydrates can actually damage collagen and elastin fibers in the skin via a process called glycation that can cause premature aging, fine lines, and wrinkles,” she cautions.

And then there is collagen supplementation. You’ve no doubt seen plenty of collagen powders and capsules promising to rejuvenate the skin. Research [shows](https://www.mdpi.com/2072-6643/11/10/2494) that collagen supplements can improve skin hydration, elasticity, texture, and density, but not all products are created equal (more on that below). 

## **How Can You Boost Collagen Levels?**
Just because your body's natural collagen levels decline over time doesn't mean there aren't ways to kickstart production. Eating a well-balanced diet, taking collagen supplements, adopting healthy lifestyle habits, and even trying certain skincare and aesthetic treatments can stimulate collagen production. 

### **1. Diet**
You are what you eat. To build collagen, the body makes procollagen from amino acids (i.e. glycine and proline), vitamin C, and minerals. Consuming a [diet](https://aedit.com/aedition/best-diet-for-healthy-beautiful-skin) that is rich in these nutrients will give the body the fuel it needs to create natural collagen.

### **Eat This**
- **For Amino Acids**: Animal & fish protein
- **For Vitamin C**: Guava, kiwi, citrus, berries, leafy greens
- **For Minerals**: Oysters, cashews, sesame seeds, almonds

“Diets that contain animal and fish proteins can help collagen production, as they contain the specific amino acids that the body uses to form new collagen,” Hanway explains. “Adding protein-rich foods into our diets provides us with the raw materials necessary for collagen production.” She recommends “high quality animal proteins,” such as organic chicken, grass-fed beef, and wild-caught salmon. Bone broth is also “a great source of dietary collagen” that can be used for sipping or added to sauces, she notes. 

As Hanway explains, [vitamin C](https://aedit.com/aedition/guide-to-topical-vitamin-c-in-skincare) is an essential cofactor in the formation and stabilization of new collagen, so foods rich in the antioxidant vitamin are essential. “Guava and kiwi are the two fruits that are highest in vitamin C, but other citrus fruits, berries, and leafy greens are also great sources,” she says. Additionally, “copper, manganese, and zinc are the three minerals that play a key factor in collagen production,” she shares. They are, however, “often lacking in our modern-day diets,” she cautions. To up your intake, she suggests adding oysters, cashews, sesame seeds, and almonds to the menu.

While feeding your body what it needs to build collagen is paramount, there are also foods you can add to your diet to fortify your collagen reserves. “Fermented foods such as tempeh, yogurt, sauerkraut, and kombucha contain lactobacillus, a strain of probiotic bacteria that produces superoxide dismutase,” Hanway says. “Superoxide dismutase is a powerful antioxidant that may prevent collagen breakdown by reducing the production of free radicals.” Her advice: “Aim for one serving of fermented foods a day and consider supplementing with a good quality probiotic.” 

### **2. Supplements**
When we talk about [supplements for skin](https://aedit.com/aedition/how-dietary-supplements-can-benefit-the-skin), collagen is almost always part of the conversation. “I’ve supplemented with collagen powder for years and I recommend it to all my clients who want to look after their skin from the inside out,” Hanway shares. Clinical [research](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7070905/) and [trials](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6073484/) have shown that collagen supplements can support skin elasticity, minimize the appearance of fine lines, and boost moisture levels in the skin. “While even I was skeptical at first, there is strong research to support this,” Dr. Lamb says. “It is exciting.”

With that said, the type of supplement matters. “Hydrolyzed collagen is composed of low molecular weight small peptides, which means it is both highly digestible and easily absorbed and distributed in the human body,” Hanway explains. “When taken orally, it is absorbed into the bloodstream in the form of both collagen peptides and free amino acids that are then distributed around the body – especially to the skin – where they can stay for up to 14 days.”

When they reach the skin, Hanways says the collagen peptides and free amino acids have a two-fold benefit:

1. They provide building blocks for the formation of collagen fibers.
2. They stimulate the production of new collagen, elastin, and hyaluronic acid. 

In order to enjoy the benefits of supplementation, it needs to come from the correct source. “I recommend choosing marine collagen from wild caught fish or bovine collagen from grass fed cows,” Hanway says. Collagen only exists in the animal kingdom, which means the concept of ‘vegan collagen’ is a little misleading. “There is no such thing as vegan collagen,” she notes. “Collagen powder is made from the skin or connective tissue of fish and animals.” If a supplement is marketed as vegan, it's probably better classified as a collagen booster and will likely contain ingredients like amino acids, vitamin C, [vitamin E](https://aedit.com/aedition/guide-to-topical-vitamin-e-in-skincare), and other botanicals that protect against collagen degradation. “There are some supplements available that contain the cofactors for collagen formation that may be helpful,” Hanway says.

When it comes to format, Hanway recommends a collagen powder over a collagen capsule because of the clinically significant serving size. “It takes around 10 grams a day to notice changes in the skin, and that amount is hard to get via a capsule,” she says.

As with any type of supplement, not all are created equal. “The conclusions behind research looking at collagen supplements are a mixed bag,” Dr. Camp cautions. “Some data supports the use of supplements, some does not, and some is biased as the makers of supplements produce it.” This is why research into the brand you are purchasing from is key. 

### **3. Lifestyle**
We don’t need to tell you that your lifestyle plays a role in the overall quality of your skin, and collagen is no exception. Unprotected exposure to [damaging ultraviolet (UV) rays](https://aedit.com/aedition/best-skincare-to-treat-sun-damage), poor sleep hygiene, smoking, not eating well, and stress can all cause the premature breakdown of collagen. When you are in your peak collagen-making years, you might not notice the effects of an all-nighter or sweet tooth, but, as natural production slows, the effects will become visible and compound. As such, there are some healthy habits you can adopt to kickstart your body's natural collagen production *and* protect what you already have:

- Get enough sleep
- Limit sun exposure 
- Manage stress
- Quit smoking
- Eat a well-balanced diet
- Avoid sugar & alcohol 
- Use collagen-stimulating skincare 

### **4. Skincare**
You can’t have a conversation about inducing collagen production without talking about aesthetics and skincare. Let’s start with what you can do in-office. On the most non-invasive end of the spectrum, [red light therapy](https://aedit.com/procedure/led-light-therapy) has been [clinically shown](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3926176/) to improve intradermal collagen density. [Sculptra®](https://aedit.com/procedure/sculptra) is a poly-L-lactic acid (PLLA) bio-stimulatory injectable that encourages the body to create new collagen, and Dr. Lamb says [hyaluronic acid-based fillers](https://aedit.com/aedition/hyaluronic-acid-filler-vs-biostimulatory-injectables) can jumpstart production as well. 

### **Aesthetic Treatments**
- Biostimulatory injectables
- Thread lifts
- Microneedling
- Red light therapy
- Resurfacing lasers
- Radiofrequency

[Thread lifts](https://aedit.com/procedure/thread-lift) are also touted for their collagen-boosting abilities, as is [microneedling](https://aedit.com/procedure/microneedling) (a.k.a. collagen induction therapy). Studies [show](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556180/) the tiny needles penetrate the stratum corneum with minimal damage to the epidermis, though it leads to the generation of growth factors that then stimulate the production of collagen and elastin in the papillary layer of the dermis. And then there are energy-based modalities. “Most [resurfacing lasers](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing) and [radiofrequency devices](https://aedit.com/aedition/radiofrequency-skin-tighening-fat-reduction) stimulate collagen,” Dr. Lamb says. Consulting with a board certified dermatologist or plastic surgeon can help determine the best treatment plan for your anatomy.

Topical skincare can also play a role in collagen production. As Dr. Lamb shares, [retinol and retinoids](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare) are perhaps best known active ingredients for collagen concerns. [Bakuchiol](https://aedit.com/aedition/guide-to-bakuchiol-in-skincare) is often touted as a gentler, plant-based alternative to the vitamin A derivatives, and [research](https://pubmed.ncbi.nlm.nih.gov/24471735/) shows it doesn’t skimp on the collagen upregulating benefits. 

### **Skincare Ingredients**
- Retinol & retinoids 
- Bakuchiol
- Glycolic acid
- Peptides
- Vitamin C
- Sunscreen

A member of the alpha hydroxy acid (AHA) family, [glycolic acid](https://aedit.com/aedition/benefits-of-glycolic-acid-for-body) is [believed](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7891644/) to increase collagen production by triggering the body’s natural healing response. [Vitamin C](https://aedit.com/aedition/facts-about-vitamin-c-in-skincare) is instrumental to collagen making and preserving in all forms, but, as a topical, the antioxidant [plays a part](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7547010/) in collagen synthesis and stabilization. Additionally, certain types of [peptides](https://aedit.com/aedition/guide-to-topical-peptides-in-skincare) can either slow the breakdown or increase the supply of collagen and elastin.

Finally, a word on [sunscreen](https://aedit.com/aedition/dermatologist-approved-sunscreen-for-face-body). In case you need another reason to double down on your sun care routine, unprotected exposure to UV rays speeds up the degradation of collagen. Wear a broad spectrum sunscreen with a sun protection factor (SPF) of at least 30 every day as a first line of defense.

## **The Takeaway**
Collagen is a protein that plays a crucial role in the body's makeup, including the structure of the skin. With age, natural collagen production slows and levels begin to decline, which leads to fine lines and wrinkles, thinning, dryness, and volume loss. From diet to supplements to at-home and in-office skincare, however, there are steps you can take to stimulate collagen for smoother, stronger, and more supple skin.

Wellness

A deep dive into the structural protein that keeps skin supple, sculpted, and supported.

The Role Of Collagen In The Skin

Everything You Need To Know About Collagen And The Skin

brian-asare-RxVfMN7xyno-unsplash

It goes without saying that looking at a photograph is not the same as seeing something in real life. A two-dimensional snapshot simply cannot capture the nuance of a three-dimensional world, yet selfie and [social media culture](https://aedit.com/aedition/march-2020-study-shows-relationship-between-social-media-cosmetic-surgery) too often fails to respect that important distinction. Whether it’s through makeup, lighting, or face tuning apps, the photos that fill our feeds are not necessarily indicative of reality. But, increasingly, people are turning to cosmetic treatments to recreate a specific aesthetic that might look great in a picture but doesn’t translate to a natural-looking appearance in person because it lacks the movement and expression we expect to see. This is where an additional dimension of beauty – one that accounts for life in 2D *and* 3D – comes into play.

Recently, we hosted an Instagram Live with [Julius Few, MD](https://aedit.com/provider/julius-few-md-15580), a board certified plastic and reconstructive surgeon in Chicago and creator of [Aforé Beauty](https://www.aforebeauty.com/), to learn more about his concept of “four-dimensional beauty” and how it influences his approach to aesthetic medicine to achieve the most natural and holistic results for his patients. Watch the entire conversation below or read on for a breakdown of five key takeaways.

<a href="https://www.youtube.com/watch?v=6QcFwi8ptxQ" class="embedly-card" data-card-width="100%" data-card-controls="0">Embedded content: https://www.youtube.com/watch?v=6QcFwi8ptxQ</a>

## **1. Defining Four-Dimensional Beauty**
Dr. Few has been in practice for over two decades. While the original outpost of [The Few Institute](https://www.fewinstitute.com/) is in Chicago, he has a satellite office in Los Angeles where he tends to some very famous faces. As he explains, treating public figures has taught him a lot about our understanding and perception of attractiveness. “One of the things that struck me was how I could see a household-name celebrity, who, in a photograph or in a movie, looked a certain way and by all accounts was attractive,” he shares. “But you saw them in person and they went to even a more dramatic and more appealing level.” 

It’s that dichotomy between what he calls the “in-person encounter” and the “print version” that led him to formalize the idea of four-dimensional beauty. “What that represents is the concept that we deal with the three dimensions we all know – length, width, and distance – and the fourth dimension is time and moments in time,” he explains. “We're not talking about days, hours, minutes – we're talking about microseconds of movement and what is communicated both in terms of verbal and non-verbal communication.” 

While there are extreme examples of people overdoing it, even just a little too much filler or neurotoxin can look off if it impacts the natural movement of the face, he says. “That really is what four-dimensional beauty represents – that transition from moment to moment in interpersonal interaction that can either make or break a moment,” he shares. 

## **2. Photo vs. Video**
Even if your in-person schedule is not quite back to pre-pandemic strength, days spent in Zoom meetings, scrolling through TikTok, or rolling your eyes at Instagram’s ever-conspicuous push for video content are a reminder that we do, in fact, live in a three-dimensional world. The best way to look your best IRL is to consider how the result of whatever you are having done is going to impact your features and expressions. 

Dr. Few says the onus is on the provider to properly assess the patient. “Probably the most important thing that any cosmetic plastic surgeon, dermatologist, or provider of any kind really needs to hone in on is the idea that you have to look at animation during that in-office visit,” he shares. One way to educate the patient and further drive home the point is by supplementing traditional [before and after photos](https://aedit.com/aedition/importance-of-before-and-after-photos-in-plastic-surgery) with video. “I've started to incorporate more and more videography into the assessment, so I can show people,” he says. “I do believe that's going to become the norm in many ways.” 

With the ability to put a smartphone with a 4K camera into the palm of anyone’s hand, all providers need to do is standardize their lighting setup and positioning (à la traditional B&A photos). Dr. Few and his team recently [published a study](https://academic.oup.com/asjopenforum/article/doi/10.1093/asjof/ojac002/6515787?login=false) in the *Aesthetic Society Journal* based on the clinical results of using the [Aforé Beauty CR Emulsion](https://www.aforebeauty.com/products/cr-emulsion) – a serum that blends 0.2 percent retinol, [cannabidiol (CBD)](https://aedit.com/aedition/cbd-beauty-skincare-wellness-benefits), peptides, and hyaluronic acid to improve skin tone, texture, and hydration – that included a dynamic video component. “It gave us a platform to develop the videography assessment tool, which is in its infancy,” he says. “We're still working on it in terms of validating and putting it together, but we're well on our way.”

Long term, Dr. Few sees video as “a great equalizer” that will foster transparency. “There will be more and more of a demand for influencers and the like on social media to have videography versus a static picture,” he notes. “What different people got away with just because they had a great 2D picture, that's not going to be good enough.”

## **3. The Rise of Prejuvenation**
It’s usually easier to prevent something than correct it, and that is certainly true of age-related skin and aesthetic concerns. There is a lot to be said about rejuvenating procedures, but, in the last decade, the conversation has expanded to include the idea of ‘[prejuvenation](https://aedit.com/aedition/i-was-practicing-prejuvenation-before-it-was-a-trend)’ (i.e. preventative treatment). “I kind of came up with that term ‘prejuvenation’ at a multi-specialty meeting probably 10 or 11 years ago,” Dr. Few shares. “The whole concept came up during a panel because, at that time, I was just starting to really kick into taking care of a lot of models and actors, and that group really was keen on the idea of avoiding the knife.” Instead, they were interested in less invasive solutions that they could start earlier in life to potentially delay or eliminate the need for more invasive measures down the line. 

But it’s not just celebrities who want to get ahead. Dr. Few says he has long had patients who are predisposed to deeper frown lines or have a family history of jowling and want to address them as early as possible. “You can preempt that whole phenomenon just by simply targeting that area when it first starts to form, and then you hold it in suspended animation,” he explains, adding that it’s not about stopping the clock or dramatically altering someone’s appearance. “I believe if you try to take that given point where things are transitioning in maybe not the most positive way and hold it, well then that’s mission accomplished,” he says. “You've now made somebody achieve their goal of looking naturally beautiful and aging in the most graceful way, which, in my opinion, is the way to go.” 

Returning to those four dimensions of beauty, it’s all about enhancing what is already there in the most natural way. “It's not about aging ungracefully or in any artificial way or even not aging at all,” Dr. Few explains. “To me, where the artistry of cosmetic medicine and surgery comes through is in creating subtle contrast.” For example, “you have somebody who maybe has gray hair but, at the same time, has a youthful kind of very subtle cuteness that shines through,” he says. “That's their own individual expression.”

## **4. Blending Surgical & Non-Surgical Solutions**
Just because Dr. Few is a plastic surgeon doesn’t mean that every patient of his is going under the knife. “I am somebody who's kind of formed an expertise in both the surgical and non-surgical space – especially for facial rejuvenation and prejuvenation,” he says. In his view, it’s not so much surgical versus non-surgical but rather a continuum. “I try to position things in a way so that if somebody is not sure which direction they want to go, it's easier to do something that's a bit more temporary – that's non-surgical – that then can lead into a surgical option if that's what they want,” he explains.

Generally speaking, prospective patients fall into three categories: 

1. I definitely want surgery.
2. I definitely don’t want surgery – regardless of what I need.
3. I’m undecided and want to know my options.

After determining which bucket someone falls into, there are a trio of factors Dr. Few considers during a consultation to formulate a treatment plan: skin quality, volume loss, and facial laxity. “When you look at those three components, then I get to go into my toolbox and decide what are the options that work for it,” he shares. “For the skin, it may be different forms of resurfacing lasers, peels, etc., and then you look at non-surgical versus surgical lifting.” Seeing as he remembers the days when [Restylane®](https://aedit.com/procedure/restylane) was only one hyaluronic acid-based filler on the market, today’s innovation – especially in the non-surgical space – means there are now “more options than you could even hope to use.” As such, “it becomes much like picking the right paint brush for the component of the canvas you're painting on,” he says.

Finding the right balance between surgical and non-surgical has actually spurred hybrid solutions over the years. Dr. Few cites the evolution of the so-called [Nefertiti neck lift](https://aedit.com/aedition/where-to-use-botox-from-head-to-toe) as one such example. While injecting neurotoxin into neck bands can have a dramatic impact on texture and contour, the effect is temporary. For a longer-lasting result, Dr. Few developed a slightly more invasive neck band procedure. “That's where I can use a special needle that's called a no cord needle to actually go in and break up the bands of the muscle – much like the [Xeomin®](https://aedit.com/procedure/xeomin), [Dysport®](https://aedit.com/procedure/dysportr), or [Botox®](https://aedit.com/procedure/botox) would do – but it does it in a more permanent way,” he says. “You can marry these concepts, which is what makes it fun.”

## **5. The Benefit of ‘Stackable’ Treatments**
Long before the pandemic made the idea of [maximizing in-office time](https://aedit.com/aedition/best-aesthetic-procedures-to-combine-to-maximize-appointments) with your provider a must, Dr. Few was honing the technique of what he calls “stackable treatments.” “When I first came up with ‘stackable treatments’ as a concept, it was the combination of [Ulthera®](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy) and lasers and fillers – doing that all in one setting,” he shares. As he explains, the combination approach was, initially, “purely out of necessity.” “When I first started seeing patients in New York, I didn't have the luxury of trying to space it out over six months,” he notes. But then he realized the multimodal nature of the appointment was more than just convenient. “There's synergy in it,” he shares, that actually improves the results that would be possible with each treatment individually. 

But not all stacks need to happen at once. Lately, one of the popular pairings at his practice involves combining Dr. Few’s signature [thread lift](https://aedit.com/aedition/pdo-thread-lift-for-facial-rejuvenation) with [Sofwave™](https://aedit.com/aedition/sofwave-for-skin-tightening-collagen-production), a new non-surgical skin-tightening treatment that uses ultrasound waves to firm the skin, and [Kybella®](https://aedit.com/procedure/kybella) to address an array of age-related concerns in the lower face. “I'll do thread lifting, get a result, and then we can come back and do Sofwave™ to further enhance,” he explains. “It seems to really play on that matrix that has been created by the thread lifting.” But that’s not all. “If they still have a little bit of jowl fat, I can do a bit of off-label Kybella® injection to shrink it down,” he adds. “All of a sudden we're creating this approach that can deliver a progressive result.”  

Perhaps most importantly, this trio is not designed to create a trendy, overly snatched jawline. “Always bearing in mind four-dimensional beauty, we’re not trying to do anything just for the sake of a photograph on social media,” Dr. Few says. Instead, the procedures subtly-yet-substantially sculpt the lower face and neck for a more youthful countenance. The result: You’ll look like a rejuvenated version of yourself.

Board certified plastic and reconstructive surgeon Julius Few, MD, breaks down the concept.

Ask The Expert