Julia Avamotive via unsplash

Ross Helen via Canva

According to the most recent[ American Society of Plastic Surgeons (ASPS)](https://www.plasticsurgery.org/documents/news/statistics/2023/minimally-invasive-procedure-trends-2023.pdf) data (and some rough math), someone is undergoing a filler treatment nearly every five seconds. This past year, doctors recorded over [six million ](https://www.plasticsurgery.org/documents/news/statistics/2023/minimally-invasive-procedure-trends-2023.pdf)treatments of dermal filler, making it the second most popular minimally invasive cosmetic treatment — after Botox, of course. But, lately, we’ve been hearing some pretty mixed reviews of the omnipresent treatment. Most commonly, we’ve heard rumblings that filler can “migrate” or move after it’s been injected. We’ve also heard horror stories that it might not [dissolve](https://www.newsweek.com/mri-scan-33-year-old-woman-face-shows-filler-ended-surgery-1925089) or can even make your face puffy. Given it’s almost as widespread as Botox, we all agreed that we needed answers. Stat. So, we reached out to our network of experts to find out if filler migration is a myth or fact.

## **Why is Everyone Talking About Filler Migration Now?**

If you feel like the term “filler migration” just popped up overnight, it’s not just you. It kind of did. Over the summer, a Beverly Hills oculoplastic surgeon posted a [video](https://www.tiktok.com/@kamiparsamd/video/7390433025697533230) to TikTok sharing the findings of an MRI scan of facial filler… and the internet went absolutely wild. The patient, a 33-year-old woman, reported she had 12 CCs of hyaluronic filler over the past six years, yet the scan showed that there was over double that amount of facial filler present under her skin, and in places she hadn’t even been injected. The video’s comment section became flooded with similar stories of having never-dissolving filler, which contradicts everything we’ve been told about filler.

Until now, we’ve been, we’ve always been under the impression that fillers are not permanent. If you ask any doctor, they’ll most likely give you a similar answer: HA-based fillers typically last anywhere from six months to a year and a half whereas non-HA-based fillers last a minimum of two years. It’s hard to predict exactly how long a filler will stay in someone’s body, but board-certified NYC cosmetic dermatologist [Dr. Michele Green](https://www.michelegreenmd.com/) says the longevity of any filler can also be affected by the patient’s skin characteristics, metabolism, and lifestyle choices.

“Low skin elasticity makes it hard for the skin to hold a filler, leading to a shorter length of results. Fast metabolisms can lead to quicker degradation of a filler. Excess sun exposure can break down collagen fibers, leading to reduced longevity of a filler,” she tells us.

## **What is “Filler Migration” and Can it Really Happen?**

Though it’s an uncommon side effect, our expert network confirmed that it’s not just a myth — filler migration does exist. For several reasons (we’ll get to that later on), it is possible for the injected filler to move from its injection site to another area of the face. But, to be clear, we’re talking about movement in millimeters, not anything drastic. 

“Filler migration is not a common side effect of dermal filler injection procedures,” NYC-based board-certified dermatologist [Brendan Camp, MD](https://aedit.com/provider/brendan-camp-md-34645) assures us. “It may be more likely to occur when someone gets filler treatments often in which a high volume of filler is used over time and is layered on previously injected filler.”

So, if you notice lingering asymmetry, lumps, unevenness, or puffiness after getting filler, then there’s a good chance it could be the infamous “filler migration.” According to Dr. Green, the dreaded filler migration can occur anywhere, but it most commonly presents itself in areas with thin skin, like the lips and tear troughs (under the eyes). While the onset of filler migration varies, Dr. Camp says it usually happens within days of the treatment if the injection was too superficial or within months as the filler is metabolized and its structure is altered.

But, again, remember that it’s not that common. 

## **What causes Filler Migration?**

While we can’t control whether or not our filler migrates, there are a few things to stack the odds in our favor. Dr. Green says that the most common causes of filler migration are overfilling, incorrect injection technique, and using the wrong filler. 

Dr. Green breaks it down for us: “too much filler in an area can cause a pressure imbalance, resulting in the filler migrating towards adjacent tissues. Inadequate injection techniques, such as injecting too close to the surface or using excessive pressure, can also lead to filler migration. Additionally, there are many different types of fillers on the market, all with varying concentrations and formulations. Using a filler that is not suited for the injected area can result in filler displacement.”

While any filler can result in filler migration, Dr. Camp and Dr. Green both said that non-HA-based fillers are less likely to migrate compared to HA-based fillers. This is because they promote new collagen production, which reduces the risk of migration.

And, Dr. Camp warns that HA-based fillers can expand after treatment because the filler is not saturated with water in the syringe. As a result, the HA molecule attracts and retains water and can cause additional swelling after it has been placed in the skin.

## **Can You Remove Filler?**

There’s a good chance you’ve heard conflicting answers to whether or not filler can be removed — and, that’s because some types of filler can be dissolved whereas other types can’t be. According to the experts, HA fillers can be dissolved whereas non-HA fillers can’t.

HA-based fillers can fortunately be dissolved with an agent called hyaluronidase, which is a naturally occurring enzyme that breaks down hyaluronic acid into its smaller components. Once injected into the area of filler migration, hyaluronidase acts immediately, with results visible after just 48 hours, says Dr. Green.

Unfortunately, there’s still no technology to dissolve or remove non-HA filler. The only solution is time and, depending on the type of filler used, patients may have to wait several months or years. That being said, Dr. Green said there are certain circumstances where a plastic surgeon might help, like if a granuloma has formed and can be excised. 

## **The Bottom Line**

Filler migration does exist, but it shouldn’t hold you back.  While the issue isn’t black and white, there are always ways to mitigate risk, most importantly by selecting the right injector. Seeking treatment from a board-certified physician who has the knowledge to choose the right type of filler for you and inject it properly is the safest way to ensure you are getting ideal results. 


Now Trending

Filler migration, are all users at risk? 

The risk of Dermal Filler migration. What to know from the medical experts. 

Filler Migration: Should You Be Worried? Experts Weigh In

cottonbro-studio-pexels

If you thought skincare couldn’t get more innovative, think again. From snail slime to bee venom, scientists are constantly exploring new frontiers in skincare. Now, there's a new player in town: polynucleotides. Derived from an unexpected source—salmon sperm—this skincare treatment is making waves, particularly in the UK, where it has seen a surge in popularity. But what exactly are polynucleotides, how are they used, and is this trend something you should consider adding to your beauty routine?

## **When Did the Treatment First Become Popular?**

Although it sounds cutting-edge, the use of polynucleotides in skincare isn’t entirely new. Polynucleotide-based treatments have been quietly gaining traction in Asia for several years, particularly in South Korea and Japan, where cutting-edge beauty innovations frequently originate. However, it was only recently that the treatment gained widespread attention in the UK and Europe. Social media influencers and beauty bloggers have played a significant role in this surge, documenting their experiences with the treatment and swearing by its skin rejuvenation properties. As with many beauty trends, the treatment's celebrity endorsements have amplified its popularity, making it the latest must-try in advanced skincare. Over recent months, the treatment has been making its way into dermatologists’ offices across the US, with skincare enthusiasts hailing it as the latest must-have addition for youthful skin. 

## **What Are Polynucleotides?**

At the core of this buzz is a molecule known as polynucleotides, which, in scientific terms, are made up of DNA or RNA chains. In simpler terms, these molecules provide essential support to your skin at the cellular level. [Dr. Saami Khalifian](https://www.drsaami.com/), a board-certified dermatologist from SOM Aesthetics, explains, “Polynucleotides are beneficial for the skin because they promote hydration, reduce inflammation, and support the skin's natural repair mechanisms.” This makes them a gold mine for anyone looking to improve skin elasticity, reduce fine lines, or combat dullness.

The fact that these molecules are derived from salmon sperm might sound off-putting at first, but it’s worth noting that they’ve undergone extensive purification processes to isolate the beneficial components. Much like how collagen supplements are sourced from animal byproducts, polynucleotides are a valuable tool in the skincare arsenal, offering scientifically backed benefits that translate into smoother, more youthful-looking skin — without a fishy smell in sight!

## **What Does the Treatment Entail?**

So, what does undergoing a polynucleotide treatment actually look like? Thankfully, the process is non-invasive. It typically involves the application of a serum or gel enriched with these molecules. Think of it as a supercharged facial, where the polynucleotides penetrate deep into the skin, delivering a surge of hydration and nutrients.

Unlike treatments that require recovery time, polynucleotide facials are quick, painless, and involve zero downtime. It’s often compared to a deep-conditioning treatment, but for your skin. According to [Dr. Khalifian](https://www.drsaami.com/), “The procedure is akin to a deep conditioning treatment for the skin, providing essential nutrients and hydration without the need for invasive methods or lengthy recovery.” This means you can easily fit it into a lunch break and go about your day with glowing, rejuvenated skin.

## **Who Is a Candidate for This Treatment?**

The beauty of polynucleotide treatments is that they’re suitable for a wide range of people. Whether you’re in your 20s and looking to stave off early signs of aging or in your 40s wanting to restore elasticity and smoothness, this treatment can cater to various skin needs. It’s particularly effective for those dealing with dryness, dullness, or fine lines, helping to revitalize tired-looking skin.

However, as with all cosmetic treatments, there are some caveats. Pregnant individuals, for example, should avoid this treatment due to the lack of studies on its safety during pregnancy. Likewise, anyone with specific allergies to the components of the treatment should steer clear. A consultation with a board-certified dermatologist is always recommended to ensure the treatment is right for your skin.

## **How Long Do the Results Last?**

One of the most common questions surrounding polynucleotide therapy is the longevity of its results. Unlike more temporary treatments, the effects of polynucleotide facials tend to last for several months. Factors such as your skin type, environmental exposures, and how well you maintain your skincare regimen can all play a role in how long the glow sticks around.

[Dr. Khalifian](https://www.drsaami.com/) notes that “consistent treatment and proper skincare can help prolong the effects.” While the treatment provides immediate hydration and a noticeable glow, it’s the long-term benefits—smoother, firmer skin—that keep clients coming back. Typically, a full treatment plan involves several sessions over the course of a few months, with each session building upon the last for lasting results.

## **What Is the Average Cost?**

If you're considering adding this trending treatment to your beauty routine, it's important to know the financial commitment involved. The cost of polynucleotide therapy can vary depending on where you go, but you can generally expect to pay between $200 and $500 per session. A complete treatment plan, which may involve multiple sessions, can increase the overall cost, but many clinics offer packages to help make the process more affordable.

In terms of value, the benefits of polynucleotide treatments—such as lasting hydration and the stimulation of your skin’s natural repair mechanisms—make it a more sustainable investment compared to quick fixes like superficial facials. While the initial outlay might seem steep, the long-lasting results could outweigh the need for more frequent, lower-cost treatments.

## **Where Can You Get This Treatment?**

Currently, polynucleotide facials are primarily offered at medspas, dermatology clinics, and plastic surgery centers. As the treatment gains traction, more providers are beginning to include it in their service offerings.

In the U.S., the treatment is still in its early stages of popularity, but as word spreads and more clinics adopt the technique, it’s likely only a matter of time before it becomes as ubiquitous as microneedling or chemical peels. For now, you may have to do a bit of research to find a clinic in your area that offers polynucleotide therapy, but rest assured that it’s an option well worth considering if you’re serious about upgrading your skincare routine.

## **Is the Salmon Sperm Facial Worth the Hype?**

At first glance, the idea of applying salmon sperm to your face might seem bizarre, but the science behind polynucleotides and their skin-rejuvenating properties is hard to argue with. From enhanced hydration to smoother, more resilient skin, this treatment offers a range of benefits that go beyond what many conventional facials can provide.

If you’re curious about trying the latest in skincare innovation and are willing to make an investment in your skin, polynucleotide therapy might just be worth the hype. With growing popularity and increasing availability, the salmon sperm facial could soon become a staple in advanced beauty treatments across the globe.


Overview of polynucleotides and why the "salmon sperm" facial is the new trending treatment in skincare.

Everything you need to know about the salmon sperm facial.

The Salmon Sperm Facial: What Are Polynucleotides, and Is This Trending Skincare Treatment Worth All the Hype?

altin-ferreira-TSFmAgJoDoM-unsplash

Every feature plays a role in [facial harmony](https://aedit.com/aedition/facial-harmony-in-aesthetic-medicine). When it comes to the upper third of the face, we often devote our time and attention to [the eyes and the brows](https://aedit.com/aedition/brow-lift-vs-blepharoplasty-vs-both) – but what about the forehead? The area from the hairline to the brow bone holds a lot of prominence and conveys a lot of emotion, which is why it can have such an impact on the overall proportion of the face. And, like so many other facial features, there is no singular forehead concern or procedure to treat it. From a forehead reduction to Botox, there are both surgical and non-surgical solutions to address a myriad of [forehead-related aesthetic concerns](https://aedit.com/concern/forehead-shape-and-size). Here’s what you need to know.

## **Forehead Proportions**
Based on its size alone, the forehead has always been at the forefront of the face. But nearly two years of wearing pandemic-related face coverings has put a spotlight on it in a new way. “With the COVID-era and [mask use](https://aedit.com/aedition/influence-of-covid-19-face-masks-on-medical-aesthetics-trends), the upper face is more noticeable than ever,” says [Samer Jaber, MD](https://aedit.com/provider/samer-jaber-md-3882), a board certified dermatologist and founder of Washington Square Dermatology in New York City. 

Unlike [lip volume](https://aedit.com/aedition/what-to-know-before-getting-lip-filler-for-the-first-time) or [brow fullness](https://aedit.com/aedition/guide-to-surgical-and-non-invasive-brow-lift-procedures), there aren’t really aesthetic ‘trends’ related to the appearance of the forehead. Instead, patients and providers alike are looking at it relative to the face as a whole. “While there is no universal perfect forehead size, having a forehead that is [proportional](https://aedit.com/aedition/plastic-surgery-results-are-about-proportion-not-perfection) to the rest of your face can make you feel more attractive,” Dr. Jaber says. Generally speaking, “in an ideal appearance, the forehead should make up one-third of the face and should be approximately equal in size to the midface and the lower face,” explains [Rebecca Marcus, MD](https://northdallasderm.com/rebecca-marcus-md/), a board certified dermatologist in Dallas, TX. “This rule of ideal proportions is called the Golden Ratio.”

## **Aesthetic Forehead Concerns**
Now that you have a better sense of how the forehead relates to the rest of the face, it’s time to talk about the specific aesthetic concerns that people often have about the feature. “The most common general concerns are related to volume loss seen in the temporal region,” says [Amir Karam, MD](https://www.drkaram.com/about/meet-dr-karam/), a board certified facial plastic and reconstructive surgeon and founder of [KaramMD Skin](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fkarammdskin.com%2F). “Volume loss can cause the temples to sink in to give it a more hollow look making the face look bonier.” Dr. Marcus, meanwhile, regularly sees patients who believe their forehead “may be too wide, too narrow, too short, or too long.” Additionally, the [hairline](https://aedit.com/aedition/surgical-and-non-surgical-procedures-to-reshape-the-hairline) may be encroaching, receding, or uneven. 

And then there is the skin of the forehead. You’ll be hard pressed to find someone who doesn’t have any [horizontal forehead lines](https://aedit.com/concern/fine-lineswrinkles) (unless, of course, they’ve long been a neurotoxin devotee). These expression lines are caused by the constant movement of the frontalis muscles, the pair of vertically oriented muscles that lift the eyebrows. Furthermore, “the skin on the forehead can also overproduce oil or possess enlarged oil glands, known as sebaceous hyperplasia, which would manifest as small bumps in the skin,” Dr. Marcus adds. 

Regardless of what’s bothering you about your forehead, there are both [surgical and non-surgical solutions](https://aedit.com/procedure/forehead-reduction-solutions) that can address the shape, size, and skin. 

## **Surgical Forehead Procedures** 
In general, surgical procedures yield the most dramatic and lasting results. Depending on your forehead concern, they may be the best option. Below are three of the most common:

### **1. Browplasty**
A [browplasty](https://aedit.com/procedure/brow-lift-forehead-lift-browplasty) (a.k.a. forehead lift or brow lift) is a cosmetic surgery that can address the positioning of the eyebrow, which, in turn, enhances the forehead. While there are different types of brow lifts that each carry varying degrees of invasiveness and scarring, surgical brow lifts can reposition the brow, remove excess skin and fat, and tighten the muscles in the forehead area. This combination can minimize the appearance of forehead lines, soften frown lines, and restore a more youthful brow. It can be performed alone or to complement a [blepharoplasty](https://aedit.com/aedition/combining-blepharoplasty-and-brow-lift), [facelift](https://aedit.com/aedition/best-procedures-to-combine-with-a-facelift), or other facial procedure. For patients who have exhausted the so-called [Botox brow lift](https://aedit.com/procedure/chemical-brow-lift), Dr. Jaber says “a surgical brow lift with a plastic surgeon could be pursued for a more dramatic effect.” 

### **2. Hair Transplant**
Whether you realize it or not, your forehead and hair are inextricably linked. After all, the shape of your hairline directly affects the shape and size of your forehead. If you are concerned about a receding or uneven hairline, a [hair transplant](https://aedit.com/procedure/hair-transplant) may be for you. “Hair transplants, when done well, look wonderful and make a huge impact on one's confidence,” Dr. Marcus shares. 

[Follicular unit extraction (FUE)](https://aedit.com/procedure/follicular-unit-extraction-fue) involves transplanting individual hair follicles from the back of the head to the front to create a new hairline. This technique generally works best for people with short hair. [Follicular unit transplantation](https://aedit.com/procedure/strip-harvesting) (i.e. strip harvesting), meanwhile, is usually the preferred method for those with longer locks. Rather than explanting one at a time, a strip of follicles is taken from the rear of the head and then distributed to thinning or balding areas. 

In either case, you’ll need to be patient as the transplanted follicles establish themselves and start to grow. You’ll see initial results in about six months, with the full effect visible 12 to 18 months post-op.

### **3. Forehead Reduction**
While celebrities like Naomi Campbell and Vanessa Paradis are known for their larger foreheads that perfectly complement their facial features, not everyone is comfortable with the size of theirs. If your forehead is larger than you’d like, a [forehead reduction](https://aedit.com/procedure/forehead-reduction) may be in order for the right candidate. “With a forehead lowering procedure, an incision is made at the hairline from ear to ear,” Dr. Karam says. As he explains, one to two centimeters of skin are removed and the entire scalp is advanced forward. “The downside is that it’s surgery and will have a [scar](https://aedit.com/aedition/scarring-after-facial-plastic-surgery) at the hairline, but, otherwise, it is effective in creating the right proportions,” he adds. It can be a solution for those with a naturally strong hairline that needs to be lowered, but it’s not applicable for those who have had a [coronal brow lift](https://aedit.com/procedure/coronal-brow-lift) or strip harvesting. 

## **Non-Surgical Forehead Treatment Options** 
Whether you’re not quite ready to go under the knife or you want to treat something that doesn't require cutting, here are some of the best non-surgical procedures to address aesthetic forehead concerns.

### **1. Laser Hair Removal**
We talk a lot about receding hairlines, but [hair loss](https://aedit.com/concern/hair-loss) isn’t always the issue when it comes to the appearance of the forehead. “If the hairline is too low, removing hair at the hairline could help the forehead to appear larger,” Dr. Marcus explains. [Laser hair removal](https://aedit.com/procedure/laser-hair-removal) can provide the necessary reprieve, and celebrities like Kim Kardashian have admitted to seeking this solution. The process is virtually painless, though it does require [multiple sessions](https://aedit.com/aedition/laser-hair-removal-for-men) before the final result is achieved. While the technology has come a long way, it’s not an option for everyone. Those with [darker skin tones](https://aedit.com/aedition/best-laser-skin-hair-removal-treatments-for-darker-skin-tones) or lighter hair colors may not be candidates. [Electrolysis](https://aedit.com/procedure/electrolysis) may be an alternative.

### **2. Neurotoxins**
We’re all familiar with wrinkle-smoothing benefits of [Botox®](https://aedit.com/procedure/botox), [Dysport®](https://aedit.com/procedure/dysportr), [Jeuveau®](https://aedit.com/procedure/jeuveau), and [Xeomin®](https://aedit.com/procedure/xeomin), and one of their most beloved applications is for horizontal forehead lines. While neurotoxins can be injected directly into said wrinkles, strategic placement can yield an even more rejuvenating effect. “Botox® can be strategically injected to lift the medial and lateral portions of the eyebrows and help the forehead to appear more open and lifted,” Dr. Marcus says. “This is one of my favorite ways to provide a patient with a quick freshening up.” The minimally invasive solution not only softens the appearance of existing lines by temporarily ‘freezing’ the underlying muscles, but it also helps prevent further deepening. 

### **3. Non-Surgical Skin Tightening & Resurfacing** 
If [skin tone](https://aedit.com/concern/uneven-skin-tone), [skin texture](https://aedit.com/concern/uneven-skin-texture), or skin quality are a concern, there are additional non-surgical [skin tightening](https://aedit.com/aedition/best-nonsurgical-skin-tightening-procedures) and [skin resurfacing](https://aedit.com/aedition/ultimate-guide-to-skin-resurfacing-procedures) treatment options that can address the forehead and beyond. “Procedures such as [radiofrequency](https://aedit.com/aedition/radiofrequency-skin-tighening-fat-reduction), [microneedling](https://aedit.com/procedure/microneedling), and [Ultherapy®](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy) can be used to stimulate collagen production,” Dr. Jaber says. “If the concern is to smooth out forehead wrinkles, resurfacing lasers such as [Fraxel®](https://aedit.com/aedition/guide-to-fraxel-laser-skin-resurfacing-treatments) or [CO2](https://aedit.com/procedure/pixel-co2) can be considered.” 

### **4. Dermal Filler**
When it comes to restoring [lost volume](https://aedit.com/aedition/best-procedures-to-restore-facial-volume), dermal filler is often viewed as a time machine. As it relates to the forehead, however, you’ll want to proceed with caution. Dr. Karam does not recommend filler in the region because of how expressive it is. “This is an area where the muscles move, so putting filler into this area can be ineffective and lead to clumping or irregularities,” he cautions. Dr. Jaber agrees. “If you are going to do forehead filler, make sure to discuss [potential risks](https://aedit.com/aedition/risk-of-vascular-occlusion-after-dermal-filler) with the injector prior to the procedure,” he says. “To soften forehead wrinkles, I recommend regular use of Botox®.”

What you may not realize, however, is that injecting [filler](https://aedit.com/aedition/hyaluronic-acid-filler-vs-biostimulatory-injectables) into other areas can have a big impact on the face as a whole. “If you feel like you have a large forehead, then defining your lower face with procedures like [chin filler](https://aedit.com/procedure/chin-augmentation-with-soft-tissue-fillers) or [jaw filler](https://aedit.com/procedure/neck-and-jawline-definition-solutions) can improve your facial proportions, making you feel more attractive,” Dr. Jaber explains. This holistic approach is why it is so important to visit a board certified dermatologist or plastic surgeon. They will be able to give you a complete assessment of what’s possible based on your anatomy and aesthetic goals.

### **One last tip...**
Fellas take note: [facial hair](https://aedit.com/aedition/facial-hair-care-products-grooming-tools) can be one of the quickest and cheapest ways to refresh your look. “If you don't want to do any procedures, then a simple option for men is growing a beard,” Dr. Jaber notes.

## **The Takeaway** 
Aesthetic goals and perceptions of beauty are as unique as fingerprints. “Even if a feature falls outside of these classic definitions of facial harmony and beauty, it doesn’t equate to an objective lack of beauty,” Dr. Karam emphasizes. But, if you are interested in addressing the upper third of the face, it’s helpful to remember that the region is more than the eyes and brows. Consulting with a board certified dermatologist or plastic surgeon will allow you to learn more about what treatment options may be best for you.

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

Aesthetics

Whether you think it’s too big, too small, or too wrinkled, there are an array of surgical and non-surgical solutions to address one of our most prominent facial features.

Best Procedures For Forehead Shape, Size, Wrinkles

How Familiar Are You With These Forehead Treatment Options?

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There are plenty of non-surgical procedures that get billed as facelift alternatives. And, while some have the ability to firm and smooth the skin sans scalpel, none have been able *remove* skin without surgery – until now. Since it received clearance from the United States Food and Drug Administration (FDA) last year, there has been a lot of buzz around [Cytrellis’s Ellacor™](https://www.cytrellis.com/technology/) and its micro-coring technology. 

Since we all know that trendy treatments have a tendency to come and go, you may be wondering if this one lives up to the hype. The short answer is that, in many ways, it does – though it’s not exactly a substitute for a [facelift](https://aedit.com/procedure/facelift-rhytidectomy). To break down everything you need to know about Ellacor™ and micro-coring, we tapped top dermatologists and plastic surgeons for their honest assessment. Here’s the scoop.

## **What Is Micro-Coring?**
Although some may be calling micro-coring the next best thing to a facelift, it's significantly different. For starters, it isn't surgery at all. Instead, micro-coring or fractional micro-coring is a new category of cosmetic treatment that involves the excisional removal of tiny columns of skin over a larger surface without cutting, thermal energy, or scarring.

Micro-injuries are made in the skin using a tiny, hollow needle while simultaneously removing small tissue areas to address mild laxity. “During a facelift, surgeons trim the skin from the sides,” says [Paul Jarrod Frank, MD](https://www.instagram.com/drpauljarrodfrank/?hl=en), a board certified celebrity cosmetic dermatologist in New York City. “With micro-coring, we inject local anesthesia and remove eight to 10 percent of the total skin surface.” As he explains, the idea of micro-coring originally came from the concept of skin tightening and wrinkle removal in studies showing [follicular unit extraction (FUE)](https://aedit.com/procedure/follicular-unit-extraction-fue), which involves removing individual hair follicles from the scalp before transplant. “When the tissue heals, the skin is much tighter,” he notes. 

To date, there’s only one micro-coring device on the market, Ellacor™, which has positioned itself as a minimally invasive facelift alternative thanks to its ability to remove skin without surgery. The first-of-its-kind treatment is [cleared by the FDA](https://www.prnewswire.com/news-releases/cytrellis-announces-fda-clearance-for-breakthrough-ellacor-micro-coring-technology-301341572.html) to treat moderate to severe wrinkles in the mid- to lower-face in patients with Fitzpatrick skin types I to IV. 

Ellacor™ removes micro-portions of excess skin improve the appearance of wrinkles, says [Jill Waibel, MD](https://www.miamidermlaser.com/dermatologist-miami-dr-jill-s-waibel/), a board certified dermatologist in Miami. “Whereas other skin revitalization devices use heat generated by a [laser](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing), [radiofrequency](https://aedit.com/aedition/radiofrequency-skin-tighening-fat-reduction), or [ultrasound](https://aedit.com/aedition/sofwave-for-skin-tightening-collagen-production) energy to induce intentional thermal injury to the skin, Ellacor™ uses patented micro-coring technology to reduce wrinkles,” she says.

## **Who Is an Ideal Candidate for Micro-Coring?**
Not everyone is an ideal candidate for micro-coring. “It's for someone who wants to take a more minimally invasive and natural-looking route to obtain tighter, younger-looking skin,” says [Dendy Engelman, MD](https://aedit.com/provider/dendy-engelman-md-312), a board certified dermatologist in New York City. This can appeal to people at [different stages of life](https://aedit.com/aedition/can-you-be-too-young-for-a-facelift) (and aging). “I sometimes recommend micro-coring to younger patients who are starting to notice changes in their skin and want to nip it in the bud,” she shares. And she also suggests it to “patients with more mature skin who do not want to undergo a full facelift and the [associated recovery](https://aedit.com/procedure/facelift-rhytidectomy/recovery).”

To see success with Ellacor™, the degree of [skin laxity](https://aedit.com/concern/facial-skin-laxity) – which should be on the mild to moderate side – is imperative. “Someone with excessive hanging skin is going to do better with a more invasive surgery,” Dr. Frank notes. In addition, the treatment works best on the [cheeks](https://aedit.com/concern/cheek-volume), around the mouth, and [under the chin](https://aedit.com/concern/neck-and-jawline-definition), since these areas are where loose skin tends to accumulate. 

As we mentioned, the procedure is currently only FDA cleared for [Fitzpatrick skin types I to IV](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types). “A separate clinical study is needed to evaluate the proper protocols for using Ellacor™ on darker skin types,” Dr. Waibel notes.

## **How Micro-Coring Works**
It may seem unfathomable, but, in 2022, we are at the point where doctors can remove minimal amounts of loose skin without the need to cut with a scalpel. 

Before an Ellacor™ treatment starts, [local anesthesia](https://aedit.com/aedition/everything-you-need-to-know-about-anesthesia) is injected into the area (topical anesthetic may also be used) to make the procedure more comfortable. Next, a small handpiece is placed over the desired location, creating cores in a grid formation (similar to energy-based treatments). The hollow needles within the handpiece quickly go to work and pierce out microscopic amounts of skin (less than half a millimeter). “With each excision, the tissue is removed from the needles through an integrated suction system, treating a 10 millimeter square area in less than three seconds,” Dr. Waibel says. 

Your doctor can adjust the depth of the treatment depending on your needs. There is pinpoint bleeding at each core site, which quickly resolves. Not all skin that falls within the coring square is removed. “After removing the excess skin, the body's natural healing response goes into effect as the dermal tissue quickly realigns to close the cores, resulting in improved skin architecture,” Dr. Waibel shares. As Dr. Engelman explains, removing the skin in this controlled fashion stimulates the wound-healing response that increases collagen production, ultimately promoting younger, healthier-looking skin.

## **Micro-Coring Recovery & Results**
A series of three 30-minute treatments are usually recommended to achieve optimal results, though many patients report seeing benefits after the first appointment. “Micro-coring results are more subtle than facelift surgery since each session of Ellacor™ only removes up to eight percent of the treated skin area,” says [Siamak Agha, MD](https://aedit.com/provider/siamak-agha-md-34668), a board certified plastic and reconstructive surgeon in Newport Beach, CA. “Less skin is removed than what a facelift can offer, but, with Ellacor™, that skin removal can be increased substantially without any scars.”

According to the clinical trials, each column of skin is selectively targeted and heals within an average of three days. But, of course, expect some scabbing, redness, slight [bruising](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox), and mild [swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery). “The redness of the treated areas may last 30 days or more, signifying deeper tissue healing and tightening,” Dr. Agha says. Because the skin is sensitive and somewhat compromised after treatment, [a simple, bland skincare routine](https://aedit.com/aedition/post-procedure-skincare-makeup-product-guide) (similar to what is used post-laser or surgery) is often best. Once the skin is fully healed and the resulting holes from the cores are closed up, you should be safe to resume wearing makeup and following your regular skincare regimen.
 
One of the significant advantages of a micro-coring treatment over something like a facelift is the low risk of [scarring](https://aedit.com/aedition/how-to-treat-every-type-of-scar). “Due to the tiny needle used in micro-coring (22 gauge), the scars are microscopic and therefore not visible to the naked eye,” Dr. Engelman says. For reference, [needles](https://aedit.com/aedition/guide-to-needles-used-for-cosmetic-injectables-botox-filler) used to administer neurotoxins (read: Botox®) are usually 30 or 32 gauge. A [filler syringe](https://aedit.com/aedition/guide-to-injectable-techniques-needles-for-botox-filler) is 27 or 30 gauge. Higher numbers indicate smaller needles.  

## **FAQs: Micro-Coring Edition**
Now that you have a better understanding of how micro-coring technology and Ellacor™ treatments work, it’s time to get to some of the questions you no doubt have about what it’s truly capable of. We answer a few of the most common below:

### **1. Is Micro-Coring Anything Like Microneedling?**
We’d understand if, at this point, you are wondering what (if any) relation micro-coring has to microneedling. As it turns out, the only similarity between the two is that both modalities have the prefix ‘micro’ in their names, and both employ needles to some degree. As Dr. Waibel explains, [microneedling](https://aedit.com/procedure/microneedling) uses tiny needles to injure the skin, and there's no tissue removal — the tissue is only temporarily displaced — during the procedure.

The needle depth of a professional microneedling treatment is anywhere from 0.25 millimeters to 2.5 millimeters. The hollow needles used for micro-coring can penetrate up to 4 millimeters to remove the microscopic columns of skin. While microneedling safely creates micro-injuries in the skin to incite collagen production and decrease the appearance of acne scars, fine lines and wrinkles, and sun damage, it does not excise any tissue.

### **2. Is Micro-Coring a Replacement for a Facelift?**
A [traditional facelift](https://aedit.com/aedition/popularity-of-facelift-cosmetic-surgery-for-aging-sagging-neck) does more than just remove loose skin. It also addresses the underlying muscles and repositions fat and tissue for more significant support and a fully rejuvenated yet (hopefully) natural look. Every doctor we spoke to for this story agreed that micro-coring is not a substitute for a facelift, though it may be a suitable alternative for those who are not ready for surgery but desire some skin tightening and wrinkle reduction on the lower face.

Micro-coring acts on the skin alone. So, while the results of the minimally invasive procedure can be significant, it does not address the fundamental structure of the face and cannot provide a facelift-like result. But that’s not to say it doesn’t have value. “I think micro-coring is going to offer a lot more than other minimally to non-invasive treatments like [Ultherapy®](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy), Thermage®, and other forms of [energy-based microneedling](https://aedit.com/procedure/microneedling-with-radiofrequency),” Dr. Frank says. “With micro-coring, we are going to fill that niche between non-invasive and invasive plastic surgery.”

### **THE SIMILARITIES**
- **Skin Removal**: Both a facelift and micro-coring can remove loose skin, however, the amount of skin laxity addressed through a non-surgical treatment is less than surgery.
- **Smoothing**: Micro-coring and facelifts improve wrinkling on the lower part of the face. Of course, what can be achieved with surgery is always greater than less invasive options.
- **Patience**: The results can take time to settle and fully reveal themselves after both a facelift and micro-coring, though there's more of a noticeable improvement right away post-facelift. 

### **THE DIFFERENCES**
- **Comprehensiveness**: Micro-coring does not correct or address anything below the skin like fat, tissue, and muscle. Only a facelift can target those underlying structures of the face.
- **Lift**: Whereas a facelift physically lifts the skin and requires tension, micro-coring induces collagen remodeling and firming through micro-injuries. The chances of having an unnatural result are lessened.
- **Scarring**: The tradeoff for a facelift is the [scarring](https://aedit.com/aedition/scarring-after-facial-plastic-surgery), though board certified plastic surgeons are trained to conceal the incision. There are no cuts, incisions, stitches, or scars with micro-coring.
- **Timing**: Two to three sessions of micro-coring are necessary to achieve full results. Dr. Engelman says patients typically start to see results of 60 to 90 days after the procedure, and there is usually significant improvement after just one treatment. A facelift is one and done, with results lasting a decade or more. 

Micro-coring is far less invasive than a sugical facial rejuvenation procedure such as a facelift. But, just because it's less invasive, doesn't mean it is fool-proof. As with all aesthetic procedures, a full consultation before the treatment is necessary and there is always the [risk of adverse effects](https://aedit.com/aedition/guide-to-cosmetic-surgery-complications).

### 3. **Micro-Coring vs. Facelift: Which One Is Better?**
There's no right or wrong treatment here. What checks of all your [skin-tightening](https://aedit.com/aedition/best-nonsurgical-skin-tightening-procedures) and rejuvenating boxes may not do the same for someone else. For patients who don't have the time – or, should we say, downtime – for surgery or don’t want it (for whatever reasons), micro-coring is perhaps one of the most promising alternatives available. 

With that said, Dr. Engelman reminds us that no procedure (surgical or non-surgical) is without strings. There is still anesthesia involved, your skin will require a few days to recuperate, and there is no instant gratification. “Downtime is minimal, but it will take some time for the results to be visible,” she shares. And be sure to keep your expectations in check. The results “will be more subtle,” she adds.

### **4. Can Micro-Coring Delay the Need for Surgery?**
Given the array of non-surgical modalities available today, it may be possible to delay the need for facial surgery with the right combination of treatments. But will Ellacor™ alone allow you to sidestep a facelift in the future? Probably not. “Micro-coring does not offer the same results as more invasive techniques, like facelifts,” Dr. Engleman says. “So, in that regard, it cannot replace these more dramatic techniques.” That’s not to say it doesn’t have it’s place though. “It is a great alternative for people seeking more natural-looking results with less invasive methods,” she shares.

## **The Takeaway**
Micro-coring is a new skin-eliminating treatment that is the first of its kind, which means there is still a lot to learn. Will it replace the standard facelift? Probably not – at least not right now – but it gives both patients and providers a lot to be excited about. “There is absolutely no doubt that it is going to offer a new category of treatment in between totally non-invasive and totally invasive procedures,” Dr. Frank says. “It will help fulfill that growing niche of patients that want to do something significant in terms of wrinkling and skin tightening but are not yet ready or willing to go through more invasive techniques.”

Everything you need to know about the minimally invasive procedure that removes skin – sans scalpel.

Dermal Micro-Coring: A Non-Surgical Facelift Alternative For Skin Laxity

Does Non-Surgical Micro-Coring Rival A Surgical Facelift?

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What do the famous faces of Ariana Grande, Brad Pitt, Miranda Kerr, and Mario Lopez have in common? They all have dimples. Technically speaking, those small indentations in the cheeks that appear when some people smile are a genetic abnormality. Aesthetically speaking, many consider dimples to be an attractive facial feature. “Women and men are enticed by a dimple and wish to have one,” says [Douglas Monasebian, MD, DMD](https://aedit.com/provider/douglas-monasebian-md-200), a New York City-based board certified plastic and maxillofacial surgeon.  

For those who like the look of dimples but weren’t born with them, there is a cosmetic surgery called dimpleplasty that can create them in one or both cheeks. “I have performed this procedure on both sexes and on all ages,” Dr. Monasebian notes. So, what do you need to know about dimpleplasty? The experts break it all down.

## **What Are Cheek Dimples?**
Dimples are indentations in the skin that can be found on different parts of the body (think: cheeks, chin, buttocks). Today, we’re talking about the [cheeks](https://aedit.com/concern/cheek-volume). Fovea buccalis (a.k.a. cheek dimples) are the small depressions in the lower cheek that make their appearance when some people smile. “A dimple is simply an anatomic defect in the cheek of the face,” Dr. Monasebian shares. 

All you need to do is consider the faces of your friends and family to realize that not everyone is born with this facial trait. Dimples “can be hereditary or acquired and can change as we age,” says [David Shafer, MD](https://aedit.com/provider/david-shafer-md-153), a board certified plastic and reconstructive surgeon in NYC. They can also occur on one or both sides of the face. “Depending on the anatomy, various shapes and locations of dimples can form,” he adds.

Cheek dimples are formed by differences in the muscles and skin of the face. “Dimples occur due to gaps between the muscles around the mouth,” Dr. Shafer says. They are most often caused by changes in the zygomaticus major, the muscle responsible for movement in the lower face. While the muscle typically runs from the [cheekbone](https://aedit.com/aedition/cosmetic-procedures-to-define-cheekbones) to the corner of the mouth, it can separate into two bundles. Both bundles are connected to the mouth, but one is also tethered to the skin above it – that’s what causes the dimple. It does not pose any functional or medical threat.

Just as no two faces are the same, no two dimples are the same. “There are different types of cheek temples that vary depending on the ethnicity and sex of the patient,” Dr. Monasebian explains. “Dimples can be of varying length, depths, and angles.” As such, the dimples created via dimpleplasty can be customized (more on that below).

## **What Is Dimpleplasty?**
In simplest terms, a [dimpleplasty](https://aedit.com/procedure/dimpleplasty) is a cosmetic surgery with the goal of creating permanent dimples in the cheek. “Dimpleplasty is a surgical procedure to purposely form an adhesion between the overlying skin and the underlying muscle,” Dr. Shafer explains. It’s an outpatient procedure that typically takes under an hour to complete.

The procedure can be performed ‘[awake](https://aedit.com/aedition/awake-surgeries-without-general-anesthesia)’ with the patient numbed with a local anesthetic or under a mild sedation. “The incision is on the side of the mouth, so there are no visible incisions on the outside of the skin,” Dr. Shafer notes. Through the intraoral incision, the surgeon will remove any tissue (as needed) and place an absorbable suture at the site of the desired dimple. “The goal of dimpleplasty is to artificially cause internal adhesions, or scars, between the muscle and skin, so the tethered skin dimples as the muscle contracts,” he explains.

Depending on the aesthetic goals of the patient, dimpleplasty can be performed on either side or both sides of the face. 

### **Dimpleplasty Recovery & Results** 
The results of dimpleplasty are immediate and permanent, though they evolve during the healing process. “I do advise the patient that, during the first few weeks, the dimple will be present at both rest and during smiling and talking,” Dr. Monasebian explains. “With time, the resting dimple will fade and they will have the dimple more when they smile, which is how a natural dimple appears.” Dr. Shafer agrees. “The result may look more pronounced at first and can fade over time,” he says. “Everyone continues to age, as can areas of dimpling.” In most cases, “a dimpleplasty ages naturally with the patient,” he adds.

In terms of recovery, the most common effects are temporary [swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) and bruising. Most patients can return to work or school within a few days. Because of the intraoral incision(s), you’ll need to stick to a liquid diet for the first five days after surgery. Normal eating, activity, and dental care can usually be resumed within the first one to two weeks.

It's important to remember that every surgery has risks. Dr. Shafer explains that longer-term [adverse effects](https://aedit.com/aedition/guide-to-cosmetic-surgery-complications) include scarring (“how we make the incision is inside the mouth, so this is minimized,” he notes), hyperpigmented skin due to trauma, and infection. “As with any surgery, once there is an incision it can’t be removed,” he cautions. “If there is [scarring](https://aedit.com/aedition/how-to-treat-every-type-of-scar), there are treatments that can help, such as laser and special injectables.”

## **Achieving a Lasting Result** 
Dimpleplasty truly is a personalizable procedure. “The cheek dimple can be customized with respect to its location, depth, and length,” Dr. Monasebian says. “In addition, I can create a dimple on both sides or just on one side or even match an existing dimple.” That’s right: If you were born with one dimple but would prefer symmetry, a plastic surgeon can add a dimple to match.

As with any cosmetic surgery, it’s imperative to find a [board certified plastic surgeon](https://aedit.com/aedition/finding-the-right-plastic-surgeon-dermatologist-or-cosmetic-dentist) who specializes in the procedure you are interested in. In the case of dimpleplasty, it’s important they understand your anatomy and aesthetic goals, in addition to understanding and accounting for how the dimple will evolve. “I usually over-correct the formation of the dimple because it will fade initially,” Dr. Monasebian shares. “I have to rely on the body to heal the dimple adequately.” And then there is the role of Father Time. “The dimple will age as the skin ages,” he notes. “The procedure will not alter the skin, so the patient’s skin will normally age as they age.”

At the end of the day, it’s all about achieving a safe and optimal result. “Like most of the aesthetic procedures I perform, patients are looking to enhance themselves,” Dr. Monasebian explains. “I strive for natural-looking plastic surgery, and it is in this manner that I create dimples.” The net-net: “As with any elective surgery procedure, if there is no harm for the patient and the patient feels better by having the dimple, I discuss with them all the risks and benefits and proceed with the dimple creation,” he says.

Plastic surgeons break down what to know about the cosmetic surgery that can create dimples in the cheeks.

The Benefits Of Dimpleplasty For Creating Cheek Dimples

Want Dimples? This Cosmetic Surgery Creates Them

adrian-fernandez-t1jlLrsMpjc-unsplash

Ask anyone who has ever done even a single treatment of [platelet-rich plasma](https://aedit.com/aedition/prp-and-stem-cells-are-changing-the-face-of-the-cosmetics-industry) (a.k.a. PRP) to [regrow their hair](https://aedit.com/procedure/plateletrich-plasma-prp-for-hair-loss), [rejuvenate the skin](https://aedit.com/procedure/vampire-facelift), or help heal an injury about their results, and you'll almost always be greeted with a resounding, ‘It's a game-changer!’ The standard PRP method has been around for years across medical specialties and involves drawing a sample of blood and separating the plasma from the rest. Just like everything else in the world of aesthetics, there are always new advancements that make way for bigger and better treatments and results – and PRP is no exception. Enter: so-called ‘supercharged’ PRP. Here’s what you need to know.

## **PRP Basics**
PRP has gained a significant following in the last few years and quickly rose to aesthetic stardom. Initially, it was an adjunct for wound healing. But, once skin-rejuvenating vampire facials (i.e. [microneedling with PRP](https://aedit.com/procedure/microneedling-with-prp)) made their way into our living rooms — you can thank Kim Kardashian for that — and onto social media feeds, they started to be an in-demand, top-performer in doctor's offices from coast to coast. And then Kim’s sister Kourtney let us all in on her [PRP for hair loss treatments](https://aedit.com/aedition/kourtney-kardashian-prp-injections-to-treat-hair-loss) after a too taut ponytail caused a bald spot, officially mainstreaming one of PRP’s most effective use cases.  

Platelet-rich plasma is a blood plasma-based protein solution packed with platelets and some white blood cells and growth factors. Extracting the PRP from blood allows the growth factors to assist in healing and rejuvenating purposes. Originally, PRP was used in orthopedics to speed recovery from injuries and then made its way to skin and hair applications, says [Macrene Alexiades, MD](https://www.nyderm.org/), a board certified dermatologist in New York City. Now, almost every surgical and pain specialty utilizes PRP to help heal injuries (especially joint and spine), rejuvenate tissue, speed healing, and reduce surgical pain and scarring, notes [William Yates, MD](https://www.dryateshairscience.com/dr-yates-hair-transplant-surgeon-chicago), a board certified surgeon and hair restoration specialist in Chicago. 

In aesthetic medicine, its fandom stems from the fact that it offers non-surgical rejuvenation. “Minimally invasive PRP has become increasingly popular in recent years since it is a natural way of addressing signs of aging,” says [Samuel Lin, MD](https://www.linplasticsurgery.com/about/dr-samuel-lin/), a board certified plastic and reconstructive surgeon in Boston. While fillers and neurotoxins are great (don't get us wrong, we love them), for those who aren’t too keen on the idea of injecting a foreign substance into their skin or are simply looking for additional options, PRP offers a natural alternative since it uses your own blood. Beyond the skin-boosting benefits, PRP injections are also a godsend for anyone [experiencing hair loss](https://aedit.com/procedure/nonsurgical-hair-restoration-solutions), thinning, and impeded growth. 

### **PRP Treatments**
Regardless of the treatment area, the basic principles of a PRP procedure are relatively the same from one to the next. First, blood is drawn from the patient's arm and put into a centrifuge where it spins out and separates the platelets from everything else in the blood. The centrifuge portion of the treatment is as significant as administering the solution itself because the concentration of platelets can vary greatly and impact efficacy (more on that in a minute).

For PRP to become activated and put healing into action, there must be an injury of some kind. For example, Dr. Yates explains that injecting PRP with a needle into the scalp puts the wheels in motion for the powerful growth factors to do their thing. The growth factors contained within the PRP are the secret sauce since the platelets quickly and effectively regenerate the skin and heal injured tissues. The platelets are a rich reservoir of growth factors that have many benefits, including combating hair loss, restoring the synovial fluid in the joints, and stimulating collagen in the skin, says [Michelle Henry, MD](https://www.skinaestheticsurgery.com/), a board certified dermatologist in NYC. “Traditional PRP is less concentrated than the supercharged version in terms of the platelets and, in theory, it has fewer growth factors,” she notes. 

## **All About Supercharged PRP**
Not all PRP is created equally. PRP versions vary based on the concentration of platelets within the solution, says [Miguel Mascaró, MD](https://www.instagram.com/drmascaro/), a double board certified facial plastic and reconstructive surgeon in Delray Beach, FL. “That means that in order to see an effect, there needs to be a concentration that is four times over baseline,” he explains. The potency obtained in standard centrifuge machines average a PRP solution with about five to six times platelet concentration. Its more powerful cousins — the so-called ‘supercharged’ versions of PRP — can feature 10 times the platelets or more. The more concentrated form of PRP provides additional benefits due to its higher levels of growth factors, which signal the body's cells to swarm to the area and speed up the healing process, says [Audrey Kunin, MD](https://www.instagram.com/draudreykunin/), a board certified dermatologist in Kansas City, MO. 

But it’s not just the processing that supercharges the PRP. It’s also what’s added into the solution. “Traditional PRP contains mainly platelets and plasma, with some residual white and red blood cells left over from the PRP preparation process,” Dr. Lin explains. “The ‘supercharged’ version of PRP – which may mean that the PRP has undergone more processing than traditional PRP to be more concentrated and contain less white and red blood cells – refers to the addition of stem cells, often taken from fat, to the PRP mixture.” As Dr. Alexiades shares, the fat is “mechanically broken down and the stromal cells are obtained and then mixed with the PRP for a highly concentrated mixture.”

Patients need not worry about how rich the platelet count is within the concentration — your provider will take care of that. Dr. Yates says there are hundreds of devices on the market that claim to deliver PRP. “The truth is that most only deliver PPP (platelet poor plasma) versus platelet rich plasma,” he cautions. “The difference is the concentration of platelets and other cells derived from the centrifuge — the system concentrates the platelets at least four to six times the normal blood count.” Systems that only concentrate one to two times the average blood count are less effective. “Plus, they don't deliver the same healing results, requiring more frequent treatments,” he adds.

### **Supercharged PRP Treatments**
To create a more potent version of PRP, a sample of blood is taken (just like in traditional treatments). “This blood is processed using a centrifuge to isolate the PRP, and, in the case of supercharged PRP, the PRP is processed further to concentrate it and remove any residual blood cells,” Dr. Lin explains. This is where the extras are mixed in. “Surgeons may add a patient's stem cells to the PRP,” he notes. [Stem cells](https://aedit.com/procedure/microneedling-with-prp-and-stem-cells) and [nano-fat](https://aedit.com/procedure/nanofat-and-prp-injections-for-hair-loss) are retrieved from a separate liposuction procedure. Finally, the PRP is administered through targeted injections or topically as part of a microneedling session.
 
So, how are doctors going about pulling the most out of a single blood draw and putting it to good use? It all comes down to the technology used, of course. “There are currently two companies, [Regen®](https://www.regenlabusa.com/), which is my favorite, and [Eclipse®](https://www.eclipsemed.com/prp/) that have perfected their tubes that ‘pull out’ the PRP fraction and have demonstrated, through diligent science, that their PRP is very high quality,” Dr. Alexiades says. Because of the healing properties, some providers are using supercharged PRP for regenerative medicine, too. [Scientific data](https://pubmed.ncbi.nlm.nih.gov/33525977/) shows a connection in animal studies between PRP and fat survival after [fat transfer](https://aedit.com/procedure/facial-fat-grafting).

## **Is More Powerful Always More Desirable?**
Before you cast aside traditional PRP procedures and disregard devices that have less power than their ‘supercharged’ counterparts, we’re here to tell you that all methods can be effective. It really comes down to what your doctor offers, the concerns at hand, and the inherent quality of the blood and its plasma. Dr. Mascaró, for example, prefers to use higher concentrations over baseline for most patients when doing hair restoration or anything that requires more cellular turnover and growth factors. “This may also be the case in laser resurfacing and during facial fat grafting and facelift surgery,” he says. But, during most microneedling sessions, he sticks with “more traditional PRP concentrations.” 

The science is still evolving on exactly what potency is best for what purposes. “There is ongoing research regarding the optimal concentration of PRP,” Dr. Lin shares. “For some musculoskeletal uses, a higher concentration of platelets in PRP is preferred and … in a study of 10 patients, supercharged PRP [shows](https://academic.oup.com/asj/article/40/4/NP177/5492510?login=true) to be effective for improving [male pattern baldness](https://aedit.com/aedition/common-causes-of-hair-loss-balding-thinning-in-men).” But, in other cases, lower platelet concentration may be effective enough.
 
For cosmetic applications — particularly hair growth — there may not be enough evidence to make everyone a ‘supercharged’ believer. Dr. Lin says that while there are few studies on supercharged PRP, its applications and benefits are likely similar to standard PRP. What's still up for debate is the longevity of the results and if a more potent concentration of PRP, plus the presence of fat-derived stem cells, leads to longer-lasting results. Only time will tell.

Is this version better than the standard?

The Benefits Of Supercharged PRP With Stem Cells For Hair Loss, Skincare

Why Everyone Is Talking About ‘Supercharged’ PRP

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During the cosmetic surgery consultation process and again before you enter the operating room, your plastic surgeon will explain the [side effects and complications](https://aedit.com/aedition/guide-to-cosmetic-surgery-complications) that can occur after a facelift. On the side effect front, bruising and swelling can be expected and usually begin to subside after the first couple of weeks. On the complication front, [hematoma](https://journals.lww.com/prsgo/Fulltext/2021/08000/Methods_for_Minimizing_Bleeding_in_Facelift.21.aspx#) – a word that means ‘collection of blood’ – occurs after an estimated 0.2 to 8 percent of rhytidectomy (read: [facelift](https://aedit.com/procedure/facelift-rhytidectomy)) surgeries, making it the most common postoperative complication of the procedure. 

Without proper attention, hematoma can negatively impact the [healing and recovery process](https://aedit.com/aedition/facelift-recovery-healing-process). So, whether you're preparing for surgery or just got home, what should you keep an eye out for? Here’s what you need to know about the causes, symptoms, and prevention of hematoma after a facelift.

## **What Causes a Hematoma?**
Hematoma occurs most often in the first 24 hours after surgery, says [Mark M. Hamilton, MD](http://www.hamiltonfps.com/), a double board certified facial plastic and reconstructive surgeon in Indianapolis and board member of the American Academy of Facial Plastic and Reconstructive Surgery ([AAFPRS](http://www.aafprs.org/)). The reason for this is that, “during a facelift, small blood vessels are disrupted in the process of lifting and tightening the skin,” explains [Samuel Lin, MD](https://www.linplasticsurgery.com/about/dr-samuel-lin/), a board certified plastic and reconstructive surgeon and associate professor of surgery at Harvard Medical School. That disruption can cause a pooling of blood beneath the skin but *outside* of a blood vessel.

As your surgeon is wrapping up your facelift, they will check to make sure that the bleeding has stopped. But, in rare cases, “bleeding may restart or unnoticed bleeding may continue after the surgery ends,” Dr. Lin notes. The collection of blood that results becomes a hematoma. Some of the most noteworthy risk factors for bleeding and bruising after a facelift include:

- High blood pressure
- Taking blood thinners (including [herbal medication](https://aedit.com/aedition/vitamins-supplements-to-avoid-before-cosmetic-surgery), ibuprofen, and the like)
- [Smoking](https://aedit.com/aedition/impact-of-cigarette-smoking-vaping-on-skin-hair-teeth-health)
- [Combining it with a neck lift](https://aedit.com/aedition/pairing-facelift-neck-lift-procedures)

Additionally, male patients are at a higher risk of hematoma than females because they have more blood vessels and a stronger blood supply in their faces (learn more in our [comprehensive guide to facelifts for men](https://aedit.com/aedition/facelifts-for-men)).

## **Symptoms of a Hematoma**
While [bruising](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox) is common after a facelift, patients should be aware of the difference between a hematoma and a standard bruise. After all, hematomas often look like very dark bruises. There are, however, a few key differentiators to keep in mind. A hematoma is a firm and [swollen](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) red, black, or blue lump that can grow in size over time. It may or may not be painful. On the contrary, a bruise is usually flat and slightly tender – though not hard – to the touch. In general, bruises are much less serious than hematomas.

If you suspect you may have a hematoma, contact your surgeon as soon as possible. “Smaller hematomas may be drained in the office,” Dr. Hamilton says, though they can also require a return trip to the OR “to remove the clot and control any bleeding.” In extreme cases, a hematoma can “expand and put pressure on the airway, interfering with the patient’s ability to breathe,” Dr. Lin cautions. 

## **How to Prevent a Hematoma After a Facelift**
The fact of the matter is, hematomas are not 100 percent preventable. But there are a few steps patients can take to reduce the likelihood. The first is establishing that you are in [good overall health](https://aedit.com/aedition/why-you-should-lose-weight-before-plastic-surgery). Halting any medications that can impair the body’s natural clotting mechanism – including anticoagulants like Coumadin and Plavix – for at least two weeks before surgery is a must, says [P. Daniel Ward, MD](https://www.wardmd.com/), double board certified facial plastic and reconstructive surgeon in Salt Lake City. He notes that if a patient is on those two meds, they may not actually be healthy enough for surgery to begin with. This assessment should occur during the consultation process. 

In his practice, Dr. Hamilton tells patients to avoid alcohol for at least one week before surgery and to quit smoking for at least one month prior, as the former thins the blood and the latter can cause bleeding and impact the healing process. In case it’s not obvious, laying off both post-op will only help your [facelift recovery](https://aedit.com/procedure/facelift-rhytidectomy/recovery).

There are also steps that can be taken after surgery to mitigate the risk of both hematoma and bruising. If provided, you’ll want to wear a gentle [compressive dressing](https://aedit.com/aedition/benefits-of-compression-garments-after-cosmetic-surgery) or strap as per your surgeon’s guidelines. Additionally, you’ll be advised to avoid activities that raise your blood pressure – such as [exercise](https://aedit.com/aedition/when-to-start-exercising-again-after-cosmetic-surgery-procedures). Since hematomas are most likely to occur within the first 24 hours, getting as much rest as possible and keeping any movement mindful will be key. 

## **The Takeaway**
Hematoma is the most common complication patients experience after a facelift, and, as with any procedure, risks and rewards must be weighed. While every case is unique, Dr. Ward agrees that there usually isn’t a reason for healthy individuals to skip out on the surgery for fear of hematoma. Instead, patients should feel empowered to call their surgeon if they have concerns about how they are healing. “We’re doing this to help care for our patients and make them feel better – we don’t want them to suffer,” Dr. Ward says. “Call us and make us earn our keep.”

Without proper attention, it can negatively impact healing and recovery.

The Risk Of Hematoma After A Facelift

What You Need To Know About The Risk Of Hematoma After A Facelift

brooke-cagle-w475s9ZhD4I-unsplash

Much like 2020 before it, we don’t need to tell you that 2021 was a unique year. Even so, new data from the [American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS)](https://www.aafprs.org/) –  the world’s largest association of facial plastic surgeons – finds that lingering pandemic-related concerns couldn’t thwart the demand for aesthetic procedures. “After lockdowns ended and vaccinations rolled out, our patients who had been postponing reconstructive work, upkeep, maintenance, or surgery were eager to schedule treatments to help them feel refreshed, confident, and ready to take on work, events, playdates,” says [Corey S. Maas, MD](https://www.maasclinic.com/), a double board certified facial plastic and reconstructive surgeon and president of the AAFPRS. 

Based on reporting from some 2,200 AAFPRS members, the total number of facial plastic surgery treatments was up substantially, with an estimated 1.4 million [surgical](https://aedit.com/aedition/biggest-medical-aesthetics-trends-of-2022-for-face-body) and [non-surgical](https://aedit.com/aedition/biggest-non-surgical-aesthetics-trends-of-2022) procedures completed. On average, facial plastic surgeons performed about 600 more procedures in 2021 than they did in 2020. That amounts to a 40 percent increase. So, what did the uptick in bookings mean for treatment trends and patient motivations? Below are some of the key takeaways from the [2021 AAFPRS Annual Survey](https://www.aafprs.org/Media/Press_Releases/2021%20Survey%20Results.aspx). 

## **Surgery Reigns Supreme**
While there was a return to in-person gatherings at certain points of 2021, the hybrid nature of the year had patients opting for surgical intervention at a higher rate. Of those AAFPRS members who experienced an increase in appointments, 92 percent indicated it was because people had more time and flexibility to [recover](https://aedit.com/aedition/best-plastic-surgery-recovery-nurses-centers-products). “With more time still being spent at home, there was less concern about the recovery time for surgical treatments,” Dr. Maas notes. Similarly telling: 83 percent of AAFPRS members say 75 percent or more of their work is facial plastic surgery – up from 75 percent in 2020. 

But that doesn’t mean everyone was going under the knife. More patients than ever were interested in ‘tweakments.’ [Neurotoxins](https://aedit.com/aedition/where-to-use-botox-from-head-to-toe) (63 percent) and [fillers](https://aedit.com/aedition/hyaluronic-acid-filler-vs-biostimulatory-injectables) (57 percent) were among the top procedures performed most often on women in 2021. Rounding out the top three? [Rhinoplasty](https://aedit.com/aedition/reinventing-rhinoplasty-whats-different-about-modern-nose-jobs) at 62 percent, which is also the top surgery for patients under the age of 34.

The top procedures for male patients were rhinoplasty (79 percent), neurotoxins (58 percent), and [blepharoplasty](https://aedit.com/procedure/blepharoplasty-eyelid-surgery) (42 percent). While women still make up the large majority of aesthetics patients, [more men than ever](https://aedit.com/aedition/what-you-need-to-know-about-male-plastic-surgery-trends) are seeking treatment. [Hair transplants](https://aedit.com/procedure/surgical-hair-restoration-solutions) may be the only procedure for which men far surpass women as patients, but it is part of a larger development. Blepharoplasty and neuromodulators are trending towards more balance, with a lower percentage of surgeons indicating these procedures are performed on “mostly females.” 

## **Patient Perspective**
In 2020, an [AEDIT survey found](https://aedit.com/aedition/aedit-survey-reveals-how-2020-altered-aesthetic-landscape) that millennials and gen Z accounted for the largest age group interested in aesthetic procedures. The AAFPRS survey continues to bear this out. Patients age 56 or older represented a lower percentage of overall procedures in 2021 than previous years (the organization notes that this may be because of COVID-19 concerns). 

[Social media](https://aedit.com/aedition/march-2020-study-shows-relationship-between-social-media-cosmetic-surgery) and our continued reliance on video conferencing remain key motivators for patients seeking treatment. In fact, 79 percent of facial plastic surgeons identify patients seeking procedures for an improved appearance on video conferencing as a rising trend, compared to only 16 percent the previous year. “The use of video for business, social media, and self-promotion is now so ingrained in society that it provides an easy and ever-present lens for self-scrutiny,” Dr. Maas explains. “We’ve slowly moved from static image filters to ‘Zoom dysmorphia’ being the major patient motivator as the pressures of a virtual lifestyle continue to impact the way we view ourselves and the way we present to peers.”

And then there is the ongoing influence of face coverings. We deemed ‘[eyes the new lips](https://aedit.com/aedition/popularity-of-eyelid-surgery-cosmetic-eye-procedures-during-covid-19)’ back in June 2020, and the upper third of the face continues to take center stage. More than 70 percent of AAFPRS members indicated that more and more patients were asking for eyelid procedures to [look less tired](https://aedit.com/procedure/eye-rejuvenation-solutions) (up 17 percent from 2020). Interest in [brow lifts](https://aedit.com/aedition/guide-to-surgical-and-non-invasive-brow-lift-procedures) also saw a jump, as did [face and neck lifts](https://aedit.com/aedition/pairing-facelift-neck-lift-procedures).

A newer but notable lift trend: The rise of [lip lifts](https://aedit.com/aedition/lip-lift-procedure-instead-of-lip-filler) (i.e. the surgical procedure that addresses the distance between the base of the nose and top of the lip for a fuller, more youthful effect). A new category for the 2021 survey, 70 percent of surgeons report that they performed the pout-enhancing procedure last year. It serves as a longer-lasting and more natural-looking alternative to the overly augmented look that recently dominated patient requests. Curious to see what you would look like after a [lip lift](https://aedit.com/procedure/subnasal-bull-horn-lip-lift)? You can ‘try on’ the procedure and instantly visualize results with The AEDITOR. [Download the AEDIT iOS app now](https://aedit.onelink.me/E6Rw/7f228807).

## **All About Expertise**
Perhaps one of the most encouraging findings is the emphasis on expertise. The 2021 survey indicates that patients’ primary concern is finding a surgeon they can trust (36 percent), followed by worries about an unnatural result (30 percent). While no procedure is [without risk](https://aedit.com/aedition/guide-to-cosmetic-surgery-complications), the likelihood of a safe and successful outcome is greatly influenced by the qualifications (think: [board certification](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology)) and specialty of the provider. Increasingly, patients seem to be valuing and prioritizing this. “For most procedures, effective communication between surgeon and patient is the number one key to a successful outcome,” Dr. Maas notes. “This includes a mutually agreed upon, [reasonable expectation](https://aedit.com/aedition/how-plastic-surgeons-balance-patients-cosmetic-surgery-desires-and-safety) for improvement and what is realistically possible for individual patients and their goals.”

Surgical procedures are up, as are the number of men looking to address aesthetic concerns.

Facial Plastic Surgery Trends From 2021 AAFPRS Member Survey

New Survey Finds There Was A 40 Percent Increase In Facial Plastic Surgery In 2021

shutterstock 170651342

If it works, it will stand the test of time – and there’s no truer example than the practices of Traditional Chinese Medicine (TCM). While we often look to modern innovations to solve ailments that come with having a body (think: headaches, sore muscles, low energy), it’s often because we’re seeking a quick fix. When it comes to TCM and, more specifically, acupuncture, however, the remedy isn’t a bandaid and it certainly isn’t one and done. The treatment doesn’t just focus on the pain point, but rather its root and how to treat it long-term. 

Now, the majority of us are no strangers to the overwhelming cycle of work, family, and life responsibilities. They can take a toll on not just the psyche but our physical wellbeing, too. It’s a hamster wheel of stress that we often wear on our face with dark circles, a dull complexion, or tired eyes and in our bodies with area tension and pain. 

To find another way of treating these symptoms *and* combating these stressors at their root, I had the chance to try acupuncture at one of New York’s most sought after wellness destinations, [WTHN](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwthn.com%2F), with its co-founder and chief healing officer, [Shari Auth, DACM](https://wthn.com/pages/acupuncture#healers). With some two decades of experience, Dr. Auth was able to explain exactly what the ancient treatment can offer, its lesser-known benefits, and why it’s never going out of style.

## **What Is Acupuncture?** 
“Acupuncture is 3,000 years old and is one of the oldest forms of medicine in the world as a part of TCM,” Dr. Auth says of the treatment. The practice of placing hair-thin needles across specific pain points is known to stimulate the nervous, immune, cardiovascular, endocrine, reproductive, and digestive systems (if the millennia of practice aren’t enough, perhaps the over 4,000 scientific studies espousing the efficacy of acupuncture for concerns ranging from [tennis elbow](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7870184/) to [PTSD](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328930/) to [skin health](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5653339/) will make you a believer). 

And while acupuncture seems to do it all, this painless healing treatment is capable of so much more. For Dr. Auth, acupuncture is part of a holistic approach to wellbeing. The mission for WTHN is “to make it more accessible and do the education necessary because it has proven benefits. We don’t want it to be intimidating – it’s a treatment that is incredibly healing,” she says. 

## **The Treatment** 
The image of acupuncture is very mainstream – tiny needles placed all over the body in a manner that seems simultaneously haphazard and methodical. There is a method to the placement of said needles to truly make an impact. “The needles are placed in acupuncture points, the meeting place of blood, nerve, and lymph,” Dr. Auth shares. Part of the training to become an acupuncturist requires an understanding of where those points are on the body and how they interact.

Prior to my appointment, I filled out an online form to dive into my specific concerns (chief among them: lower back pain, insomnia, and muscle fatigue) to give Dr. Auth a better understanding of what was troubling me. This information is especially crucial when making an appointment to safeguard your experience. 

Now, as somebody who is used to injections (be it Botox® or a vaccine), I was fully prepared to feel the needles. In my mind, it’s a surefire sign that something is happening. However, to say that the insertion was painless would be an understatement. Furthermore, the sensation once they were placed was nonexistent to the point where I was concerned if it would work or not. “Those who are afraid of needles will notice that, after that first needle goes in, it’s not noticeable and not a big deal,” Dr. Auth notes. 

My session was paired with a guided meditation via headphones, so I was able to truly immerse myself in the ambient surroundings. The WTHN space is clean, inviting, relaxing – the antithesis of the busy New York streets. To say that I walked out a new (and more relaxed) woman would be an apt description. 

## **Benefits of Acupuncture** 
From migraines to physical strains and even anxiety, the treatment is beneficial for virtually anyone, and while we are all familiar with these pain points, here are a few more benefits of acupuncture to note. 

<a href="https://www.youtube.com/watch?v=WuJ_6Z2JHqI&feature=youtu.be" class="embedly-card" data-card-width="100%" data-card-controls="0">Embedded content: https://www.youtube.com/watch?v=WuJ_6Z2JHqI&feature=youtu.be</a>

### **1. Aesthetics**
Acupuncture is not just a mind-body treatment, it may offer aesthetic benefits, too. The tiny needles can be placed over the back of the body or the face, and, while it’s not going to sculpt your cheekbones or give you six-pack abs, it may be a part of your complexion-perfecting regimen. “It’s good for a host of skin ailments from [psoriasis](https://aedit.com/aedition/what-its-like-to-live-with-and-treat-psoriasis) to [eczema](https://aedit.com/aedition/best-skincare-products-to-treat-eczema-flare-ups-in-the-winter) and helps reduce wrinkles, as well as boosting collagen and elastin,” Dr. Auth says. Known as [cosmetic acupuncture](https://aedit.com/aedition/cosmetic-facial-acupuncture-for-aging-skin-rejuvenation), inserting needles into key areas of the face has been shown to stimulate collagen production (à la [microneedling](https://aedit.com/aedition/difference-between-professional-microneedling-at-home-dermarolling)) and the flow of energy.

Furthermore, Dr. Auth notes that it can address digestive issues (IBS, anyone?) and those that relate to gas or bloating, which can not only feel uncomfortable but impact the skin and over all self-image. 

### **2. Better Beauty Sleep** 
We know the importance of a [good night's sleep](https://aedit.com/aedition/impact-of-beauty-sleep-on-skin-health-nighttime-skincare-products) for our physical and mental wellbeing, and acupuncture can help induce sweet slumber. As Dr. Auth explains, it provides a boost of “natural melatonin and gamma-aminobutyric acid, which helps to relax the mind.” 

So, was a better night’s sleep in the cards for me? As someone who has a love-hate relationship with bedtime, post-acupuncture, I was treated to a level of rest I hadn’t experienced in months. To further relieve my sleep concerns, Dr. Auth recommended the [WTHN’s Dream On](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwthn.com%2Fproducts%2Fdream-on) herbal supplements, which are formulated with organic ashwagandha, jujube, and valerian to promote deep sleep. They have helped combat my insomnia and done wonders for my circadian rhythm.  

### **3. Mood Elevation**  
Acupuncture can be an antidote to what Dr. Auth calls “the gambit of negative mental health complaints (i.e. [stress](https://aedit.com/aedition/impact-of-stress-on-skin-acne-wrinkles-dryness), anxiety, depression) because “it decreases your stress hormone and increases serotonin and dopamine levels.” A natural mood-booster, this therapeutic treatment also provides a much-needed break from overflowing schedules. Though your mood might not instantly change after one session, with continuous visits, it will become a fringe benefit of the treatment. 

Personally, it absolutely shifted the day that I was having. By taking away certain physical pain (more on that below), it allowed me to recenter my focus and be less irritable to the small inconveniences the day may bring. 

### **4. Improved Recovery** 
“Acupuncture is great for inflammation-based pain, as it increases circulation and is good for tight muscles,” says Dr. Auth. Post-procedure and during [recovery](https://aedit.com/aedition/best-plastic-surgery-recovery-nurses-centers-products), your nervous system is prioritizing healing, which can be a [painful experience](https://aedit.com/aedition/benefits-of-lymphatic-drainage-massages-after-cosmetic-surgery). While acupuncture is not necessarily recommended immediately after a procedure (hello, healing stitches and limited mobility), it may be beneficial in the months to come to promote healing and minimize pain. The treatment can be a part of a holistic approach to post-op care, as it offers immune-boosting benefits and muscle relief (among many other things).  

I haven’t had any aesthetic treatments lately, but I entered the appointment with sore muscles and lower back pain. The relief was almost immediate. One appointment certainly couldn’t solve my problems (nor did I expect it to), but there’s no doubt in my mind that my session with Dr. Auth provided much welcomed relief and made me seriously consider incorporating acupuncture into my overall health and wellness routine. 

### **5. Women’s Health** 
Dealing with an irregular [menstrual cycle](https://aedit.com/aedition/skincare-during-menstrual-cycle), painful periods, [polycystic ovary syndrome (PCOS)](https://aedit.com/aedition/pcos-related-skin-hair-concerns), PMS, or some combination of the above? Acupuncture can likely help. “This treatment is great for a host of women’s health complaints,” Dr. Auth says. “It’s a woman’s best friend all of her life.” 

Additionally, acupuncture can have a positive impact on family planning and pregnancy. “Both naturally as well as alongside IVF, it can be beneficial for fertility while also helping in prenatal care to combat morning sickness, acid reflux, and fatigue,” Dr. Auth notes. It may also prove effective for [treating postpartum depression](https://pubmed.ncbi.nlm.nih.gov/31259837/), [aiding lactation](https://www.ncbi.nlm.nih.gov/books/NBK501890/), and improving energy. 

## **The Takeaway** 
As tried-and-true as it comes, there is a reason acupuncture has been used to treat an array of health, wellness, and beauty concerns for centuries. As with any specialized treatment, expertise is key. In order to enjoy the benefits of acupuncture, it is important to find a highly skilled practitioner who can be realistic about what is achievable and develop a treatment protocol that will suit your needs.

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

Wellness

A staple of Traditional Chinese Medicine, acupuncture is known to alleviate pain and restore balance – but here’s what you may not know about this healing treatment. 

Beauty And Wellness Benefits Of Acupuncture

5 Benefits Of Acupuncture You May Not Know About 

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Hot right now — literally and figuratively — is radiofrequency (RF)-based aesthetic treatments. Part of the allure? It’s host of benefits, sans surgery. “The final frontier in aesthetic medicine is the non-surgical rejuvenation and tightening of skin along with fat reduction,” says [Ryan Neinstein, MD](https://neinsteinplasticsurgery.com/?gclid=Cj0KCQiAweaNBhDEARIsAJ5hwbeRtsR4ZnReWqZyMJssBYHmW_08Ey3LQTnyi08ZlkwEuG4hj6EUVqkaAtdPEALw_wcB), a board certified plastic and reconstructive surgeon in New York City. What once took multiple modalities, can now be achieved in a single step.
 
In the past, [ultrasound](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy) and [lasers](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing) have been used to induce skin injury as a means to remodel the skin firmer than it was prior to treatment, while [cryolipolysis](https://aedit.com/procedure/cool-sculpting), or forced cooling, of selective tissue has been a go-to for fat reduction. “These modalities, while important in the evolution of what we use today, have fallen out of favor for best-in-class, up-to-date aesthetic medicine,” Dr. Neinstein explains. Our understanding of collagen aging and stretch, he notes, has allowed for the development of new solutions. “Building on pioneering science in the field of fat metabolism, new technologies have allowed more robust non-surgical treatments without the complications of traditional modalities,” he says. 

Here, we’ll cover what radiofrequency is, how it’s used in aesthetic medicine, and some popular treatments top dermatologists and plastic surgeons are offering in-office now. 

## **What Is Radiofrequency?** 
Radiofrequency (RF) energy is part of the electromagnetic spectrum. In daily life, it can be found in WiFi signals, radio and TV waves, and microwave ovens. Because RF energy can be delivered through various types of tissue (i.e. skin, fat, and muscle) to generate thermal energy, it has also been used in just about every medical speciality — [including aesthetics](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7489578/). 
 
Despite all of the recent buzz around RF to address cosmetic concerns, it's nothing new. In 2002, the United States Food and Drug Administration (FDA) approved the ThermaCool™ (a.k.a. [Thermage®](https://www.thermage.com/#home)), the first monopolar RF device for wrinkle reduction. Needless to say, the technology has evolved ever since. During a radiofrequency [skin tightening procedure](https://aedit.com/aedition/best-nonsurgical-skin-tightening-procedures), heat is used to encourage the production of new collagen and elastin. When RF energy is directed to subdermal adipose tissue, meanwhile, it leads to fat necrosis without burning or injuring the epidermis. 
 
Because of the lower frequency of RF, it can safely be used on a wide range of skin tones. “The RF and RF microneedling treatments are usually safe for patients of all skin types as opposed to lasers, which work best for patients with lighter skin types,” says [Jennifer Levine, MD](https://www.drjenniferlevine.com/), a double board certified facial plastic and reconstructive surgeon in NYC. For all these reasons, RF devices have earned a spot in many dermatology and plastic surgery practices. 

## **Types of Radiofrequency Treatments**
As we’ve covered, radiofrequency can be used to tighten the skin, reduce fat, or a combination of the two on both the face and body. Below is a roundup of some of the most popular RF treatments on the market today:
 
### **1. Evoke**
[InMode Evoke](https://aedit.com/aedition/evoke-radio-frequency-for-jawline-neck-skin-tightening) uses RF technology to stimulate collagen and lift and tighten the skin around the cheeks, jawline, and jowls. “It uses artificial intelligence to maintain a constant temperature, which promotes collagen production,” Dr. Levine says. During a session, “radiofrequency energy is delivered to the treatment area, penetrating the layers under the skin’s surface to remodel the tissue and muscle in the area, resulting in smoother skin texture, toned, tighter skin and more defined facial features,” explains [Bruce Katz, MD](https://www.instagram.com/juvaskinandlasercenter/), an NYC-based board certified dermatologist. “It’s great for someone who wants a more youthful appearance, with a quick treatment time and no downtime.”
 
Dr. Levine sees Evoke as a contouring treatment and says it works best for fuller faces with mild to moderate laxity, and Dr. Katz says those who are concerned about their lower face tend to see the best results. “The procedure excels at tightening and defining the [jawline area](https://aedit.com/concern/neck-and-jawline-definition),” he shares. Who isn’t a good candidate? “If a patient needs to lose a significant amount of weight to help shape the face, Evoke is not the ideal procedure for that patient,” he adds. 
 
### **2. EmSculpt Neo®**
The original [Emsculpt®](https://aedit.com/aedition/why-everyone-is-talking-about-emsculpt) employed high-intensity focused electromagnetic (HIFEM) technology to build muscle, and the latest iteration of the device, [Emsculpt Neo®](https://aedit.com/aedition/what-its-like-to-get-emsculpt-neo), combines HIFEM with — you guessed it — RF to simultaneously tone muscles while melting away fat in a manner that board certified dermatologist [Kenneth Mark, MD](https://kennethmarkmd.com/), calls “unparalleled.” 
 
As you may have heard, “the HIFEM aspect of the device causes muscles to contract at an incredibly rapid speed that no one could replicate with an at-home workout for visibly toned muscles — 20,000 in 30 minutes,” says Toronto-based board certified dermatologist [Geeta Yadav, MD](https://skinscience.ca/). “The radiofrequency works in tandem to heat the overlying fat on the muscles, which causes the fat cells to die, making the patient look even more toned.” It is meant to be used on the arms, abdomen, buttocks, and calves, she adds.
 
An initial series of at least four treatments (though up to six may benefit some) are needed to see results. From there, one session every few months will help maintain your toned muscles, Dr. Yadav says. Speaking of results, you will notice some of the strengthening benefits within a few weeks of your final treatment, but it takes three months for the full effect of the fat reduction to present.
 
All of our experts agree that Emsculpt Neo® works best for patients who are already in shape and looking to target a stubborn area. For patients with more than a little pinchable fat, Dr. Neinstein suggests performing liposuction first for maximum results. “If someone is overweight or has a BMI of over 35, Emsculpt Neo® will not deliver the desired results,” Dr. Katz notes. While it’s safe for all skin tones, Dr. Levine says it can not be used on patients who have metal near the area of treatment. 
 
### **3. RF Microneedling**
While radiofrequency alone has skin tightening benefits, [RF microneedling](https://aedit.com/procedure/microneedling-with-radiofrequency) combines the powers of the two minimally invasive collagen-stimulating treatments. “This procedure causes controlled trauma to the skin with microneedling, which stimulates your body's healing response,” Dr. Yadav says, adding that [Infini™ RF](https://aedit.com/procedure/infini-rf) is her technology of choice. 
 
It is ideal for treating [skin texture concerns](https://aedit.com/concern/uneven-skin-texture). “We have multiple radiofrequency platforms, such as Vivace® Microneedling RF, VirtueRF, and Morpheus8,” says [Paul Jarrod Frank, MD](https://pfrankmd.com/), a board certified dermatologist in NYC. “We use them to treat acne scars, enlarged pores, scars, and crepey skin on the face, neck, chest, inner arms, and above the [knees](https://aedit.com/aedition/best-cosmetic-procedures-for-knees).” 
 
Another benefit? “When it comes to skin tone, most radiofrequency devices are color blind and can be used on various skin tones,” Dr. Frank adds. When treating [Fitzpatrick skin types](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types) III and IV (including Asian, Indian, and melasma-prone skin), he and his team adjust the heat to avoid unwanted discoloration. “It is rare for [hyperpigmentation](https://aedit.com/aedition/guide-to-hyperpigmentation-dark-spots-melasma) to happen and most microneedling devices now have insulated needles, which allows consistent distribution of heat and mitigates a lot of the risk,” he explains. 

Dr. Mark, who offers Infini™ RF at his practice, says multiple treatments will be needed to see results. “It stimulates collagen to help tighten the skin to reduce fine lines and wrinkles,” he explains. “When done as a series of three or four sessions spaced roughly a month apart, some lifting can also be accomplished.” 

## **The Takeaway**
At this point you’ve hopefully gleaned that not all radiofrequency treatments are the same. “For example, some go to a different depth, some are a different temperature, some devices combine microneedling or acoustic wave technologies,” Dr. Frank says. RF alone stimulates collagen and firms the skin, but, “when combined with microneedling, it will reduce pores, scars, uneven skin tone, and fine lines,” he adds. 
 
As with any non-surgical treatment, there are limitations. “If someone is severely wrinkled, they will not get near the benefit of a [fractional ablative CO2 laser](https://aedit.com/procedure/ablative-co2-laser), period,” Dr. Mark cautions. With that said, RF still has value. “For the patient who is not that wrinkled and/or cannot afford the downtime of that laser, the radiofrequency, when combined with microneedling, is an awesome compromise,” he says. Consulting with a board dermatologist or plastic surgeon will help determine whether you are a candidate.

Minimally invasive RF treatments can tighten skin and reduce fat without any downtime. Here's what you need to know.

Guide To Radiofrequency Skin Tightening And Fat Reduction

Why Everyone Is Talking About Radiofrequency

alexander-krivitskiy-yIitNO2Bgdo-unsplash

I am a soon-to-be-31-year-old beauty editor, and, for as long as I can remember, I have considered my laugh lines to be no laughing matter. Many of us have a facial feature we fixate on. In my case, that feature has always been my [nasolabial folds](https://aedit.com/aedition/nasolabial-fold-treatments). Those parentheses-like creases look different on everyone. For the women in my family, they tend to run deep — and get deeper with age. 

I mention the fact that I am a beauty editor because it means that I have long been spoiled by the opportunity to try great skincare products. I have a [pretty solid routine](https://aedit.com/aedition/best-skincare-routine-products-ingredients-for-30s) that includes [exfoliating acids](https://aedit.com/aedition/guide-to-topical-alpha-hydroxy-acids-in-skincare) to improve tone and texture, [antioxidants](https://aedit.com/aedition/facts-about-vitamin-c-in-skincare) to brighten and repair, and, of course, [daily sunscreen](https://aedit.com/aedition/best-sunscreens-that-act-as-makeup) to protect. But even the best lotions and potions cannot do much (if anything) to soften said folds. So, what’s a girl to do? 

As I shared a couple years ago, [I started getting Botox® injections](https://aedit.com/aedition/everything-you-need-to-know-before-getting-botox-for-the-first-time) just shy of turning 29 in an effort to get ahead of the increasingly omnipresent nature of my forehead lines. Last month, I headed to see [Lesley Rabach, MD](https://www.instagram.com/lmmedical.nyc/), a double board certified facial plastic and reconstructive surgeon, co-founder of [LM Medical](https://lmmedicalnyc.com/) in New York City, and my go-to aesthetic provider, for a neurotoxin touch-up with nary a thought of doing anything else. During our quarterly catch-up session (she fills me in on all the interesting things she’s noticing in her practice and patiently answers my questions about some of the trends we’re considering covering here at The AEDITION), however, something compelled me to broach the subject of my stubborn smile lines.

As Dr. Rabach emphasized, some amount of creasing is necessary in the region — after all, babies are born with nasolabial folds — but there are both surgical (hi, [deep plane facelift](https://aedit.com/procedure/deep-plane-facelift)) and non-surgical (think: filler) solutions that can help soften their appearance. In my case, half a syringe of [hyaluronic acid (HA)-based filler](https://aedit.com/aedition/everything-you-need-to-know-about-dermal-fillers) was all I needed to subtly yet substantially rejuvenate my face (keep reading to see before and after photos) for up to a year. Intrigued? Here’s what you need to know.

## **Returning to the Fold**
Also called laugh lines and smile lines, the nasolabial folds run from the corners of the nose to the corners of the mouth. Look back at your baby photos and you’ll see that those creases have always been there. “Even children have smile lines,” Dr. Rabach shares. As such, “it is imperative to maintain a fold because without it, we look very unnatural,” she adds. 

Depending on your anatomy, genetics, and lifestyle, however, the current state of your nasolabial folds may be quite different from their OG appearance. “As we get older, the cheeks [lose volume](https://aedit.com/aedition/best-procedures-to-restore-facial-volume) and, together with years of smiling, the nasolabial folds deepen,” Dr. Rabach explains. Yes, smiling is one of the causes of deepening folds, which means those lines are a sign of a life well lived and laughed. While I can’t help but smile at that, it doesn’t totally reconcile my relationship with said creases. 

From my teenage years through my mid-twenties, I always had a fuller midface. My nasolabial folds were fairly prominent then, too, but something about the overall proportion of my face seemed to camouflage them. By my late-twenties, my countenance bid adieu to any lingering baby fat, which added a bit more emphasis to those pesky parentheses. 

<CaptionImg url={https://images.ctfassets.net/zw35sfestf1t/3qFCcAgw8jjA1eOhXzOrlZ/b12a7acd7b36a9f17a0fe03a52a2f6a6/NasolabialFoldBefore.jpeg}>
  The writer before her filler treatment.
</CaptionImg>

It’s been in the last year or so, though, that I’ve noticed the most visible change. Doubling down on my [fitness regimen](https://aedit.com/aedition/what-its-like-to-get-emsculpt-neo), the stressors of everything going on in the world, and the anatomical realities of being a 30-something seemed to converge in a way that left my mid- and lower-face looking… blah. As someone who has always been conscious of my penchant for RBF (IYKYK), combining that with a leaner face and deepening folds made me look tired, stern, and just not like the best version of myself.

## **Fixing the Folds**
Sitting in Dr. Rabach’s Greenwich Village office on an unusually mild December afternoon, I explained to her the evolution of my smile lines and, based on how my mom, aunt, and grandma have aged, forecasted the future of my folds. While she was quick to quip that my nasolabial folds were no deeper than those of her four year old, she did admit that a little HA filler could likely go a long way.

This is, she says, “a common area to be treated with dermal fillers,” but the placement of the product can be customized based on the patient and their aesthetic goals. “Nasolabial folds can be treated either by directly filling into the fold or by [filling the cheek](https://aedit.com/procedure/cheek-augmentation-with-fillers) to lift the fold,” Dr. Rabach shares. “It depends on the individual anatomy which will be more natural and effective.” 

I was more familiar with the latter option ([augmenting the cheek](https://aedit.com/aedition/cosmetic-procedures-to-define-cheekbones) for a more lifted appearance), but, as it turns out, I am not an ideal candidate at this point in my life. “Younger patients, where the folds aren't so deep, often benefit from a very small amount of filler placed just in the deepest area to soften that,” she explains. In my case, the deepest area was by the nose. Put another way: Because my cheeks are (relatively) full, it's better to inject into the fold. “If your cheeks were flat, then injecting into the cheek is better,” Dr. Rabach notes. Either way, the goal is the same. “The goal is always maintaining a natural amount of depth,” she reiterates. 

Sure, [cheek filler](https://aedit.com/aedition/restylane-contour-cheek-filler) could help rejuvenate my folds, but it would also address a concern ([cheek volume](https://aedit.com/concern/cheek-volume)) that didn’t, well, concern me. As Dr. Rabach explained, the amount of filler I would need to see results, coupled with the fact that my goal was not cheek enhancement, made it inefficient from both a cost and benefit perspective. Instead, she said splitting a half-syringe of Versa™ by Revanesse® between my two folds would give me the subtly satisfying look I was after.

## **Fill ‘Em Up**
Until now, my experience with cosmetic injectables has been limited to [Botox®](https://aedit.com/aedition/where-to-use-botox-from-head-to-toe), which requires a bit of patience. Anyone who has ever gotten neuromodulators knows that it takes a minimum of a few days (and up to two weeks) to fully enjoy the effects of the wrinkle relaxers. Hyaluronic acid-based fillers, on the other hand, offer instant gratification.

While some areas of the face require [numbing cream](https://aedit.com/aedition/numbing-cream-breakouts) before filler injections, the nasolabial folds are not one of them. Dr. Rabach gave me a stress ball to squeeze, but, truth is, it hardly felt like anything more than a pinprick (there is lidocaine within the filler to further ease any potential pain). After two pricks into the upper part of the fold on my right side, she handed me a mirror to inspect the first half of the results. Much to my surprise — and delight — the crease was softer. She repeated the same thing on the other side and, in all of five minutes, I looked totally rejuvenated in the most understated way.

<CaptionImg url={https://images.ctfassets.net/zw35sfestf1t/59gtLQ1sM4YKqLFOhOSwRg/0b2adbac8f7042284d0b5773053b7fb2/NasolabialFoldBA-Crop.jpg}>
  The writer before (*left*) and about an hour after (*right*) her filler treatment.
</CaptionImg>

Dr. Rabach used Versa™ on me because, she says, “it is very versatile for the folds, moves with the person, and integrates well into the tissues.” Depending on the patient, however, she also likes [Restylane®](https://aedit.com/procedure/restylane), Teoxane Teosyal RHA® 3, and [Juvéderm® Ultra](https://aedit.com/procedure/juvederm) for this area. For most, HA filler results last nine to 12 months in the nasolabial fold region.

## **Recovery & Results**
Regardless of the product, the most common side effects of HA fillers are temporary swelling and mild discomfort for a few days. As with any injectable, [bruising](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox) is possible (though relatively rare in this part of the face). As you can see in my ‘after’ photos, I experienced a bit of redness at the injection sites for about 24 hours. After that, I found the area to be slightly tender to the touch (most noticeable when I washed my face) for about five days. 

A month later, I am pleased to report that the results have exceeded my expectations. Not a single person — including my ever-observant mother, with whom I FaceTimed when I got home from my appointment — has been able to pinpoint what I had done. Yet, when I show them my B&A, the results are abundantly clear. 

<CaptionImg url={https://images.ctfassets.net/zw35sfestf1t/NPqEbL7qaT7uP4ntmow6Y/9d625d3ed648174a787e854c4b489677/NasolabialFoldBA-Full.jpg}>
  The writer before (*left*) and about an hour after (*right*) her filler treatment.
</CaptionImg>

For some, the subtlety may be a letdown. For me, it’s the draw. Coupled with Botox® in my forehead and glabellar lines (the effects of which were not yet visible in these photos) and a skincare routine focused on keeping my combination complexion clear and radiant, nasolabial fold filler has offered a level of rejuvenation that I didn’t know could be achieved. For the first time in my life, I am smiling about my smile lines.

If you are curious about what you would look like with nasolabial fold filler, [The AEDITOR](https://aedit.onelink.me/E6Rw/95b299f8) — the patented 3D Aesthetic Simulator available exclusively in the AEDIT iOS app — allows you to ‘try on’ the procedure and instantly visualize medically accurate results. [Download the app here](https://aedit.onelink.me/E6Rw/95b299f8), and, once you give it a try, [consult](https://aedit.com/providers) with a board certified dermatologist or plastic surgeon to determine if HA filler is the right treatment option for you.

Patient Perspective

A beauty editor shares her experience getting hyaluronic acid-based filler injected into her nasolabial folds to soften her smile lines.