From smoothing wrinkles to slimming hips, it’s easier than ever before to fine-tune your appearance without having to deal with the major downtime associated with going under the knife. In fact, the American Society of Plastic Surgeons reports that the number of minimally-invasive cosmetic treatments increased 200 percent since 2000, with Botox and fillers being the most popular of all. “I think that we’re living in a time where people are accepting the concept that you can be a person of substance and also care about your appearance,” says Lara Devgan, MD, a board-certified plastic surgeon in NYC.
With technology rapidly advancing and more people seeking treatment, the stigma once associated with getting “work done” is beginning to melt away. Not to mention, the increased awareness. While social media is often criticized for normalizing less-than-accurate standards of beauty, it’s also responsible for pulling back the veil on the world of medical aesthetics, allowing those interested in procedures to look into the treatments that are available to them. “I think social media has really demystified the entire world of medical aesthetics and plastic surgery, where it used to be hidden in the dark corners of your doctor's office,” Dr. Devgan says. “Now, it's on your Instagram feed in a time-lapse video or a before-and-after photo.”
Whatever the reason, there's no denying increased the popularity of cosmetic treatments. We turned to some of the top doctors in NYC, who filled us in on the trends they’re seeing in their practices and the new advancements they’re most excited about for 2019.
With flawlessly-filtered photos of actresses, models, and influencers who appear to be aging backwards crowding our Instagram feeds, it’s no surprise that wrinkle-smoothing injectables, like Botox, are the most common of all the non-invasive cosmetic treatments on the rise. “Injectables are the hugest trend in medical aesthetics right now,” says Dr. Devgan. “People don’t want a massive overhaul — they’re looking for a short, minimally-invasive, low-downtime procedure that’s going to make them look a little bit fresher.”
Dr. Devgan adds that the age of patients seeking injectables in her practice is getting younger and younger, too, especially now that people are interested in the preventable benefits. “There has been a huge realization that prevention is better than cure,” she says. “If someone is 70 with deeply etched lines between their brows, it's going to be very difficult, even in the best hands, to soften them. But if you're 30 or 35 and noticing the slightest wrinkles, you can smooth them out and age without ever developing them again.”
As to what wrinkle reducers are most popular, Dr. Devgan points to Botox and Xeomin. “They’re basically the same thing, it’s sort of like a Coke vs. Pepsi situation,” she says, adding that they both work in similar ways to temporarily freeze the facial muscles and treat the lines formed from repetitive facial movements like squinting and smiling. However, Xeomin is a very purified form of botulinum toxin, meaning that the body is less likely to develop tolerance to it over time.
And while anyone with fine lines or wrinkles is a good candidate, she admits that results vary based on the patient and the severity of their wrinkles. “The skin is like a piece of paper: If you fold it a thousand times, at a certain point, it becomes very difficult to smooth out,” she says. “Stopping the formation of deeply-formed lines before they happen is going to keep you looking fresher for longer.” When you start to spot wrinkles while your face is at rest, consider booking a consultation.
Lips fillers done differently
Of all the minimally-invasive cosmetic treatments conducted in 2017, soft-tissue fillers ranked second and saw a three percent increase from 2016. “Lip fillers have been in vogue for a few years now, but the excitement remains at an all-time high,” says Irene Gladstein, MD, founder and medical director at ENHANCE Asthetic Arts in NYC. Like many other doctors, though, Dr. Gladstein is noticing a shift in her practice. Patients are now more interested in naturally-contoured lips than full on glam (a la Kylie Jenner), she explains.
When it comes to achieving natural-looking results, nothing does the trick quite like Juvéderm Volbella XC, a hyaluronic-acid-based injectable that subtly plumps lips while also softening the appearance of marionette lines. “We tend to use Volbella for clients who are looking to contour rather than volumize,” Dr. Gladstein says. “It produces softer results without the tell-tale signs of lip fillers.”
And rather than injecting a large dose all at once, doctors now prefer to gradually build up to the desired effect with appropriately spaced out sessions. “Trying to rush into results without respecting the process leads to all things undesirable – rubbery, thick, duck lips,” says Dr. Gladstein. Treatments, when done correctly, can last up to 12 months, although it’s important to keep in mind that the results will vary by patient.
The liquid facelift
It seems that patients who may have initially booked their first appointment to plump up their pout are now interested in the benefits of facial contouring. “We have seen a steady and significant rise of procedures that enhance and define the cheeks, jawline, chin, and marionette folds over the past year,” Dr. Gladstein tells us. “Most patients are looking to enhance their existing features without looking too ‘done.’”
That’s where the “liquid facelift” comes in. It’s a non-surgical procedure in which dermal fillers, such as Juvederm and Restylane, are injected into the face to enhance different angles and temporarily lift facial features. It’s meant to subtly define lights and shadows while producing a more chiseled version of you, Dr. Gladstein explains. Results can last for up to two years.
Also exciting on the facial contouring front? A new blunt-tip needle known as the microcannula. It moves around the tissue, under the skin, rather than piercing the blood vessels as traditional needles do. The single point of entry allows for wider coverage and more even distribution throughout the area of injection. It also helps alleviate the side effects, which usually consist of mild swelling and bruising, and minimizes downtown, notes Dr. Gladstein.
While botulinum toxins and fillers were the top two treatments patients sought out last year, the American Society of Plastic Surgeons states that “non-invasive procedures to eliminate fat and tighten the skin are gaining popularity.” And nothing is quite as ground-breaking in the field of body-contouring as Emsculpt. While a variety of treatments target fat cells, Emsculpt also helps to define muscle tone, making it a complete game-changer in the industry.
“Emsculpt flips the script on the current approach to body shaping, which contours through elimination of fat and circumferential reduction,” says Bruce Katz, board-certified dermatologist and founder of Juva Skin & Laser Center in NYC. “Current body shaping techniques fail to address muscles, which greatly affect body contouring, but this goes beyond just waistline reduction to destroy fat while simultaneously building muscle tone.”
The treatment utilizes highly-focused electromagnetic energy to trigger supra maximal contractions (approximately 20,000 muscle contractions during a half-hour session), allowing muscles to contract in a way that’s not possible through exercise. “The contractions result in a rapid metabolic reaction in cells to not only strengthen and build muscle, but also breakdown fat,” explains Dr. Katz. It’s currently cleared for use on the abdomen and buttocks and is best suited for individuals with a lower BMI who want to improve muscle definition and fat-reduction in hard-to-target areas.
The ability to stimulate your muscles and burn fat without breaking a sweat is definitely appealing, as is the fact that there’s little-to-no downtime associated with the procedure — though you may just feel a bit sore, the way you would after an intense workout. In order to achieve the best outcome, patients are encouraged to schedule a minimum of four half-hour treatments, no more than two to three days apart. This can cost you anywhere from $3,000 to $4,000 in total, but the results are permanent.
The only caveat? You have to put in the work post-treatment. “It’s important to remember that it’s not a magic fix,” Dr. Katz cautions. “As with any weight loss or strength training program, you can gain fat back or lose muscle tone if you stop training, so a healthy lifestyle is important to maintain results.”