A new crop of minimally invasive treatments are an alternative to surgery, offering visible results and less pain.

By By Kate Sandoval Box
November 19, 2018
Photo: hedgehog94/Shutterstock

If You Want to... Improve Your Skin Tone

The best new treatment: lasers

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

However, if you have just one issue, you'll want a specialty laser.

For brown spots, that 's the PiQo4, which, just like the Aerolase, makes quick pulses but in picoseconds, which are one-trillionth of a second. This can truly reduce your sun damage, says dermatologist Ellen Marmur, M.D., a member of the Shape Brain Trust, but it takes up to five sessions spaced a few weeks apart. "Many patients with melasma and hyperpigmentation want perfect skin in one session, but that would damage it-a slow and steady approach is better," Dr. Marmur says. Price per session: $150 for a single spot to $1,500 for a full face.

For redness, dermatologist Jeremy Brauer, M.D., turns to the Vbeam, the gold standard for treating rosacea, port-wine stains, and red scars. "This pulsed-dye laser treats large areas efficiently and effectively," he says. Expect three to four sessions starting at $300 each. (Related: How to Even Out Your Skin Tone with Laser Treatments and Peels)

If You Want to... Stimulate Repair and Growth

The best new treatment: Microneedling + platelet-rich plasma

You may have heard of-or even tried-microneedling: a treatment performed with a device called a micropen, which has multiple needles and is stamped or rolled on your face. It creates controlled wounds that rev the body's collagen production in an effort to heal.

What's new is coupling it with a platelet-rich plasma (PRP) treatment. "This combination is bringing shorter downtimes and better outcomes, especially for patients with texture inconsistencies, like acne scars," says cosmetic surgeon Sachin Shridharani, M.D. Your doctor spins 24 cc of your blood in a centrifuge. This separates the growth-factor-rich plasma, which is applied before and after microneedling. "The microneedling helps activate the growth factors in the plasma, which reduces healing time to a couple of days," says dermatologist Gary Goldenberg, M.D. PRP can be combined with other procedures, like hair restoration, to boost efficacy, and with laser and filler injections to cut healing time. Price starts at $1,500. (FYI: You shouldn't try microneedling if you have certain skin conditions.)

If You Want to... Target Your Body Too

The best new treatment: BTL EMSCULPT

This new FDA-approved body-contouring technology uses high-frequency electromagnetic energy to contract your muscles and burn fat. In a 30-minute session, your muscles will do the equivalent of 20,000 crunches or 20,000 squats, says dermatologic surgeon Dendy Engelman, M.D. Each time the machine pulses, your muscles contract.

"My patients describe it as an intense workout without the sweat," Dr. Engelman says, adding that some of them use the treatments to help with diastasis recti-a condition in which the abdominal muscles have separated because of pregnancy. Studies have shown an 11 percent decrease in diastasis recti and a 23 percent fat reduction over a six-month period, adds plastic surgeon Barry DiBernardo, M.D. He suggests four sessions in two weeks and two maintenance sessions every few months. Cost: up to $1,000 per session.

Add Volume to Your Face

The best new treatment: fillers

You can inject a biostimulatory filler to increase the body's collagen production rather than use a replacement filler to, say, instantly triple the size of the cheekbones. That new thinking is leading to remarkably natural and long-term results, says plastic surgeon Z. Paul Lorenc, M.D. Sculptra Aesthetic (starts at $1,000), poly-L lactic acid beads often injected into cheeks, smile lines, and temples, dissolves in months but stimulates collagen so well that areas stay voluminous for up to three years. Bella ll (starts at $800), approved for smile lines and acne scars, uses polymethyl methacrylate microspheres to promote and support collagen, with effects lasting up to five years.

There are also new techniques: Dr. Wexler performs microinjections in the lines around the mouth and crow's-feet with Belotero Balance (around $1,000), a structural filler that she says "pushes on the skin cell's fibroblasts to create collagen." Dr. Shridharani likes to do microdroplet injections in the forehead and cheeks and around the mouth with Juvéderm Volbella XC (starts at $950), a hyaluronic acid filler that locks water near the top of the dermis to give skin a dewy, believably youthful quality. (Related: I Got Lip Injections and It Made Me Take a Kinder Look In the Mirror)


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