As we enter 2022, what big trends in aesthetic medicine will the new year bring? “Greater transparency about plastic surgery procedures in general,” says Jennifer Levine, MD, a double board certified facial plastic and reconstructive surgeon in New York City. “People are more willing to discuss having it.” Look no further than Marc Jacobs’ candid chronicling of his deep plane facelift and subsequent recovery to see that this (very welcome) trend already has roots.
A more mindful approach is also on the minds of many, says NYC-based board certified plastic and reconstructive surgeon Ryan Neinstein, MD. “As we enter 2022, we all have a greater sense of the importance of health and wellness highlighted by the pandemic,” he explains. “An extension of wellness is our sense of self” — which leads us to the procedures themselves. Dr. Levine sees continued interest in the more invasive end of the spectrum as our ‘new normal’ takes hold. Between masks and Zoom, “some people just want the best results and are willing to have the downtime to achieve them,” she shares.
To learn more about what to expect from the aesthetic space in the year ahead, we tapped some of the biggest names in plastic surgery to get their takes on what they foresee to be new and next for face and body in 2022.
For the most rejuvenating and natural-looking results, expect more patients to opt for clever combinations of surgical and non-surgical procedures that look good on Zoom and in real life. Here’s what 2022 has in store for the face:
1. Nasal Rejuvenation Surgery
Those who wish to address the aesthetic or function of their nose often do so earlier in life, but, like any part of the face (and body), the appearance of the nose changes with age. Dara Liotta, MD, a double board certified facial plastic and reconstructive surgeon in NYC, says she’s seeing a rise of patients in their forties and fifties coming in for what she calls “nasal rejuvenation surgery.” As she explains, the goal is not so much to “change their look” but rather “to get back to the more refined and airbrushed look that they had when they were younger.”
One possible reason for the trend? Zoom culture, which has people staring at themselves in ways they hadn’t previously. “These aren’t the patients obsessed with their selfies and striving for perfection,” Dr. Liotta notes. “These patients don’t want a rhinoplasty to look different.” As we age, she says two things happen to the nose:
- Thinning Skin: The first is that our skin thins, “and this can unearth irregularities that we didn’t see before — such as a bump on the nose, a little twist or asymmetry in the tip of the nose, or a ridge or depression that it seems we didn’t have when we were younger,” she explains.
- Relaxing Cartilage: The second thing is that the cartilage of the nose loses a bit of its structure. “This can cause the midportion of the nose to begin to look a little pinched or asymmetric,” Dr. Liotta shares. Additionally, “the ribbons of cartilage that make up the tip of the nose can relax outward and downward, making the tip of the nose look rounder, wider, and ‘droopier’ than it used to,” she notes.
This relaxation of cartilage can also cause breathing difficulties to emerge or worsen. “Nasal rejuvenation surgery also optimizes the breathing, restoring structure and support not only to improve aesthetics but to improve breathing as well,” Dr. Liotta adds.
2. The Anti-Zoom Boom
In late-2020 and throughout 2021, we talked a lot about the so-called ‘Zoom Boom’ in aesthetic medicine. 2022 may prove to be the antidote to that. Norman Rowe, MD, a board certified plastic and reconstructive surgeon with offices in New York and New Jersey, says that the ‘Anti-Zoom Boom’ is related to the return of in-person events. During the pandemic, we could hide behind our computer screens, but, as in-person events, work, and holiday gatherings ramp up, people are flocking to get ‘tweakments’ like lasers, fillers, and neurotoxins to tighten, lift, and smooth features on their face. The goal: To look and feel your best — in real life.
3. Move Over PRP
At this point, you’ve likely heard of platelet-rich plasma (PRP). The procedure involves taking a blood sample from the patient (usually the arm or some other non-invasive locale) and putting it into a centrifuge to isolate the platelet-rich plasma. The PRP solution can be applied topically or injected into various parts of the body. A few of the most buzzed about? It’s injected into the scalp to promote hair growth; it’s rubbed on the face after microneedling for a rejuvenating effect; and it can even be injected into the penile shaft (P-Shot) or vagina, clitoris, and labia (O-Shot) to improve sexual wellness.
In 2022, expect to hear a lot more about PRP’s cousin, platelet-rich fibrin (PRF), Dr. Levine says. PRF contains a higher concentration of white blood cells and fibrin than PRP, and it also includes a small number of stem cells that boost its wound-healing and skin-rejuvenation benefits. Additionally, Dr. Levine says to keep an ear out for more talk of exosomes and collagen-stimulating procedures.
4. The Rise of Chin Enhancement
Chin enhancement procedures gained popularity during the pandemic, and the interest hasn’t waned. “There is increased interest in the chin area and recognition that a bit of increased chin projection can help balance the profile,” Dr. Liotta explains. The chin has long been an underappreciated facial feature, but it’s finally getting its due. In addition to improving overall facial harmony, “a strong chin helps make our neck look longer and our submental angle look deeper,” she says. For temporary improvement, chin filler is an option. Those looking for permanent prominence, meanwhile, can achieve it with a chin implant.
5. Combination Procedures
Whether it's minimally invasive treatments or surgeries, there are many reasons to consider combining or stacking procedures. For starters, it allows you to make the most of your time in the office, consolidate recovery, and maybe even save a bit of money (in the case of surgery, for example, anesthesia will only need to be administered once). “People feel if they are going to have downtime, they may want to add something on,” Dr. Levine says. And, when it comes to results, strategic combinations can yield even better benefits.
On the non-surgical side, Dr. Levine says patients are realizing that it’s probably not enough to just do injectable neuromodulators and fillers. Instead, adding lasers or micro-focused ultrasound or radiofrequency (or all of the above) may be best. “These are customizable to the individual patient,” Dr. Levine notes. Fat reduction with skin tightening for the body is another popular combination, she adds.
Dr. Liotta says that it’s common to combine rhinoplasty and chin augmentation, plus or minus submental liposuction. She calls this trio a “profile makeover.” In the right patient, “combining these procedures helps balance the profile, and allows the results of the individual procedures to make the greatest impact,” Dr. Liotta says. It also leads to a more natural aesthetic. “Combining procedures to achieve a more ideal profile can actually help the results of rhinoplasty look more natural — like your profile was meant to be like that,” she adds.
Combining procedures also minimizes downtime — there’s one anesthesia and one recovery — and usually saves a bit of money. “Who doesn’t like that?” Dr. Liotta says. We’d have to agree.
6. The Minimally Invasive Brow Lift
The last couple of years have seen many add ‘brow lift’ to the list of concerns they are looking to treat with neurotoxins. While the so-called Botox brow lift can have a lifting effect, the results are temporary (think: three to four months) and limited (it’s best for younger patients with minimal sagging). So, what’s the alternative? Enter the minimally invasive surgical brow lift. Gone are the days of cutting from ear to ear to lift the upper face. Instead, an endoscopic brow lift can achieve substantial and long-lasting brow elevation that rejuvenates the eye, brow, and forehead area with inconspicuous incisions. “It’s minimally invasive, little downtime, and has almost no scar,” Dr. Rowe says.
7. New Injectables on the Horizon
Last year, we welcomed new hyaluronic acid-based fillers (hi, Restylane® Contour) to the market. In 2022, Dr. Levine says to expect “hyaluronic acid fillers as skin boosters” (as found abroad in treatments like Juvéderm® Volite and ProfHilo®), CaHA (“combining calcium fillers with HA fillers”), and “hyper-diluted and biostimulatory fillers to stimulate collagen and elastin” to be big.
As for neurotoxins, Revance is seeking approval from the United States Food and Drug Administration (FDA) for daxibotulinum toxin (a.k.a. DAXI), which seeks to improve the longevity of neuromodulators from the standard 12 to 16 weeks to an average of six months. On the flip side, Bonti is a new toxin being developed by Allergan (the maker of Botox®) that should have a quicker onset time (within 24 hours!) but a shorter lifespan (just two to four weeks).
Our experts expect lots of surgical and non-surgical body contouring requests this year (the COVID 19 is real) — plus, a modern take on the breast lift.
8. Cellulite Treatments
When Qwo™, the first-of-its-kind injectable that treats moderate to severe cellulite on the buttocks, received FDA approval in the summer of 2020, patients and providers alike rejoiced at the minimally invasive treatment option that was found to be safe and effective. After rolling out to doctors’ offices in 2021 (read about one beauty editor’s experience), Dr. Rowe expects the procedure to get even more popular in 2022. “It is quick and easy and is really the only effective treatment,” he shares. While it may be the best in the business at the moment, Dr. Levine says to stay tuned. “There may be other treatments coming out,” she forecasts.
9. The Lipoabdominoplasty
A traditional abdominoplasty (a.k.a. tummy tuck) is known for removing excess skin and tightening the abdominal muscles, but what if fat is your primary concern? Meet the lipoabdominoplasty. “It’s the thinner version of the old tummy tuck,” says Lisa Cassileth, MD, a board certified plastic and reconstructive surgeon in Beverly Hills. As she explains, the surgery works well for patients who are looking to remove central fat around the waist in combination with any excess skin. With pandemic-induced weight gain and the continued demise of the American diet, Dr. Cassileth says many patients find that, even with their best efforts, this fat is stubborn and is the new normal for them. The procedure “has the advantage of being able to remove all the fat, whereas tummy tucks focus primarily only on loose skin,” she notes.
10. Post-Pandemic Customized Mommy Makeover
“With the pandemic baby boom, my focus has become the post-pandemic customized mommy makeover,” Dr. Neinstein says, adding that a lot of moms come into his office with an ‘if not now when’ mentality since they find themselves unable to achieve their postpartum aesthetic goals with diet and exercise alone.
To provide better and enhanced care, his practice offers a variety of procedures beyond the traditional tummy tuck and breast augmentation. “With so many fit moms, my common procedures are sculpting of the abdomen and waist or lipo 360 using the powerful energies of Vaser® and Renuvion® along with my innovation of c-section shelf repair and mini tucks,” he explains. In his experience, many women no longer need or want a full tummy tuck. “We can now, with new instruments and techniques, not interfere with the belly button and accomplish their goals,” Dr. Neinstein says.
11. The Pocket Lift
A fresh take on a mastopexy (a.k.a. breast lift), Dr. Cassileth says the so-called pocket lift “holds the breast high” and “looks great” — sans implant. “No longer will a patient need an implant to get a great lift,” she shares. During the procedure, the breast tissue is tucked under the pectoral fascia. “This holds the breast up, gives it support, and makes the top of the breast full again,” Dr. Cassileth explains. “Traditionally, breast surgeons used implants for this to work, but the pocket lift gives it a younger, fuller look without the implant.”
The recovery is similar to a traditional lift, about a week of downtime followed by a month of no aerobics or heavy lifting. “The pocket lift is best for those who don’t want a bigger breast, but just want a lift with a great long-term, high result,” Dr. Cassileth notes. It can also be paired with a breast reduction. For really ptotic (read: saggy) breasts, a piece of absorbable mesh is used to lock in the lift as the fat is tucked under the breast. “It’s also important to know that this technique, with or without mesh, will not interfere with mammograms,” Dr. Cassileth adds. “The breast tissue is still easily visible through the thin fascia.”
12. Double Reverse Mini Tuck
Back to the belly, Dr. Neinstein says the double reverse mini tuck is another take on an abdominoplasty that is increasingly popular. “For women with loose, stubborn skin above the belly button, I can harness the skin-tightening effect of Vaser® and Renuvion® with the hybrid skin removal of a reverse tuck,” he explains. If you’re curious about the incision (and resulting scar), it is well-concealed. “Here, we take the skin out under the breast, hiding the scar in the fold,” he shares. “It typically looks like a scar from a breast augmentation, but it allows me to address their concerns of the abdomen,” he adds.
13. Radiofrequency Skin Tightening
You are no longer resigned to surgery if you want to treat skin laxity concerns on the body (or face). Dr. Cassileth says that radiofrequency (RF) skin tightening has continued to improve to the point where she and her team can, in some cases, address loose skin without cutting. Needless to say, not everyone is a candidate, but it can be a great alternative for the right patient. “It works best with thinner skin, like on the arms, which contour easily and lift well with the radiofrequency energy,” she says.
14. ‘Nooks & Crannies’ Surgery
Patients travel from near and far for Dr. Neinstein’s “nooks and crannies surgery,” as he calls it. Last year, he and his team custom-built instruments and created a safety protocol to perform calf and ankle liposculpting. “Women are now wearing dresses and shorts for the first time because they have the lean sculpted calves and ankles they have desired but genetically were held back,” he says. “This has been so rewarding.”
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