jd-mason-GL1aMZWAty8-unsplash

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.

Aesthetics

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

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[Hyperpigmentation](https://aedit.com/concern/uneven-skin-tone) is a lively topic these days — and for good reason. From post-acne inflammation to age spots, there are so many different types of dark marks. As such, it can be difficult to identify exactly what kind of pigmentation you’re dealing with. And, from there, it may take some trial and error to figure out the best course of treatment for it. Here, we tapped three top dermatologists to talk about what exactly hyperpigmentation is, the difference between the various types, and how to deal with it in the best way for your skin type. 

## **What Is Hyperpigmentation?**
In simplest terms, “hyperpigmentation refers to darkening of the skin because of an accumulation of melanin,” says [Joshua Zeichner, MD](http://www.zeichnerdermatology.com/), a board certified dermatologist in New York City. While it looks different on everyone, very few are immune to unwanted pigmentation. “Hyperpigmentation is a common condition that many people, at all ages, suffer from,” says [Paul Jarrod Frank, MD](https://pfrankmd.com/), a NYC-based board certified dermatologist, adding that the discoloration leads to an uneven skin tone that leaves many patients frustrated. 

One cause of the frustration may be that it can be difficult to pin down exactly where the pigmentation is coming from. As Dr. Zeichner explains, there are many causes of hyperpigmentation and a variety of ways to help treat it. Very often, it’s the result of too much sun exposure. But the reality is that it can be caused by almost disruption to the skin, including acne, rashes, and even hormonal changes (think: pregnancy, birth control), Dr. Frank shares.
 
While an at-home skincare routine that includes [daily sunscreen](https://aedit.com/aedition/how-to-apply-sunscreen-and-not-miss-a-spot) (a non-negotiable) and a smattering of brightening and exfoliating active ingredients can go a long way, hyperpigmentation often requires professional intervention. “It can be difficult to treat with at-home or over-the-counter remedies, especially for patients with stubborn and extensive situations,” Dr. Frank says. “However, the appearance of hyperpigmentation can often be greatly reduced by treatments available at dermatologists’ offices.” 
 
Another important thing to know about hyperpigmentation? Treatment is rarely one and done. Pigmentation concerns tend to be ongoing and require a combination of at-home skincare and in-office treatments to manage. Patience and diligence are key, as is identifying exactly what type of hyperpigmentation you have… 
 
## **Types of Hyperpigmentation** 
Since ‘hyperpigmentation’ is an umbrella term, it’s important to drill down a little further and figure out what is causing your dark spots. While there are some treatments that will work across types, others can actually make matters worse. Consulting with a board certified dermatologist is the best way to determine what type of hyperpigmentation you have and how to treat it, but below is a primer to kickstart your conversation:
 
### **1. Sun Spots**
Whether you call them ‘sun spots,’ ‘liver spots,’ or ‘lentigines,’ these small, flat brown spots are caused by [damaging ultraviolet (UV) rays](https://aedit.com/aedition/cosmetic-procedures-treatments-to-correct-sun-damage). “Under the microscope, these spots actually show an increase in the number of the pigment producing cells,” Dr. Zeichner says. This is in contrast to [freckles](https://aedit.com/aedition/whats-the-difference-between-freckles-and-sun-spots), “which have a normal number of pigment producing cells that are just overactive,” he adds. The common locations for this type of hyperpigmentation are the face, chest, arms, and hands, says [Mona Gohara, MD](https://dermatologyofct.com/about/our-providers/mona-gohara-m-d/), a board certified dermatologist in Hamden, CT. It’s also more likely to occur in light skin. 
 
The fact of the matter is that it’s just about impossible to avoid sun spots. “If we lived in a bubble, we would never have these!” Dr. Gohara quips. To prevent this type of hyperpigmentation from cropping up uninvited, she [recommends](https://aedit.com/aedition/dermatologist-approved-sunscreen-for-face-body) wearing a broad spectrum sunscreen with an SPF of 30 or higher and reapplying every two hours (or more often if swimming or sweating) “365 days a year, regardless of weather.”
 
The earlier you treat lentigines, the better. “Spots that have been present for extended periods of time often can only be treated effectively with lasers,” Dr. Zeichner says. But that doesn’t mean a solid skincare regimen doesn’t have value. Nighttime is the best time to use products and those to help with hyperpigmentation, such as [retinoids](https://aedit.com/procedure/tretinoin) and [alpha hydroxy acids (AHAs)](https://aedit.com/aedition/guide-to-topical-alpha-hydroxy-acids-in-skincare). “These products will encourage cell turnover and leave the skin smooth and exfoliated,” Dr. Frank says.  
 
### **2. Melasma**
“[Melasma](https://aedit.com/concern/melasma) is brown blotches that most commonly occur on the face, cheek, or around the jaw,” Dr. Gohara says. It’s also possible to see it on the temples and upper lip, the latter of which can make it appear like a mustache, Dr. Zeichner adds. While it’s quite common, its exact cause is unknown. “Melasma is determined by your genetics and is influenced by hormonal fluctuations,” Dr. Zeichner explains. “It often gets worse in times when estrogen levels increase, such as [during pregnancy](https://aedit.com/aedition/most-common-skin-hair-conditions-during-pregnancy) or when taking a birth control pill.” This is why melasma is often referred to as the ‘mask of pregnancy.’ Other potential culprits? Heat exposure, UV rays, and [blue light](https://aedit.com/aedition/how-to-treat-blue-light-damage) from computers, cell phones and light bulbs.
 
Melasma is more common in melanated skin, and, to treat it, Dr. Gohara recommends a variety of brightening and lightening topicals — including [retinoids](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare), [antioxidants](https://aedit.com/aedition/facts-about-vitamin-c-in-skincare), licorice root extract, and [hydroquinone](https://aedit.com/aedition/giude-to-hydroquinone) — and, of course, sunscreen. “SPF is non-negotiable, preferably [mineral](https://aedit.com/aedition/difference-between-chemical-sunscreen-physical-mineral-sunscreen) with an element of [iron oxides](https://aedit.com/aedition/iron-oxides-for-visible-light-protection) to protect against blue light,” she says. Dr. Zeichner agrees: “Sunscreen is always important because even small amounts of UV light exposure can undo weeks of improvement with topicals.” 
 
There are also [in-office procedures](https://aedit.com/procedure/melasma-solutions), such as peels and lasers,  that can help, though it’s important to be treated by a provider who is well versed in treating melasma because it’s easy to exacerbate the condition.
 
### **3. Post-Inflammatory Hyperpigmentation (PIH)**
Dr. Zeichner says to think of post-inflammatory hyperpigmentation (PIH) like a stain in the skin. “Any type of inflammation in the skin, ranging from a [burn](https://aedit.com/aedition/how-to-treat-first-second-third-degree-burns) to [acne](https://aedit.com/aedition/how-to-treat-acne-induced-post-inflammatory-hyperpigmentation), can heal with a dark blotch in that area,” he explains. These marks can last for several months or even years — making them, in some cases, even more bothersome than the original condition. Generally speaking, lighter skin types experience PIH that is more pink or red in color, while darker skin types have purple, brown, or black marks.
 
Because this type of discoloration occurs *after* the skin is somehow inflamed, Dr. Gohara advises treating the underlying condition first. Even though PIH tends to fade over time, Dr. Frank says it’s always best to treat the spots right after they occur with an energy-based device. For red marks, he likes to use a vascular laser (either the [Vbeam](https://aedit.com/procedure/pulsed-dye-laser) or the [Excel® V](https://aedit.com/procedure/excel-v), to be exact). For brown PIH, he likes to use the Pico Genesis™. It all depends on the color of the post-inflammatory hyperpigmentation, he says. 

When it comes to topical skincare, Dr. Frank says AHAs and retinoids can be helpful in treating red marks on lighter skin. “For darker skin types, where the mark is more brown, I recommend AHAs, hydroquinone, kojic acid, arbutin, or a combination of these ingredients,” he shares. His [PFRANKMD Vanishing Stick](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fpfrankmd.com%2Fvanishing-stick%2F), for example, is formulated with arbutin, kojic acid, and [vitamin C](https://aedit.com/aedition/guide-to-topical-vitamin-c-in-skincare). “The ingredients work synergistically to help visibly brighten, lighten, and tighten skin for a more even, glowing appearance,” he says. 
 
Similarly, Dr. Zeichner says to look for ingredients that disrupt melanin production. “Retinol enhances cell turnover and hydroxy acids, like glycolic acid, have an exfoliating effect,” he explains. [Niacinamide](https://aedit.com/aedition/guide-to-topical-niacinamide-vitamin-b3-in-skincare), licorice root extract, and [tranexamic acid](https://aedit.com/aedition/guide-to-topical-oral-tranexamic-acid-in-skincare), meanwhile, “help calm inflammation,” he adds. He likes the [Bliss Bright Idea Vitamin C + Tri-Peptide Serum](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.ulta.com%2Fp%2Fbright-idea-vitamin-c-tri-peptide-collagen-protecting-brightening-serum-pimprod2014641), [Rodan + Fields Reverse Tone Correcting Treatment](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.rodanandfields.com%2Fen-us%2Fshop%2Freverse-tone-correcting-treatment%2Fp%2FRVTTG50), and [Pond's Clarant B3 Dark Spot Correcting Cream](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.walmart.com%2Fip%2FPond-s-Dark-Spot-Corrector-Clarant-B3-Normal-to-Dry-Skin-7-oz%2F14178846) for at-home care.

## **The Takeaway**
No two hyperpigmentation cases are the same, but Dr. Zeichner says there are some basic treatment tenets that remain true regardless of what’s causing it. “First, you want to reduce inflammation in the skin; second, you want to block production of abnormal pigmentation; and third, you want to enhance cell turnover to help the skin shed the darkly pigmented cells,” he says. This can be achieved through a combination of professional solutions and topical skincare, so it’s important to [consult](https://aedit.com/aedition/skin-care-questions-for-your-dermatologist) with a board certified dermatologist to develop the best treatment protocol for your needs.

Wellness

From sun spots to melasma and everything in between, we’re breaking down what you need to know about the most common pigmentation conditions and how to treat them.

Guide To Treating Hyperpigmentation And Dark Spots

The Ultimate Guide To Dark Spots And Hyperpigmentation

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‘In case of emergency’ is a concept we’ve all come to be familiar with and, with any aesthetic decision, we have to be cognizant of the risks. While the majority of '[tweakments](https://aedit.com/aedition/why-im-all-about-tweakments)’ are deemed safe and effective — they're low risk and high reward — no aesthetic procedure is without side effects and complications, some of which can be severe. 

Case in point: hyaluronic acid (HA)-based filler. HA fillers are known to cause temporary [swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) and [bruising](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox) at the injection site, but did you know that there is a risk (however rare) of vascular occlusion and, subsequently, skin necrosis and even blindness if the filler is injected into or near a blood vessel. So, what do you do in case of this emergency? The AEDITION spoke with two top plastic surgeons to break down the warning signs, risks, treatment options, and more.   

## **What Is Vascular Occlusion From Filler?**
[Vascular occlusion](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5965121/) is a rare but potentially serious complication of hyaluronic acid filler injections. It results from accidental injection of the product into an artery, and it can also be due to compression of the artery from surrounding filler. “In certain circumstances, when filler is injected near or into the blood vessel, they become occluded due to the pressure,” says [Jason Roostaeian, MD](https://aedit.com/provider/jason-roostaeian-md-449), a board certified plastic and reconstructive surgeon in Los Angeles. “If the pressure is above a certain level, the vessels are compressed and blood flow is limited, which is what causes the damage.” 

To put it plainly, the artery or capillary is constricted due to pressure of the filler or injected with filler. As a result, it is unable to function properly. The lack of blood flow causes the skin to suffocate and thereby can be damaging to both vision and skin (more on that below). “When something causes the artery or vein to be blocked, it’s like a heart attack caused by filler, and the affected area is the skin,” explains [Amir Karam, MD](https://www.drkaram.com/about/meet-dr-karam/), a double board certified facial plastic and reconstructive surgeon. 

## **Risk of Vascular Occlusion** 
Yes, the chances of vascular occlusion occurring are quite low. A [December 2020 study](https://jamanetwork.com/journals/jamadermatology/fullarticle/2774505) in *JAMA Dermatology* found that the risk of vascular occlusion is “exceedingly low” — one in 6,410 syringes [via needle](https://aedit.com/aedition/guide-to-needles-used-for-cosmetic-injectables-botox-filler) and one in 40,882 via microcannula injector — when injected by a board certified dermatologist. 

Even so, it shouldn’t be taken lightly. “This complication, if left untreated, can lead to blindness in rare circumstances,” Dr. Jason explains. The reason? “Any vessels around the eyes, such as the nose, the glabellar region, the vessels in the temples, those vessels do not have valves,” Dr. Karam shares. “Therefore, the blood flow can go back towards the eye and cause blindness.”

But blindness isn’t the only risk. Vascular occlusion can rapidly progress to tissue necrosis if not identified and treated quickly. Symptoms of skin necrosis include skin blanching, change in tone, intense pain, and bruising. When the vessel is blocked, “there is no blood flow to that segment of the skin,” Dr. Karam notes. 

Those familiar with post-filler bruising know what it looks like on them and should be able to identify the normal from the atypical, but newbies may want to pay closer attention. “Bruising from filler does not hurt,” Dr. Karam explains. And it tends to be localized. “Discoloration of the skin that goes beyond the area of injection is a tell-tale sign of vascular occlusion,” he adds.

So, how soon after injecting do the effects of vascular occlusion start to show? Depending on the case, it can happen immediately and be treated on the spot. But Dr. Jason notes that it can also occur after you’ve left your injector. Likely, the skin will begin to blanch due to the lack of blood flow and other symptoms will follow. “Usually, you see it happen in the first 24 hours, but the symptoms don’t always happen right away,” he cautions. 

To further complicate matters, it can be difficult to diagnose. “It can devolve over six to 12 hours, and many might confuse it for a bruise,” Dr. Jason explains. “That’s why it takes a trained professional to know what they are looking at in case there is a risk of tissue damage.”

## **Vascular Occlusion Treatment Options** 
If you feel that you are experiencing a complication from your filler injections, our experts recommend seeking out your injector first. To dissolve the filler and prevent further damage, they will administer [hyaluronidase](https://aedit.com/procedure/hyaluronidase) — an enzyme that breaks down hyaluronic acid — followed by an aspirin regimen and, in some cases, warm compresses. As it relates to the latter remedy, Dr. Jason notes that the warm compress may be added to help boost blood flow but admits that the jury is still out on whether warm or cold compresses are best. 

We’ve focused this article around HA filler, but, if the filler in use is not formulated with HA, [dissolving with hyaluronidase](https://aedit.com/aedition/hyaluronidase-to-dissolve-dermal-filler) is not an option. “Other measures include using aspirin to thin the blood and adding nitroglycerin to the area of the skin until the area has been relieved of its occlusion,” Dr. Karam shares. 

As studies suggest, the best way to prevent vascular occlusion is to be treated by a skilled injector who has a deep understanding of the anatomy of the area you are looking to treat — but, even in the most well-trained hands, Dr. Jason acknowledges that it’s somewhat of a numbers game. “There are certain areas where it is more prevalent when there’s one main source of blood flow to the area, but it can still happen to any injector,” he explains. 

With that said, there is no substitute for expertise when it comes to reducing the risk of this complication. “There are certain measures, such as understanding where the blood vessels are located and having a good understanding of vascular anatomy, that can help prevent this,” Dr. Karam notes. Additionally, he says that [injection technique](https://aedit.com/aedition/guide-to-injectable-techniques-needles-for-botox-filler) is a factor, too. “Using a microcannula or using the fanning method before the deployment of filler can decrease this risk,” he adds. 

With skin necrosis, the first course of action will be to let the area heal. From there, the damage can be assessed, Dr. Jason says. Some patients who experience complications from vascular occlusion swear off filler for good. But, for those interested in returning to the office again, Dr. Jason notes that a new approach will likely be necessary. “Some people have a higher likelihood to have this occur again, and the injector would likely stay away from that area in particular,” he says. 

## **The Takeaway** 
One of the most difficult parts of treating vascular occlusion is how easily it can go undetected. When detected early, however, long-term damage is often preventable. The early warning signs manifest as bruising and sensitivity. So, while they may blend in with the discoloration and soreness that can be expected from the treatment, any abnormalities shouldn’t be overlooked. In case of emergency, always seek help from your injector immediately.

When an injectable filler hits an artery or blocks one, the results are dangerous. So, how common is this and how do you avoid it? The experts weigh in.

The Risk Of Vascular Occlusion, Skin Necrosis, Blindness After Dermal Filler Injections

This Filler Risk May Be Rare, But It Can Lead To Skin Necrosis And Blindness

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*Feel like you need a dictionary every time you look at the ingredient list of a beauty product? Still unsure of the difference between retinol and retinoids? What about the unique benefits of vitamins B, C, and E? Are alpha and beta hydroxy acids the same thing? The skincare aisle can be overwhelming, but you don’t need a PhD in cosmetic chemistry to navigate it. With expert help, The AEDITION is demystifying and simplifying the beauty industry — [one label at a time](https://aedit.com/aedition/category/read-the-label).*

Vitamin B is well-known for its plethora of skincare and wellness benefits, but things can get murky when it comes to its numerous offshoots, including vitamin B3 (a.k.a. [niacinamide](https://aedit.com/aedition/guide-to-topical-niacinamide-vitamin-b3-in-skincare)), vitamin B6, and vitamin B12. Vitamin B5 (read: pantothenic acid) is another vitamin under the ‘B’ umbrella, and, in order to learn more about how it can be added to your skincare regimen, we talked to two industry experts for the lowdown.

## **What Is Vitamin B5?**
Vitamin B5, also known as pantothenic acid, is a water-soluble B vitamin. It’s necessary for making red blood cells, breaking down fats and carbohydrates for energy, and maintaining a healthy digestive tract. When it comes to topical skincare, Krupa Koestline, clean cosmetic chemist and founder of [KKT Consultants](https://www.kktconsultants.com/portfolio), explains that “it’s found to have anti-inflammatory, skin barrier-strengthening, and wound-healing properties.” As such, “it helps prevent infections by preventing biofilm formation on the skin,” she adds.

![Vitamin B5 (Pantothenic Acid) Skincare Benefits Infographic](//images.ctfassets.net/zw35sfestf1t/5oOwzvrgUbQnPJIpk9yHHY/a4001ca7d5d1fa40bc4c174e98fe9bd0/Vitamin-B5-Pantothenic-Acid-Skincare-Benefits-Infographic.jpg)

While we’re used to talking about soothing skincare ingredients as either a humectant that draws moisture into the skin (think: [hyaluronic acid](https://aedit.com/aedition/guide-to-hyaluronic-acid-in-skincare-dermal-filler)) or an emollient that locks it in (hi, [squalane](https://aedit.com/aedition/benefits-of-squalane-for-skin-hair)), vitamin B5 is both. “It acts as both an humectant and occlusive to both hydrate and moisturize the skin,” Koestline shares. So, while pantothenic acid may not get the same level of attention as some of its fellow hydrators and moisturizers, its multitasking status earns it plenty of respect.

When it comes to finding vitamin B5 in the beauty aisle, Koestline confirms that most skincare products are formulated with panthenol, a pro-vitamin (or precursor), “that the body quickly converts to pantothenic acid.” 

## **The Benefits of Vitamin B5 in Skincare**
As you’ve likely started to notice, pantothenic acid has a multitude of benefits. “It is an excellent and important skin nutrient,” says [René Serbon](https://www.reneserbon.com/), an aesthetician and skin expert. She breaks down its capabilities in the following way:

- Hydrate & retain moisture in the skin
- Reduce inflammation
- Calm irritation
- Promote skin healing & regeneration
- Stabilizes disrupted skin barriers

But that’s not all. Because of all these nourishing and barrier-boosting properties, “vitamin B5 has shown to be beneficial to skin suffering with [acne](https://aedit.com/concern/acne),” she adds.

## **The Best Candidates for Vitamin B5**
Do you have [acne-prone](https://aedit.com/aedition/difference-between-oily-and-acne-prone-skin), [dry](https://aedit.com/aedition/how-to-treat-prevent-dry-skin-face-body-hands), or [sensitive](https://aedit.com/aedition/difference-between-sensitive-vs-sensitized-skin) skin? Say hello to your new best (skincare) friend. “Vitamin B5 is generally gentle and safe for everyone with low chances of irritating the skin,” Koestline says. And those with oily skin “may also like it, as it provides very lightweight moisturization,” she adds. 

Heading into your provider with a skin resurfacing treatment? You may want to add a product with panthenol to your [post-op skincare routine](https://aedit.com/aedition/post-procedure-skincare-makeup-product-guide). “Because of its wound healing properties, it’s particularly useful post-procedure, like any type of [microneedling](https://aedit.com/aedition/difference-between-professional-microneedling-at-home-dermarolling), [ablative laser](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing), or [chemical peels](https://aedit.com/aedition/guide-to-superficial-medium-deep-chemical-peels),” Koestline shares. As for those who should stay away, Serbon says there are no particular skin types that need to avoid vitamin B5. 

## **How to Find the Right Vitamin B5 Product**
Finding the right B5 product starts with reading the ingredient label, as the item may not say ‘vitamin B5’ outright. Koestline notes that it can be listed as panthenol, provitamin B5, butanamide, and d-pantothenyl alcohol.

Next, you’ll want to take your skin type into account. “If you have sensitive skin and are looking for a vitamin B5 product to soothe your skin, look for a product [without any fragrance](https://aedit.com/aedition/fragrance-free-beauty-skincare-for-sensitive-skin),” she suggests. And then there is a the potency. Since the concentration of vitamin B5 in a product isn’t usually publicized, you’ll want to look for one that’s formulated with other hydrating ingredients — “like antioxidants, other humectants, and other occlusives,” Koestline explains — to boost its benefits. 

## **How to Add Vitamin B5 to Your Skincare Routine**
Vitamin B5 gives you the gift of choice, as you can choose where you want to put it in your routine. The beauty of the ingredient is that it does not increase photosensitivity, which means it can be used both morning and/or night, and it plays well with other ingredients. 

For serums, the [Sweet Chef Celery + Hyaluronic Acid Hydrating Serum Shot](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.target.com%2Fp%2Fsweet-chef-celery-hyaluronic-acid-hydrating-serum-shot-1-fl-oz%2F-%2FA-83470764) contains panthenol, and it can be used as a hydrator before your moisturizer. [Glossier Super Bounce](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.glossier.com%2Fproducts%2Fsuper-bounce) is another great moisturizer, while the [Tula Calming Vitamin B Serum](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.tula.com%2Fproducts%2Fsensitive-skin-treatment-drops-calming-vitamin-b-serum%3F) is a good option for those with irritated or acne-prone skin.

A fan of [toners](https://aedit.com/aedition/benefits-of-toner-in-skincare)? “Another benefit that vitamin B5 has is its ability to ‘piggyback’ other ingredients into the deeper layers of the skin,” Serbon shares. “This is especially true when in a formulation such as a toner.” The [Etude House SoonJung pH 5.5 Relief Toner](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fsokoglam.com%2Fproducts%2Fsoonjung-ph-5-5-relief-toner%3F) is perfect for sensitive skin, and oily skin types should go for [Paula’s Choice Skin Balancing Pore-Reducing Toner](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.paulaschoice.com%2Fskin-balancing-pore-reducing-toner%2F135-1350.html).

Masking options include the [La Roche-Posay Cicaplast B5 Facial Sheet Mask](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.laroche-posay.com.au%2Fcicaplast%2Fcicaplast-b5-mask) and [SkinCeuticals Hydrating B5 Mask](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.dermstore.com%2Fskinceuticals-hydrating-b5-masque%2F11289620.html). Both are ultra nourishing and suitable for sensitive, post-procedure, and dry and dehydrated skin.

It’s worth noting that vitamin B5 has a similarly softening and shine-inducing effect [on the hair](https://aedit.com/aedition/best-hair-care-products-by-texture-color), and it may be in some of the conditioners and leave-in treatments you are already using. It’s also possible that it’s in some of the products [in your makeup routine](https://aedit.com/aedition/skincare-ingredients-in-makeup) thanks to its emoillient and moisturizing properties.

## **The Takeaway**
Vitamin B5 is a member of the B complex vitamin group. Inside the body, it helps to make red blood cells. On the skin, pantothenic acid can be used to help pretty much all skin types retain moisture, restore the skin barrier, and reduce inflammation. From skincare and body care to makeup and haircare, there is a good chance pantothenic acid is already in your beauty routine, but, if it’s not, it’s definitely deserves a spot in your regimen.

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

Beauty

Vitamin B5 just might be the wonder ingredient you’ve been looking for in your skincare routine. Here’s the scoop.

Guide To Vitamin B5 (Pantothenic Acid) In Skincare, Hair Care, Makeup

Read The Label: What You Need To Know About Vitamin B5 In Skincare

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If you have been diagnosed with polycystic ovary syndrome (PCOS), we don’t need to tell you how difficult it can be to keep up with and treat the diverse array of symptoms. For example, the hormonal imbalances associated with PCOS can lead to skin and hair concerns ranging from [breakouts](https://aedit.com/aedition/how-to-treat-hormonal-acne-body-acne-cystic-acne-whiteheads-blackheads) and pigmentation or unwanted hair growth and loss. 

We know that the lack of information out there on the topic is, at best, frustrating, which is why we tapped our expert network to break down the complexities of PCOS diagnosis and treatment. From what PCOS is (and what kind of provider you should go to if you think you are experiencing symptoms) to how to manage it, here’s what you need to know about polycystic ovary syndrome.

## **An Intro to Polycystic Ovary Syndrome (PCOS)**
So, what is PCOS exactly? Polycystic ovary syndrome, better known as PCOS, is a hormonal disorder in which the ovaries produce an abnormal amount of androgens (read: male sex hormones). The name describes the small cysts that form in the ovaries, though not everyone with PCOS experiences cysts. It should also be noted that not all females with ovarian cysts have polycystic ovary syndrome.

### **Diagnosing PCOS**
While PCOS is increasingly common among females of childbearing age, it is not a straightforward diagnosis. “[It] can be a difficult condition to diagnose due to its varied presentation,” says [Iyanna Liles, MD](https://www.womenshealthct.com/practices/comprehensive-gynecology-of-ct-formerly-fine-and-gillette/providers/iyanna-liles-md/), Connecticut-based OB/GYN and women’s health specialist. “In general, most patients who are evaluated for PCOS by an OB/GYN present with symptoms of irregular periods.” 

But that’s not all. “They can report other symptoms such as increased [acne](https://aedit.com/concern/acne), abnormal body hair growth (requiring extensive hair removal techniques), infertility, or metabolic syndromes including diabetes or high cholesterol,” Dr. Liles explains. Weight gain, anxiety and depression, [hair loss](https://aedit.com/concern/hair-loss), and sleep apnea are also possible side effects.

When it comes to diagnosing PCOS, providers often start with a discussion of medical history — including, skin, hair, and weight changes — and a physical exam. From there, a pelvic exam, blood tests, and an ultrasound may be in order.

### **Causes of PCOS**
The symptoms are well-documented, yet there is less known about what causes PCOS. “While we do not completely understand PCOS, we do know that this condition involves increased available circulating androgens due to multiple possible causes,” Dr. Liles says. Factors that are thought to play a role include insulin resistance and genetics. Generally speaking, PCOS signs and symptoms tend to be more severe in patients who are obese.

### **Treating PCOS**
Just as there is no singular presentation of PCOS, there is no one-size-fits-all treatment plan. There are, however, a number of ways the condition can be managed depending on a patient’s symptoms. “In general, we start treatment for PCOS with lifestyle changes such as diet and exercise,” Dr. Liles says. “These interventions decrease the amount of circulating androgens and their effect on the body.” It’s also important for your provider(s) to know if and when you hope to become pregnant, as “some medications will either prevent pregnancy or should not be used in pregnancy,” she cautions.

Many PCOS diagnoses begin at the gynecologist because patients are concerned about irregular periods or difficulty conceiving. But long-term care plans often include additional specialties and experts. “If a patient primarily has skin and/or hair issues without menstrual issues, a dermatologist or skincare specialist may take on treatment,” Dr. Liles explains. “It can be confusing to know who to go to first, but both types of providers can refer to the appropriate specialist based on the patient's concerns.”

[Elizabeth Trattner, AP, DOM](https://www.instagram.com/dreliztratts/?hl=en), a board certified acupuncturist and doctor of Chinese and integrative medicine in North Miami Beach, FL, works with clients with PCOS and advocates for a comprehensive approach. “I believe it takes a team of professionals to create a cohesive treatment plan,” she shares. “I always triage patients to gynecologists and dermatologists [because they] like a teamwork approach.” This is especially important when prescription medications are involved. “There are many times that patients are under other physician’s care and are on medication,” she adds. “It is important to work in tandem with other doctors to monitor blood levels, track progress, and lower medication as the patient improves.”

At [Dr. Trattner’s practice](https://elizabethtrattner.com/), PCOS is treated using a combination of Traditional Chinese Medicine (TCM) and integrative medicine techniques. “Chinese Medicine, including acupuncture and herbal medicine, are a comprehensive and effective system for treating PCOS,” she explains. “It alleviates symptoms along with regulating the endocrine and reproductive system.” In fact, there is a good deal of [research](https://pubmed.ncbi.nlm.nih.gov/20230329/) into the many benefits of acupuncture for patients with PCOS. “[It] can [regulate](https://pubmed.ncbi.nlm.nih.gov/23482444/) ovarian and adrenal sex hormone levels,” she notes.

As it relates to integrative medicine, she says dietary changes are an important component of treatment. “This multi-pronged approach helps address both root issues and symptoms,” Dr. Trattner says.

## **The Impact of PCOS on Skin & Hair**
As we mentioned, skin and hair concerns are common among patients with PCOS. Acne is a common side effect, as is both excessive hair growth and [hair loss](https://aedit.com/aedition/common-causes-of-hair-loss-thinning-shedding-in-women). Below, we break down what you need to know about treating and managing skin- and hair-related PCOS symptoms.

### **How PCOS Can Affect the Skin**
There are a number of ways PCOS can affect the skin. Many patients experience face and body [acne](https://aedit.com/aedition/how-to-treat-prevent-body-acne). Some also develop [melasma](https://aedit.com/concern/melasma) and (in rarer cases) [skin tags](https://aedit.com/concern/birthmarks-and-moles). Not everyone deals with any or all of these symptoms, but, for those that do, they are often treated with a combination of professional and at-home remedies.

For starters, it’s important to consider what your plans are for the months ahead. “If a patient is actively pursuing [pregnancy](https://aedit.com/aedition/most-common-skin-hair-conditions-during-pregnancy) in the next year, I would recommend lifestyle changes and discuss various skincare techniques,” Dr. Liles says of treating patients with PCOS-associated skin concerns. “If a patient is not pursuing pregnancy, I recommend lifestyle changes, [improved skincare](https://aedit.com/aedition/best-skincare-ingredients-to-treat-acne-blackheads-whiteheads), and combined oral contraceptives (birth control pills) for about three to six months.”

As she explains, birth control pills “decrease ovarian androgen secretion and increase a protein that binds circulating androgens with the intent to decrease circulating androgen levels.” She specifically prescribes pills with a progestin component that has low androgen potential. If patients do not see their desired effect during the trial period with oral contraceptives alone, Dr. Liles usually refers them to a dermatologist for further evaluation.

Additionally, Dr. Trattner says that Chinese Medicine and acupuncture can be employed to “regulate the endocrine system and lower the number of androgens in the body.” To complement acupuncture sessions, she also integrates Western supplements and Chinese herbs and recommends [blue light therapy](https://aedit.com/aedition/difference-between-professional-at-home-led-therapy) for skin concerns. “Using these modalities lower testosterone and insulin levels,” she explains. “It takes at least three months to rebalance hormones, but, within that time, excessive hair growth and skin issues — including acne and melasma — begin to wane.”

### **How PCOS Can Affect Hair**
Like the skin, the hair is also affected by PCOS in many ways. Because PCOS increases the amount of male sex hormones in the body, a female with PCOS could find [unwanted hair growth](https://aedit.com/concern/unwanted-hair) on the thighs, chest, stomach, and around the nipples. The hormonal imbalance can also lead to [male pattern hair loss](https://aedit.com/aedition/common-causes-of-hair-loss-balding-thinning-in-men). “The increased circulating androgens act on the pilosebaceous units (hair follicles) in the skin leading to hair disorders such as hirsutism (abnormal sexual hair growth in male pattern) or hair loss,” Dr. Liles explains.

As with the skin, treatment protocols will depend on whether or not a patient is looking to get pregnant. “In the treatment of PCOS associated with unwanted hair growth, if a patient is actively pursuing [pregnancy](https://aedit.com/aedition/managing-treating-postpartum-hair-loss-thinning) in the next year, I would recommend lifestyle changes and mechanical hair removal techniques,” Dr. Liles says. That can include shaving, waxing, sugaring, and the like (learn more in our [comprehensive guide to hair removal](https://aedit.com/aedition/best-hair-removal-treatments-by-skin-tone)).

For patients not pursuing pregnancy, she recommends birth control pills for about three to six months. If combined oral contraceptives do not yield an adequate result, Dr. Liles says she may suggest adding anti-androgen medications such as [spironolactone](https://aedit.com/procedure/spironolactone-for-unwanted-hair), [finasteride](https://aedit.com/procedure/finasteride-propecia), or flutamide. “You should always make sure patients have reliable contraception with anti-androgen medications, as they can negatively affect a developing fetus with male organs during pregnancy,” she cautions. If unwanted facial hair growth is a concern, eflornithine cream (a.k.a. [Vaniqa](https://aedit.com/procedure/vaniqa)) may be an option. At the end of the day, “the choice of medication is individualized to the patient,” Dr. Liles says.

## **The Takeaway**
When beginning treatment for PCOS, it’s important to remember that patience will be needed. “When I begin with a new patient for PCOS, I create a comprehensive treatment plan,” Dr. Trattner says. “Once symptoms subside — after approximately three months — I will reevaluate the patient’s case on a regular basis and then transfer them to maintenance.” That maintenance will look different for everyone, but consistency is key. “It can vary from every week to twice a month,” she notes. “Hormones always need to be regulated with PCOS.” 

Additionally, regular care will allow your healthcare team to keep an eye out for more serious complications. “Other possible conditions to consider in patients with PCOS include diabetes, high cholesterol, infertility, and endometrial cancer,” Dr. Liles says. “If someone thinks they have PCOS or has been diagnosed with PCOS, they should make sure they have a clinician closely monitoring them for these conditions and assisting them in preventing the negative side effects seen with PCOS.”

If you sought out this article, we don’t need to tell you how difficult it can be to keep up with and treat the diverse array of PCOS symptoms. Allow us to help.

Polycystic Ovary Syndrome (PCOS) Skin And Hair Concerns: Causes, Symptoms, Treatments

How To Deal With PCOS-Related Skin And Hair Concerns

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Even if you only have a casual interest in beauty and aesthetics, you’ve likely seen the results of [plasma fibroblasting](https://aedit.com/procedure/plasma-skin-resurfacing) on your social media feeds over the past few months. The procedure leaves a (selfie-ready) pattern of tiny dots on the areas that were targeted immediately after treatment. Even though you may have flipped through some [before and after photos](https://aedit.com/aedition/importance-of-before-and-after-photos-in-plastic-surgery) already, you might not know what plasma fibroblasting is or how it works. That’s where we come in. Below, top dermatologists and plastic surgeons break down everything you need to know about the trendy treatment — including how it stacks up to other non-surgical skin tightening and resurfacing procedures. 

## **What Is Plasma Fibroblasting?**
In simplest terms, plasma fibroblasting is a minimally invasive technology “designed to tighten and smooth skin,” says [John Burns, MD](https://aedit.com/provider/john-burns-md-1204), a board certified plastic and reconstructive surgeon in Dallas, TX. It does so by specifically targeting fibroblasts in the skin. “Fibroblasts are a type of cell that produce collagen and protein in the dermis,” explains [Dendy Engelman, MD](https://aedit.com/provider/dendy-engelman-md-312), a board certified dermatologist in New York City. With age, these cells weaken, which leads to visible signs of aging (think: fine lines, wrinkles, skin laxity). “Fibroblast skin tightening procedures — or plasma fibroblasting — target these cells in order to tighten and smooth the skin and improve wound healing,” she adds.

So, how does plasma fibroblasting work? “It uses a pen-like device and emits an electric current that creates micro-injuries,” says [Marisa Garshick, MD](https://aedit.com/provider/marisa-garshick-md-313), a board certified dermatologist in NYC. “It is thought to work as the thermal energy and heat damage causes denaturing, or protein breakdown, in the skin, tissue regeneration, fibroblast activity, and subsequent tissue contraction resulting in skin tightening.”

As you’re probably starting to notice, the name of the treatment speaks directly to how it functions. “Plasma technology creates dual zone micro-trauma using an arc of energy,” says [Ava Shamban, MD](https://aedit.com/provider/ava-shamban-md-2325), a board certified dermatologist in Santa Monica, CA. “Using the electrostatic energy, it creates and emits a positively ionized nitrogen gas arc in the air between its tip and skin.” This ionized plasma arc “works in resurfacing and controlled tissue injury stimulating the repair process,” she noets.

What makes the technology unique is its multifactorial approach to skin rejuvenation. “It targets the superficial zone of skin while simultaneously creating a thermal injury zone at deeper dermal layers, home to fibroblasts,” Dr. Shamban says. This is why you see both short- and long-term benefits from treatment.

## **What Are the Benefits of Plasma Fibroblasting?**
Plasma fibroblasting is often referred to as a ‘skin tightening’ treatment, but that miniker doesn’t tell the whole story. “Plasma fibroblasting can be used to address multiple skin concerns on different areas of the face and delivers many skin benefits,” Dr. Engelman says. The treatment improves overall [skin texture](https://aedit.com/concern/uneven-skin-texture) and [tone](https://aedit.com/concern/uneven-skin-tone), reduces the visibility of unwanted marks and [scars](https://aedit.com/concern/scars) (including [stretch marks](https://aedit.com/concern/stretch-marks)), and boosts collagen and elastin production.” That last piece is what “firms the skin and helps patients look younger,” she adds.

Based on all the post-procedure pics you’ve no doubt seen, you likely know that plasma fibroblasting is most often performed on the face (though it can also be used below the neck). Dr. Shamban says its “specifically effective” for treating areas like:

- Periocular area (think: eyelids and crow’s feet) 
- Perioral area (i.e. around the mouth and above the lips)
- Neck and décolleté 
- Knees

“Fibroblast skin tightening is often used on areas with dynamic wrinkles, like crow’s feet around the eyes, and areas that tend to sag with age, like the neck and jowls,” Dr. Engelman says. You can also think about treatment areas in terms of aesthetic concerns. “It can help with skin laxity — especially involving the upper or lower eyelids — fine lines, wrinkles, acne scarring, and sun damage,” Dr. Garshick adds. 

## **Who Is the Ideal Candidate for Plasma Fibroblasting?**
As with its fellow non-surgical skin tightening treatments, plasma fibroblasting “is a good option for someone who wants to help with skin tightening without going to surgery,” Dr. Garshick says. An ideal candidate for plasma fibroblast treatments, according to Dr. Engelman, “is someone with mild to moderate textural skin concerns such as acne scarring, fine lines and wrinkles, and creping.” Another beneficiary? “Any males or females who have thinner skin,” Dr. Shamban adds. 

While Dr. Shamban says the treatment “can be used on all ethnicities and [Fitzpatrick types](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types)” because “it does not target or affect melanin,” those who are prone to pigmentation concerns (common of melanated skin) should be mindful. “It should be used with caution in those with darker skin or those prone to hyperpigmentation,” Dr. Garshick notes. Additionally, “the patient should not have any serious medical disorders, pigmentation disorders, or active infections and should be in overall good health if considering receiving this treatment,” Dr. Engelman says.

## **What Happens During a Plasma Fibroblasting Treatment?**
A [topical anesthetic](https://aedit.com/aedition/numbing-cream-breakouts) is applied before plasma fibroblasting procedures to minimize discomfort. The plasma pen delivers electric current to the skin, resulting in tiny, scab-like dots. “Depending on the treatment area, it can take 15 minutes to one hour to complete,” Dr. Garshick says. Generally speaking, Dr. Shamban says the treatment “is well tolerated by most patients without pain.”

How many treatments you’ll need depends on your anatomy and aesthetic goals. “The age, tone, condition, laxity of the skin, genetics, lifestyle and ethnic backgrounds can all play a factor in the final results,” Dr. Shamban explains. While the eyelids or perioral area may only need one session, “the [neck and décolleté](https://aedit.com/concern/neck-and-jawline-definition) or [knees](https://aedit.com/aedition/best-cosmetic-procedures-for-knees) might require an additional treatment to see a final result,” she says. 

In Dr. Engelman’s experience, multiple sessions (think: one to three) are typically required to see “visibly noticeable results.” Even if you do see results after your first session, Dr. Burns says that “subsequent treatments do offer benefits also.” 

## **What Does Recovery From Plasma Fibroblasting Entail?**
If there is one main downside to plasma fibroblasting, it’s the downtime. “The recovery is longer than most non-invasive treatments,” Dr. Burns concedes. “Scabs are present and generally fall off at about a week with persistent redness for two to three weeks.” As a result, Dr. Shamban says “this is not done within a week or two before a [red carpet](https://aedit.com/aedition/cosmetic-procedures-treatments-for-the-red-carpet-and-special-events), corporate presentation, TV appearance, or [holiday party](https://aedit.com/aedition/non-surgical-cosmetic-procedures-to-get-for-the-holidays).” Instead, she recommends allowing “two full weeks for the tiny red dots that form in a pattern across the treated area and scab to darken and fall off.”

According to Dr. Burns, the most common side effects of plasma fibroblsating are “delayed healing, scarring, and skin pigment irregularities.” 

## **How Long Do Plasma Fibroblasting Results Last?**
Generally speaking, Dr. Burns says the results of plasma fibroblasting can last anywhere from six months to two years. At that point, it may be time to re-book. “Aging is a progressive condition, so reassessing the area and re-treating within two years for maintenance may be recommended,” Dr. Shamban notes.

<BeforeAfterModule
  title={Before & Afters: Plasma Fibroblasting}
  procedureId={846}
/>

With that in mind, you could call the results of plasma fibroblasting the gift that keeps on giving. “While some benefits can be noticed right away, some changes may take three to six months to be seen,” Dr. Garshick says. So, what will you see when? “Both resurfacing and tightening will be seen and felt as soon as the area heals, within a few weeks,” Dr. Shamban explains. Even still, the healing process (including that collagen boost), will continue to progress with a final result of improvements seen in about 12 weeks and sometimes even as far out as 12 months,” she adds.

## **How Does Plasma Fibroblasting Stack Up?**
If you’re curious how plasma fibroblasting stacks up to other non-surgical firming and resurfacing treatments, there is much to take into consideration. “In comparison to radiofrequency (RF) [skin tightening](https://aedit.com/aedition/best-nonsurgical-skin-tightening-procedures), plasma fibroblasting requires more recovery time and and overall discomfort due to the micro-injuries sustained by the skin,” Dr. Engelman explains. “However, plasma fibroblasting only requires one to three office visits and lasts a long time (up to two or three years), while RF treatments can take about five visits and need to be maintained monthly.”

As for lasers? “[Plasma fibroblasting] is a device used to remodel skin and tighten tissue similar to a [resurfacing laser](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing),” Dr. Shamban shares. “It will resurface to smooth texture and reduce fine lines and wrinkles, as well as tone and provide tissue tightening.” When it comes to downtime and longevity, Dr. Engelman also likens the two. “Plasma fibroblasting and laser treatments usually require similar downtime — about a week, give or take, depending on the patient, extent of the treatment, and post-care practices,” she says. “Laser treatments can also last several years, especially if the skin is well taken care of.”

There is currently no research comparing plasma fibroblasting to other non-surgical tightening devices, but Dr. Garshick notes that [some studies](https://jamanetwork.com/journals/jamadermatology/fullarticle/411275) have shown that plasma fibroblasting can lead to a 37 percent reduction in facial wrinkling and 68 percent overall improvement in facial appearance. Even so, it’s important to remember that everyone is unique and what works for one person might not be the best course of action for another. As Dr. Garshick says, “it is always best to discuss the best treatment option for your concern with your provider.”

You’ve seen the post-treatment selfies on social media, but do you know what those tiny dots are actually doing? We didn’t think so.

Plasma Fibroblasting: Benefits, Treatment, Recovery, Results

Everything You Need To Know About Plasma Fibroblasting

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From blemishes to under-eye circles, makeup has become the go-to at-home solution for a myriad of skin concerns. Its transformational capabilities are unmatched, and, now more than ever, it’s possible to achieve any look you want — so why not fake a [facelift](https://aedit.com/aedition/popularity-of-facelift-cosmetic-surgery-for-aging-sagging-neck)? While it may not give you the long-lasting effects of an in-office treatment or a surgical procedure, it can create the illusion of a [snatched jawline](https://aedit.com/aedition/contouring-tips-from-celebrity-makeup-artist-patrick-ta) or a [lifted brow](https://aedit.com/aedition/best-eyebrow-pomades-powders-pencils-gels-tools) without any downtime. If you want to fake it until you make it, here are the makeup tips and tricks to lift you up. 

## **Get Your Products** 
Like any artist, you’ll need the right products to get you going. To avoid a ‘saggy’ or dull complexion, the experts recommend switching out powder-based products for those with a creamier consistency. “When you get to a certain age, a powder will drain your skin, so don’t be afraid of a shimmer or cream-based products,” explains Trinny Woodall, CEO and founder of [Trinny London](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Ftrinnylondon.com%2Fus%2F). The brand’s products are formulated to be lightweight and easy to apply with your fingers (so long as they’re clean!), so, if time is of the essence or [brushes](https://aedit.com/aedition/how-to-choose-a-makeup-brush) aren’t within reach, you can still achieve that glow. 

What makes cream products stand out is their ability to transform crepey skin, giving it a smoother appearance. Woodall also doesn’t underestimate the importance of a good treatment routine as a preventative measure to ensure your skin looks good year-round. “If you’re not doing an [IPL](https://aedit.com/procedure/ipl) or another in-office treatment, pigmentation will get to a certain size that will require more cover up later on,” she cautions. 

Now, the real beauty in makeup’s ability to transform the face is the illusions it can create. Well-rested eyes? Concealer. A glowing complexion? There's a foundation for that. Now with lifting, the trick is to create contours, and as Lulu Muca, head of makeup content for [Iconic London](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fus.iconiclondoninc.com%2F) explains, “the key to looking more lifted through makeup is all about the right products and placement.” More on that below. 

## **For Rejuventated Skin**
With any makeup look, the first step is skin prep. “Before makeup, moisturize your face and prep the skin,” Muca recommends. With a little setting spray (we like [Iconic London’s Prep Set Glow](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.sephora.com%2Fproduct%2Fprep-set-glow-hydrating-spray-P461219) hydrating spray packed with good-for-you ingredients), you can ensure that your hard work is not for naught. Muca also adds a self-care moment to the routine: “Give yourself a face massage using your fingers,” she explains. “Gently massage the face and focus that massage on upward strokes, thus creating the perfect canvas to begin your makeup routine.”

When you get to your concealer or foundation, opt for a formulation that melts into the skin to prevent caking or settling in fine lines ([Trinny London’s BFF Rebalance](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Ftrinnylondon.com%2Fus%2Fproducts%2Fbff-rebalance) will do the trick). The formulation inevitably plays a big role in achieving that youthful radiance and keeping the overall look more firm. “It’s about the glow,” Woodall says, though she does admit that, on those with oily skin, “it can appear like sweating, but it can also make you radiate.” If you have pigmentation, it can be tricky to choose a shade. Her tip: “Your makeup should be an extension of your skin, not a mask.” 

## **For Lifted Eyes & Brows** 
With age, the eyelids naturally droop and the skin becomes [more crepey](https://aedit.com/aedition/how-to-treat-the-skin-around-the-eyes-with-skincare-and-non-surgical-cosmetic-procedures). Even so, that wide-awake look is within reach. This area requires a hybrid approach to target both the skin and the skin tone. Reach for a concealer to lift the brow and eye area rather than a foundation, as a method of highlighting the bone structure without the use of a highlighter. “Apply a thin line of concealer from the outermost corner of the eye and draw the line up towards the temple,” Muca says. “This creates the illusion of an eye lift and makes your eyeshadow look snatched.”  

For those (designer) [under-eye bags](https://aedit.com/aedition/cosmetic-procedures-for-under-eye-rejuvenation), the upward motion is also in play. “We have ditched applying our concealer by creating a triangle shape under the eye and instead opt for light dots — a little goes a long way,” she adds. Kate Pymm, a Trinny London makeup artist, suggests honoring the natural hollow between the eye and cheek to prevent under-eye concealer from looking unnatural. Rather than dragging the product down, she encourages light, upward motions to evenly distribute the product for an even, natural lift. “Caking your under-eye makeup can add years to your face, so we made the [BFF Eye](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Ftrinnylondon.com%2Fus%2Fproducts%2Fbff-eye),” Woodall notes. “It is like if serum and an eye cream had a baby to help you get coverage and skincare.”

To maintain that well-rested look, it’s also worth noting that dark eye shadows may not be your friend. They can draw a lot of attention to the area, making it appear smaller while building up within the folds. If you’re looking for a smokey eye or that perfect cat wing, don't feel the need to ditch the darker hues all together — just maintain a light-hand. “Avoid heavy products in general and prioritize lightweight formulas,” Pymm says. 

## **For Contoured Cheeks**
To create a plump cheek that mimics the fullness [filler](https://aedit.com/aedition/cosmetic-procedures-to-define-cheekbones) may provide, it’s all about the shadows. “On the tops of your cheekbones, use our ‘Face Ombre Technique,’” Muca suggests. The technique is as follows: 

1. “Apply three dots of our [Illuminator](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.sephora.com%2Fproduct%2Filluminator-P461217%3FskuId%3D2380434) from the top of your cheekbone near your temple to the outer corner of your eye,” she says.
2. Next apply three dots of our [Sheer Blush](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.sephora.com%2Fproduct%2Fsheer-blush-P461220%3FskuId%3D2380392) just below that highlight,” Muca continues. “And then apply our [Sheer Bronze](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.sephora.com%2Fproduct%2Ficonic-london-sheer-bronze-liquid-bronzer-P471035%3FskuId%3D2438257) below the blush.” If you need a visual, the product should appear in three even lines on the top outer corners of your cheeks.
4. Last but not least, Muca says to blend the formulas together in “upward” strokes. “This will allow for the product to follow the natural shape of the face,” she says.

If using a contour stick, a trick is to blend it in evenly without that streaky giveaway. To do so, apply setting spray onto your brush and tap onto the contour stick before proceeding to your face. This will give you more control over your distribution and let you gently build rather than blending out. “Be clever with placement and how you use the product,” Pymm says. Her tip is to try using bronzer to sculpt rather than bronze. “It’s like an optical illusion, which is great for achieving that sculpted look without doing anything drastic,” she adds. 

## ** For a Snatched Jawline** 
For the jaw, focus on creating a seamless look that flows from neck to brow to guarantee an even complexion. “Before foundation, apply a cream contour to the areas you wish to sculpt, such as your cheekbones and along your [jawline](https://aedit.com/aedition/non-surgical-procedures-for-jawline-definition),” Muca explains. “Then, apply foundation on top, and your cream contour will pull through for a stunning ‘under-painted’ effect.” The grand finale: “Finally, sweep the powder contour across the areas you have cream-contoured for a seamless finish.”
 
When in doubt, try the ‘three’ technique, which she says suits most face shapes. “Using your contour, draw a three shape from forehead to cheekbone to jawline,” Muca explains. “We like to keep our contour light and fresh to lift and not hollow the structure of your gorgeous face.” 

## **What to Avoid**
While there is no specific product to avoid if you have a look that you want to achieve (we see you, smoky eye), the technique that you use is what will get you there. “If you want to achieve a lifted look, do not drag contour, highlight, blush, or bronzer down the face,” Muca cautions. Because the goal is a lift, the application must lift upwards as well. Muca’s tip is to “apply your products to the highpoints of the face and use gentle, upward strokes for a beautiful, lifted finish.”
 
When it comes to makeup, an update is never a bad thing. “We get comfortable with what we liked when we were younger and tend to stick to it but that’s what makes us look dated,” Woodall says. Her advice is to make your products work for the skin you have versus holding on to a look that may have worked in the past. 
 
A parting word from Muca? “A common mistake people make when trying to sculpt the face is applying too much product,” she laments. “A little bit goes a long way.”  

## **The Takeaway** 
If an in-office lifting or sculpting procedure is not in the cards or you need a quick fix, makeup can be your secret weapon for a lifted look. The secret is to use products that enhance your features without going too heavy on the brush strokes. And, as with any look, a little goes a long way to maintain a naturally sculpted glow up.  

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

Expert Opinion

Makeup isn’t just for self-expression, it can also help you contour your cheeks, sculpt that jawline, and even lift your brow in a matter of minutes with these tips from the experts. 

Face-Lifting And Sculpting Makeup Tips For More Youthful Skin

Face-Lifting Makeup Tips To Create A Naturally Sculpted Look

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Collagen is essential for a plump, youthful, elastic complexion. Unfortunately, the sun, free radicals, pollution, and even diet break down the protein found in the skin, joints, and tissues. As if that isn't enough, fibroblasts, which are responsible for creating collagen, become less active with age. As a result, the aggregate collagen and elastin fibers in the skin become fragmented and loose, giving way to wrinkles and laxity.

Collagen levels decrease at the rate of about one percent per year as we age, and the breakdown of [collagen](https://aedit.com/aedition/guide-to-collagen-in-skincare-supplements-aesthetic-medicine) in the skin contributes explicitly to the development of fine lines and wrinkles. But just because we lose collagen doesn’t mean all hope is lost. On the contrary, professional collagen-stimulating treatments can tighten the skin and boost production. So, rather than downing palmfuls of supplements and powders with the expectations of achieving youthful, bouncy skin — because hope is not a strategy — leave it to science to proclaim the next best thing for collagen stimulation. Enter: [Sofwave™](https://sofwave.com/).

## **Ultherapy vs. Sofwave: What’s the Difference?**
The use of ultrasound for aesthetic purposes is nothing new. “The dermis layer contains most of our specialized structures, and we have learned that heating the skin with ultrasound stimulates collagen production," says [Ava Shamban, MD](https://aedit.com/provider/ava-shamban-md-2325), a board certified dermatologist in Santa Monica, CA. Ultrasound waves selectively injure the skin to trigger a natural healing response. “The dermis is stimulated to produce new collagen with the resulting tissue providing more support to the skin structure, thus making it visibly and structurally tighter and more toned,” she adds.

The original [Ultherapy®](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy) device went through clinical trials in the early 2000s and first received approval from the United States Food and Drug Administration (FDA) around 2006. Ulthera (now known as Ultherapy®) is safe for all skin types and was introduced to tighten up saggy skin on the neck and face — sans surgery. Today, it is FDA-approved to lift the neck, chin, and brow and improve the appearance of lines and wrinkles on the upper chest.

A hit amongst dermatologists and plastic surgeons alike, ultrasound energy is highly effective, especially in those who are not ready for or interested in plastic surgery. Ultherapy® remains a go-to for [non-surgical skin tightening](https://aedit.com/aedition/best-nonsurgical-skin-tightening-procedures), but, as with all non-invasive energy-based devices, something newer always comes along. Sofwave™ is the latest FDA-approved ultrasound treatment that boosts collagen production and targets facial lines and wrinkles. Here’s how it compares to Ultherapy®:

### **SIMILARITY: BOTH USE ULTRASOUND ENERGY**
Unlike other collagen-stimulating treatments (think: lasers, radiofrequency, and microneedling), both Sofwave™ and Ultherapy® utilize ultrasound as the main proponent for prompting the creation of new collagen and rejuvenating the skin. However, there are some reasonably significant differences between the two comparable yet distinctive devices, including depth of penetration, the pain factor, and treatment areas, which leads us to...

### **DIFFERENCE: ENERGY IS DELIVERED AT DIFFERENT DEPTHS**
Perhaps the most significant difference between Sofwave™ and Ultherapy® is how far each one delivers ultrasound energy beneath the skin. With Ultherapy®, ultrasound is delivered to three different layers — superficially to the dermis at 1.5 millimeters, deeper to the dermis at 3 millimeters, and deepest to the SMAS and platysma muscles at 4.5 millimeters.

Sofwave™ sends ultrasound to only one depth — 1.5 millimeters — just below the surface of the skin, where collagen is most abundant. This controlled depth creates a more uniform effect without damaging the outer layers of skin or the deeper tissues and muscles such as the bones, facial nerves, fat, and blood vessels. [Samuel Lin, MD](https://www.linplasticsurgery.com/about/dr-samuel-lin/), a double board certified plastic and reconstructive surgeon in Boston, says that “because Ultherapy® delivers energy to deeper levels than Sofwave™, it can help tighten the muscle layer in addition to the skin.”  Sofwave™, meanwhile, “only provides skin tightening,” he adds.

### **SIMILARITY: BOTH ARE UNCOMFORTABLE**
The deeper depth of the delivered ultrasound energy makes Ultherapy® more painful than Sofwave™. Even so, Sofwave™ can be somewhat uncomfortable, but it's not downright unpleasant. Still, most doctors recommend using [numbing cream](https://aedit.com/aedition/numbing-cream-breakouts) (they remove it after about 20 minutes), especially on bony areas like the jawline and forehead. Next, a conductive gel is applied, which allows the handpiece to glide across the skin effortlessly. A full-face treatment is said to feel somewhat like a high-heat zing that lasts no more than a few seconds. Additionally, the Sofcool™ cooling component (it measures skin temperature) in the Sofwave™ handpiece helps make the treatment more comfortable.

### **DIFFERENCE: SOFWAVE HAS LESS RISK FOR FAT ATROPHY**
Unfortunately, one of the downsides to Ultherapy® is the potential for fat loss. The claim is largely anecdotal and there is a lack of scientific data on the topic, but some experts feel that, when it is used too deep, Ultherapy® can cause fat atrophy. Due to the limited depth of Sofwave™, Dr. Shamban says it’s ideal for the patient and provider to ensure there is no fat or tissue disruption below the collagen and elastin layer. “Although seemingly small, the difference can significantly change the provider's actions or potential errors, patient results, overall discomfort, and even cost or time per treatment,” she shares.

### **SIMILARITY: BOTH IMPROVE LINES & WRINKLES**
One of the many [causes of fine lines and wrinkles](https://aedit.com/aedition/unexpected-causes-of-wrinkles-fine-lines-face-neck-chest) is a loss of collagen coupled with a whole host of factors, like elastin breakdown, free radical damage, a loss of moisture, facial expressions, and so much more. Although both modalities help improve fine lines and wrinkles, Dr. Lin says that “Ultherapy® may be a better option for patients with deeper wrinkles and folds because it reaches a deeper level [of the skin].”

### **SIMILARITY: BOTH HAVE NO DOWNTIME OR RECOVERY PROTOCOLS**
While neither device carries any downtime, one of the most significant benefits of using Sofwave™ over other collagen-stimulating technologies is how quick the treatment is. Sofwave™ sessions last 30 to 45 minutes with little to no swelling or redness and no aftercare thanks to its proprietary Synchronous Ultrasound Parallel Beam (SUPERB) technology. As Dr. Shamban explains, the dual beams work at a specific depth, bypassing the upper layers of the skin to induce collagen formation. “Ultherapy® uses micro-focused ultrasound to generate a thermal effect under the skin and is known to be more painful,” she adds. 

Furthermore, the bigger handpiece addresses larger areas in less time. “Sofwave™ is a much faster procedure because it has a larger handpiece covering more surface area per pulse,” Dr. Shamban says. And Sofwave™ works after just one session, making it more effective for those who are short on time yet demand dramatic results. You can also do Botox®, fillers, and microneedling before or after treatment. “Sofwave™ is non-surgical and can be safely combined with other procedures, like neuromodulators, to bolster the amount of improvement in areas with wrinkles,” Dr. Lin says. “Facial filler presents an additional option for further [improving facial volume](https://aedit.com/aedition/best-procedures-to-restore-facial-volume) in addition to the skin-tightening offered by Sofwave™.”

## **The Ideal Candidate for Sofwave**
As we mentioned, collagen levels begin to deplete at a rate of about one percent per year starting as early as the [mid-twenties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-20s). That means that by the time the effects of collagen loss have set in, it’s past time to put collagen restoration methods into overdrive. 

Sofwave™ has both a corrective and preventative component to it. The treatment is beneficial for younger patients who wish to take a proactive approach to prevent aging or are showing early signs of it (think: minor laxity in the jawline) since Sofwave™ can help slow down collagen loss. But it's suitable as a rejuvenating procedure for more mature skin types, and it’s safe for all skin tones. Dr. Shamban likes to use Sofwave™ to treat early tissue laxity for those in their [late-thirties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-30s) and also to address moderate tissue sagging in patients in their [late-fifties and sixties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-50s-60s-70s). It should be noted that “it's not ideal when there is tremendous tissue laxity,” she says.

## **Sofwave Target Areas & Results**
Most dermatologists and plastic surgeons prefer to use ultrasound to tighten up slack skin on the face, chest, and neck and to target fine lines and wrinkles, too. In November, the [FDA approved](https://www.prnewswire.com/news-releases/sofwave-announces-fda-clearance-of-new-lifting-indications-for-eyebrow-sub-mental-beneath-the-chin-and-neck-facial-areas-301425403.html) clearance of additional indications for lifting the eyebrow and lifting lax submental (beneath the chin) and neck tissue. Additionally, Sofwave™ is reportedly used off-label to tighten flabby, saggy skin on both [the knees](https://aedit.com/aedition/best-cosmetic-procedures-for-knees) and [the stomach](https://aedit.com/aedition/toning-stomach-skin-after-weight-loss).
 
The collagen rebuilding process takes upwards of six months, but immediate results can be seen as soon as one week after a Sofwave™ treatment. From there, the collagen production cycle continues, and, around the three-month mark, more noticeable improvements in skin tone and quality are evident. In terms of maintenance treatments, only one session is needed every eight to 12 months. From there on out, the skin will only continue to look better and improve.

Get ready for next-level collagen stimulation.

The Benefits Of Sofwave For Collagen Production And Skin Tightening

Why Everyone Is Talking About Sofwave

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If ever a miracle injectable existed, it may just be the [family of neuromodulators](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin). Best known by their brand names — [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) — botulinum toxin type A injections are most celebrated and widely used as effective wrinkle reducers, but new findings point to yet another benefit. 

If you are planning to go under the knife for a cosmetic surgery, don’t be surprised if your surgeon brings up Botox® and the like as both a preventative and corrective step for [scar care](https://aedit.com/aedition/minimizing-scars-after-surgery). Here’s what you need to know about the benefits of Botox® for minimizing the appearance of scars.

## **What the Science Says**
Scientific data is the pinnacle of measuring the capabilities of a drug (cosmetic or not). Current research on neuromodulators to improve the look of scars is looking up. The use of neuromodulators for alleviating scars first became talk when a [2018 study](https://pubmed.ncbi.nlm.nih.gov/29481395/) tested the effects. “The results showed that the scars that received Botox injections were rated higher on their appearance than those that did not receive injections," says [Marina Peredo, MD](https://www.skinfluencenyc.com/), a board certified dermatologist in New York City. 

The [report](https://journals.lww.com/plasreconsurg/Fulltext/2018/03000/Effects_of_Botulinum_Toxin_on_Improving_Facial.14.aspx) in *Plastic and Reconstructive Surgery* detailed the benefits for patients who received treatment for four months, specifically after reconstructive surgery of the face (a procedure that often results in a bevy of distinct scars). The clinical trial showed that when these patients were treated with Botox early on, the injections produced narrower, better, and flatter surgical [scars](https://aedit.com/concern/scars). However, common scar characteristics such as color and vascularity were not notably different.

## **How Does Botox Minimize Scarring?** 
Let's take it back to the basics for a moment. Surgical sutures are the option of choice when a scar or laceration requires closure. When it comes to stitches, however, it is known that tension and movement around the edges of the scar lead to less optimal scarring, says [Jonathan Cabin, MD](https://aedit.com/provider/jonathan-cabin-md-956), a double board certified facial plastic and reconstructive surgeon in Arlington, VA. 

Plastic surgeons have long known that certain types of facial scars naturally heal better than others. One reason is the scar's direction, and how it’s positioned compared to the underlying muscles, says Esther Yoonah Kim, MD, a board certified plastic and reconstructive surgeon and co-founder of [Advanced Institute for Plastic Surgery](https://www.aiplasticsurgery.com/) and [Bloom Spa](https://www.bloomspa.com/) in Temecula, CA. “If the scar lies against the pulling muscles, there is a tug-of-war across the scar,” she explains. “This tension will pull the scar apart, leading to a widened, thicker, and uglier scar.”

We know that Botox® (and other neuromodulators) temporarily reduce muscle movement to limit wrinkle formation. Dr. Cabin explains that this same theory works to help reduce the tension and movement around healing wounds, thus reducing the forces that can worsen scarring. While neuromodulators won’t totally stop the muscles from ripping at a scar, they will help create less stress and allow the scar to heal properly. 

When repetitive tensile forces in any direction by muscles under or around wound edges or tissue might negatively affect the overall healing processes, botulinum toxin injections can have an impact, says [Ava Shamban, MD](https://aedit.com/provider/ava-shamban-md-2325), a board certified dermatologist in Santa Monica, CA. “Wound healing is a complex range of processes from homeostasis to inflammatory response and the dermal cell remodeling,” she explains. “Interruptions to these processes can lead to disruption and complications, such as derailing fibroblast activity or prolonging the inflammatory response, and delays in healing can result in scar hypertrophy or increased pigmentation.”

To make the most of the treatment, your surgeon should inject the to-be-operated-on area *before* the procedure to limit the mobility of the muscles in the region. “If I am planning to make an incision in an area, like the forehead, where Botox® can safely reduce movement, I always inject Botox® (or an equivalent toxin) two weeks before the planned procedure, since it takes that long for toxins to kick in,” Dr. Cabin shares. 

This approach creates an ideal situation where most movement in that specific area is significantly reduced right at the onset of the recovery process, but the injections can also occur post-op. “The treatment works best when injected early in healing — preferably before creating a scar — but within the first few months when the wound is going through its initial healing process and is most sensitive to tension and movement," he adds. This way, the resulting scar will heal thinner and flatter.

## **Not All Scars Are Equal**
Using neuromodulators to improve scars falls under the bucket of off-label (read: not approved by the United States Food and Drug Administration yet relatively safe and well-documented) [neurotoxin uses](https://aedit.com/aedition/where-to-use-botox-from-head-to-toe). But unlike many of Botox® and friends’ non-FDA-approved benefits, scar improvement is one treatment that provides significant physical *and* emotional benefits. Scars come with memories, some of which can be debilitating or a sign of a remembered trauma.

While all neuromodulators will theoretically have the same effect on the scar, [Jennifer Levine, MD](https://www.drjenniferlevine.com/), a double board certified facial plastic and reconstructive surgeon in New York City, says some patients and providers prefer Xeomin® in this case. "Xeomin® is often embraced because it is a [cleaner alternative](https://aedit.com/aedition/clean-injectable-filler-neurotoxin-trend) to other neuromodulators," she says. Unlike Botox®, Dysport®, Jeuveau®, it is a pure form of botulinum toxin formulated without stabilizing proteins.

Treating older scars with Botox probably won't produce the same result, but, like everything in life, there are exceptions to the rule. In some instances, scars that are mature and more than one year old may respond positively. “It really depends on the orientation of the scar,” Dr. Cabin says. “Reduction of expression through the use of Botox can temporarily reduce the repeated reinforcement of the scar and minimize its noticeability, especially in the forehead or central brow.” But, in these cases, improvements in the appearance of the said scar are more temporary in nature. Repeat treatments every few months are required.

Neuromodulators aren't compatible with [every type of scar](https://aedit.com/aedition/how-to-treat-every-type-of-scar). Even if they are new and fresh, keloid scars won’t respond positively. They need to be treated with a laser or corticosteroids. When used directly on the scar, a [corticosteroid solution](https://aedit.com/procedure/intralesional-steroid-injection) may help improve the texture and tone of the skin where an existing mark exists due to a cut or abrasion. Furthermore, Dr. Shamban says corticosteroids may help reduce the scar's height, density, and overall size since steroids break the woven bonds between collagen fibers, thus reducing the amount of scar tissue beneath the skin.

Neurotoxins, meanwhile, works best on certain new scars, such as skin cancer removal, [Mohs surgery](https://aedit.com/procedure/mohs-surgery), and reconstructive surgery, though timing is everything. In some cases, a neuromodulator alone isn’t enough to make a dramatic improvement in the appearance of the scar and additional treatments may be needed. "Some people use a combination of Botox, lasers, and [skincare](https://aedit.com/aedition/scar-minimizing-skincare-to-use-after-surgery) to get the skin in optimal condition," Dr. Peredo explains. She also stresses that using good skincare before surgery is vital to encourage better healing. “Keeping the body hydrated and reducing caffeine and alcohol intake can help with wound healing,” she says.

## **How Long Botox Lasts**
If you get Botox® and co. for wrinkles, you are accustomed to [routine maintenance](https://aedit.com/aedition/how-frequently-to-get-non-surgical-cosmetic-procedures-like-dermal-filler-botox-chemical-peel) sessions every three to four months. When it comes to treating fresh scars, however, Dr. Cabin says that only one appointment is needed because the treatment lasts about two to four months. “This provides a large window of activity, during which the initial phase of healing will occur,” he explains. After this period, neuromodulators are less critical. 

Follow-up sessions every two to four months for the first year can be beneficial for some patients, but they’re not always necessary. “It’s about minimizing movement around the healing wound during a window of time when the scar is forming, reducing the final scar,” Dr. Cabin says. When done correctly, one initial treatment can have a lifetime impact on the outcome. 

Is there anything neuromodulators can’t do?