No Knives Necessary

Time was when “a nip and a tuck” to get your face or body tweaked required going under the knife. But not anymore. Today’s minimally invasive cosmetic procedures can smooth your complexion, eliminate bulges, or tone your sagging skin in as little as a lunch hour, and with no surgery needed. Here are six procedures that experts say deliver excellent results—with little discomfort and little to no downtime. 


Neuromodulators work by weakening the forceful muscle movements that cause wrinkles, according to Joseph Sozio, MD, with Hartsdale-based SkinCenter Advanced Medical Aesthetics. “Once these repetitive movements decrease, the wrinkles start to fade,” he says, adding that muscle movements required for facial expressions are retained. While the granddaddy of the category, Botox, has been used widely since it was approved for cosmetic use in 2002, newer alternatives offer advantages. “Dysport lasts a little longer, and the onset of action is somewhat quicker for most patients,” Dr. Sozio says. “Xeomin is another option for people who build up resistance to Botox or Dysport.” Treatments generally start at $200 to $300, and, while there may be some swelling and bruising, people typically return to normal activities the day after treatment. Dr. Sozio says it can take up to two weeks for most people to see the full effects of neuromodulators, and the effects typically last three to four months.

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As their name suggests, fillers fill in wrinkles and lines so they almost disappear, according to Tobi Klar, MD, a New Rochelle dermatologist. They are injected into the skin in a quick procedure, and there’s no downtime. Among the types available are hyaluronic acid fillers (such as Restylane, Perlane, and Juvederm) and synthetic fillers (such as Radiesse and Sculptra). The hyaluronic acid types produce results that can last from four months to a year, with potential side effects that include bruising, redness, and small bumps. By contrast, synthetic types can have longer-lasting results, but the side effects may also last longer and be more severe. The average price for one syringe of filler is $600 to $1000, Dr. Klar says, adding that some areas of the face could require two or three syringes.


Micro-needling can treat fine lines, wrinkles, sun damage and even scars and dark under-eye circles, according to Micheline Giovani, MD, of Advanced Laser & Medical Spa of Rye. The procedure makes use of a device with tiny needles, which creates micro-injuries; the injuries stimulate collagen production, which improves skin appearance. Dr. Giovani notes that she often incorporates platelet-rich plasma, or PRP, into the procedure by drawing the client’s blood, separating out the platelets, and then using the needling device to drive them into the skin. The platelets boost the body’s collagen response, she says, for even better results. Treatments start at about $900, with clients often opting for up to six sessions in the first year, and then returning for one or two maintenance sessions in subsequent years, Dr. Giovani says. She adds that micro-needling involves little discomfort and no downtime; the only drawback is that clients can’t wear makeup on the day of treatment.


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Among the newest of minimally invasive cosmetic procedures, Kybella is an injectable drug used to treat submental fullness—or, as it’s more commonly known, a double chin. Approved for this use in 2015, it’s considered a great option for those who want to eliminate “chin convexity” without surgery, according to Sal Farruggio, MD, with Hartsdale-based SkinCenter. Because the injections destroy fat cells, retreatment is not typically warranted once patients have achieved the look they want. The most common side effects include temporary swelling and hardness in the treatment area. Dr. Farruggio adds that the price averages about $1,200 per session, with most people opting for one to three sessions.


Another nonsurgical treatment is CoolSculpting, a fat-freezing procedure recommended for the thighs, the abdomen, a double chin, or that side-body bulge affectionately known as a muffin top. “The treatment gets rid of approximately 20 percent of the fat in the area you choose,” says Rhoda Narins, MD, of Dermatology and Laser Surgery Center, with offices in White Plains and Manhattan. “It does a very nice job.” During the procedure, which takes about an hour, an applicator delivers controlled cooling to the targeted site. Side effects can include redness, numbness, and some bruising, but patients can go about their business as soon as they leave the office. Results begin to appear in about three weeks, with full effects becoming apparent after two months—and, because the process causes fat cells to die off, the results are considered “long-term,” according to Zeltiq, the product’s manufacturer. Prices start at about $750 and can go up, depending on the area to be treated.


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Thermage is a novel treatment that uses radio-frequency to treat skin laxity. It can be used on areas that show signs of sagging, including the eyelids, the jawline, the abdomen, and even the knees, arms, and buttocks. “Thermage works by stimulating collagen,” says Sozio of SkinCenter. “The full effect of the treatment is seen over a number of months, as the collagen builds.” The procedure, which causes heating of the lower skin layers, usually takes between 45 minutes and two hours, and Sozio offers medications to make patients more comfortable. Side effects may include soreness, redness, or swelling, but these are mild, he says. Prices generally range from $1,500 to $4,500, depending on the area to be treated. Sozio says that, while the procedure can be repeated every year, in most cases, the effects last two to three years.


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