Jasmine Moghissi, M.D.

The Basics of Non-Surgical Cosmetic Procedures

Here are many of the non-surgical cosmetic procedures available today.

Botox – Botox is the brand name for medical grade botulinum toxin type A. It is injected into specific muscles of the face and neck to weaken and relax them. This smoothes the skin lines, and over time, can make wrinkles disappear. It is usually used to treat forehead wrinkles and crows feet, although other areas of the face and neck can also be successfully treated. It does wear off, and needs to be repeated every 3-6 months. Wrinkles can only go away permanently if the injections are done regularly. Since everyone is different, sometimes the area injected can be a little off. Since it does wear off, it is almost impossible to do permanent harm with this.

Soft Tissue Fillers – There are many of these on the market, including Juvederm, Radiesse, Belotero and Restylane. Collagen was one of the first, but has had a problem with allergic reactions. The newer agents have pretty much eliminated that problem, but are more expensive. They are injected in low spots to plump them up. Examples would be scars (typically acne ice-pick scars) and lines around the mouth. There are temporary and permanent versions. Permanent fillers eliminate the need to keep coming back, but you have to live with the results forever. Be very cautious about having permanent fillers placed!

Microdermabrasion – This procedure is almost like sandblasting the skin. A sand line abrasive is pelted at the skin and vacuumed up again. A new technology where an abrasive paddle is placed on the skin and vibrated is called VIbraderm. Microdermabrasion takes off part of the top dead layer of skin. This helps with skin surface irregularities, acne, brown spots, and allows other treatments be more effective. In addition, it is thought to stimulate the growth of collagen. Depending on the machine, there may be some mild redness to peeling and raw skin.

Peels – Acids are placed on the skin to clean off the top dead layer. Chemical peels can be anywhere from superficial to deep. The deeper peels have better efficacy, but also a longer recuperative time.  A series of good superficial peels done every 3-4 weeks can show significant improvement in skin texture and coloration, with minimal downtime.

Lasers and IPL machines– In general, lasers can penetrate deeper and can be more effective. The catch is that they can also do more damage. In addition, each type of treatment requires a different wavelength, and theoretically a different laser.

Topicals – There are many skin cream lines, and individual skin creams available on the market. Most of the drug and department store lines don’t have significant effects on the skin. Many of the creams available to physicians only will make some long term changes. I have carried the Obagi line for several years now, because it appears to be the most effective in many areas. The trade off is, that it tends to be more difficult to tolerate initially. In return, it will take off that top dead layer of skin, similar to peels and microdermabrasion.  I also carry several other lines that have more modest improvements, but are better tolerated.  

I hope this basic overview gives you an idea what is available on the market today. Many of these modalities will commonly be combined to give maximum effect. Whatever you decide, the most important thing, is to use sunscreen daily (UVA and UVB) to maintain and protect your skin.