No Surgery Needed: Delaware Doctors Share Quick Cosmetic Fixes

No time for surgery? No problem. Here’s a roundup of the latest nonsurgical cosmetic procedures from Delaware doctors.

1. Hair Restoration

Hair today, gone tomorrow? A universal, unisex problem, genetic hair loss has a new treatment: NeoGraft. The transplantation process harvests hair from the back of the head, then moves it to places where hair is sparse or receding, says Dr. Lawrence Chang, who has offices in Rehoboth, Newark and Hockessin. No incisions are made, so no stitches are needed, and recovery time is minimal. “We’re doing it for men and women,” Chang says, “even to restore their eyebrows.”

2. Temporal Brow Lift

Lifting brows relieves eyes of the sagging skin around them. Dr. Ari Abel, who practices in Wilmington and Dover, is doing nonsurgical temporal brow lifts with a one-two punch of Botox and Juvéderm Voluma. “The first time the patient comes in, we use Botox to ease the muscles in that area,” he says. “During the second visit, we use Juvéderm Voluma to push up the sub-brow fat pad.” Juvéderm Voluma is different than regular Juvéderm. It’s a gel and comparatively thicker, making it Abel’s go-to for boosting bone structure. The nonsurgical brow lift isn’t for everyone, however. People with deep-set eyes and thick skin probably won’t see significant results. For those who can benefit from it, the Botox-Voluma lift lasts about nine months.

3. Nose

Nonsurgical rhinoplasty? Yep. It’s a thing. Fillers can augment bone and cartilage, reshaping the nose’s lumps and bumps. Dr. Patrick Swier of Lewes uses filler on the nose’s radix, the upper area where the nose begins its descent from the forehead. That’s also a hot spot for wrinkles. “Filler does a lot of great work there,” Swier says. “It can cover sharp lines of cartilage in people with thin skin, and it smoothes wrinkles. And it’s a great way to see what people will look like before rhinoplasty.” 

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4. Nasolabial Folds and Marionette Lines

Collagen loss is one reason that folds and lines develop around the nose, mouth and chin. Dr. Michelle Parsons of Rehoboth Beach targets them with Bellafill, an FDA-approved collagen stimulator. It’s applied via syringe, like other fillers, “but with Bellafill, you go deeper—intradermal,” Parsons says. “Bellafill is the only filler that stimulates the body to produce its own collagen, so it’s actually replacing what’s lost during the aging process.” It takes eight to 12 weeks to see results from that rebuilt collagen, but once it’s there, it lasts about 10 years. “Other fillers last about nine months,” Parsons says. “Bellafill is the only long-lasting filler that I know of.”

5. Lips

Pouty makes perfect when it comes to lips. Abel has seen an increase in requests for fuller lip treatments, thanks largely to the Kardashian-Jenner clan. Filler is the answer, but picking the right one can be tricky. “Juvéderm is more hydrophilic, which means that it holds more water, and that looks better when put into nasolabial folds,” Abel says. “But on the mouth, it can create a ‘duck lip.’ Belotero looks good, but disappears after a few months. Restylane Silk is what I use.” It’s hydrophobic, so it doesn’t absorb water, nor does it give the lip a bluish hue. As for the much-hyped lip-fat transfers, Abel says that they are expensive, can cause scarring and (thanks to the fillers) are mostly unnecessary.  

6. Chin (1) 

Kybella is a new treatment for that pesky under-chin fat. Over the summer, Dr. Paul Sabini started using it at his Newark practice. Like fillers and Botox, Kybella is an injectable. “It dissolves the fat, and although it does take about six weeks to see great results, the recovery time is only three or four days,” Sabini says. Two treatments are the norm, though some people may need three. Sabini cautions that Kybella isn’t for everyone. “Patients’ skin has to have enough elasticity so that it snaps back after the fat dissipates,” he says.  

7. Chin (2)

Liposuction done with petite tools can target under-chin fat without disturbing tissue around it. Swier performs chin lipo with a cannula, a syringe-like device that allows him to target that fat. No anesthesia is required, but Swier does recommend skin-tightening radio frequency treatment to make sure the fat-emptied skin recedes. Chang uses Precision TX laser-assisted liposuction. “The laser melts the fat while heating the skin and blood vessels, and that induces collagen stimulation to help the skin tighten,” he says. The doctors agree that the results are good, but not as good as with surgery.   

8. Fine Lines, Large Pores, Redness

Peeling skin can be a good thing when it rids the face of fine lines, large pores, and redness or discoloration. Though it sounds counterintuitive, fruit and acid peels help the skin regenerate itself. They vary in strength, with deep peels requiring about a week of recovery. “The advantage of a stronger peel is longer-lasting results,” Swier says. “Pigment-producing skin cells are at the bottom, so we have to go deeper to reach them.”

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9. Fine Lines, Skin Tightening

Microneedling sounds awful, but it’s a great way to stimulate collagen production in aging skin, says Parsons, who favors microneedling over peels and lasers because it requires less recovery time. How it works: Parsons rubs a handheld device (she compares it to a Sonicare toothbrush) over the skin. The 30-minute procedure leaves the face looking sunburned and a bit puffy, but that recedes the next day. Parsons recommends three treatments three to four weeks apart. Chang does microneedling with a kicker. He creates serum-like platelet-rich plasma, derived from the patient’s own blood, to apply to the patient’s face, then does microneedling. That sinks the plasma deep into the skin. “PRP puts collagen growth into overdrive,” Chang says. “The texture of the skin becomes much smoother, much more youthful.” 

10. Skin Tightening

Ultrasound energy is the collagen-producing technique used in Ultherapy, the nonsurgical skin tightening treatment that can be used over the entire face, neck and décolletage. Typically, only one treatment is needed, and there’s almost no downtime. Patients can resume normal activity the next day, but it takes three months to see results. “It can’t tighten the skin as well or as fast as surgery does,” Sabini says. “But it’s good for people who don’t want or can’t have surgery.”

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