With few exceptions, I do not offer any of these treatments as they produce only 5 – 10% improvement at best or no visible improvement at all.
This is not consistent with my philosophy and maybe your pocketbook as most of these treatments is very costly. In my opinion any device must deliver at least a 50% improvement. Therefore I offer many other better options, some non-invasive and others minimally invasive.
Some of these newer devices attempt to address the deeper tissues and bypass the skin but with limited credible changes.
Most people are fooled by the media and the heavy advertisement to think that the advantages of these devices are free from complications and have minimal to no downtime. Nothing is farther from the truth. The less the downtime, the less effective improvement you will achieve. Every day I hear about a new trend, but the question is what has happened to last year’s machine touted by the media as revolutionary only to be replaced today by another one?
All the lasers and radiofrequency (RF) devices can cause long term skin discoloration and a much longer recovery than advertised. Most of them are purchased by non-plastic surgeons who have limited training in cosmetic treatments and therefore cannot offer a full complement of options.
Did you know that an Obagi Blue Peel©, which has a quick (weekend) recovery and virtually no complications, can achieve the same result as one of these machines which cost 4 x times as much.
Ultherapy, External Ultrasound Devices
Ultherapy is an external ultrasound designed to smooth lines in your neck and chest (décolleté). External Ultrasound is now starting to become popular again. We have 2 of these machines. We rarely use them as a first line treatment and usually reserve them for softening of the tissues after conventional liposuction or facelift. Results will take several months to appear but you will love to hear that they are non-invasive, they usually requires only one treatment and have no downtime or ill effects. Results are not as good as other minimally invasive techniques and they are definitely not a substitute for a face or neck lift. You will get 10% vs 100% with a lift.
Coolsculpting consists of squeezing your skin with a giant vacuum cleaner like-device to freeze and destroy the fat. It is uncomfortable and requires 1 hour to treat only one single area. Unless you have multiple machines this will take up a lot of your valuable time. Also, more than one session to the same area is needed and of course cost will add up. There is a newer device with the applicator placed over the area which avoids squeezing the skin. Other disadvantages are permanent surface irregularities, on occasions severe pain and rarely a paradoxical increase in your fat. Both can also cause complications such as burns and nerve injuries. Results are mixed with some patients demonstrating little to no improvement. Similar results can be achieved with the external ultrasound without the down time. The results cannot compare to laser or ultrasound liposuction.
Thermage, Thermismooth, Exilis, Pelleve
These are RF machines which use lower energy to reduce risks but require multiple passes to produce the heat necessary for formation of new collagen. Generally they do not create sufficient clinical changes and therefore they are not part of my armamentarium as there are much better options.
Fractional Co2 Yag-Erbium Lasers. Etc.
These all work to varying degrees to resurface the skin of your face. They usually require multiple sessions and have a downtime of 7-10 days or more. You can achieve the same results with a chemical peel or an Obagi Blue Peel at a significant savings with a quicker recuperation time.