Noninvasive treatments—procedures that don’t require going under the knife—are becoming more commonplace than ever before, and just like fashion trends tend to vary based on your zip code, so do the requests that surface inside the doors of doctors’ offices. Curious to see how these treatments fluctuate, we reached out to 16 top dermatologists from six different regions (Northeast, Southeast, Northwest, Southwest, Midwest and Florida) to see which procedures were the most commonly requested in their area. From fat melting and body sculpting to fillers and lasers, you might be surprised to see what’s trending in your backyard.
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In the Northeast, it’s all about fillers (both in the lips and face) paired with facial and body contouring for an all-around more youthful appearance.
“While patients come in asking for all sorts of noninvasive procedures varying from fillers, lasers and basic skin care, etc., if I had to pick one thing that is prevalent, it would be fillers. Lip fillers are extremely popular in both younger and older patients—people mostly ask about Juvéderm, Restylane and Voluma. Younger patients are looking for a fuller lip and older patients are looking to put back the volume that’s been lost over time.” —New York dermatologist Rebecca Baxt, MD
“My number-one requested noninvasive cosmetic procedure is fillers, and the top patient complaint from patients is usually dark circles under the eyes or the combination of marionette lines and nasolabial folds. By replenishing the areas of lost volume with filler starting with the cheeks, we rarely, if ever, have to inject the nasolabial folds. My patients don’t want to look like they’ve had work done, so less is always more. I’ll add a procedure like Thermage if their skin is healthy enough to continue the improvement, and if they need a more significant lift, a combination of Ultherapy and Silhouette Lift delivers a nonsurgical option.” —New York dermatologist Heidi Waldorf, MD
“I have a large amount of both female and male patients coming in for noninvasive body sculpting, ranging from facial contouring with fat-reducing procedures to treatments like Kybella and CoolSculpting Mini. I love to pair these treatments with a secondary skin-tightening procedure, such as Ultherapy, for a complete contouring treatment. Many patients are also interested in noninvasive fat reduction in the traditional areas such as the abdomen or flanks, but are also looking for treatment in other areas like the inner and outer thighs, the ‘bra fat’ area, arms, male chest, banana roll, etc.” —Norwalk, CT, dermatologist Deanne Mraz Robinson, MD
In the Southeast, all eyes are on skin tightening and fat reduction for a taut bod year-round.
“I do a lot of Icon Laser treatments for firming skin and improving discoloration and acne scarring. We are also doing SculpSure for fat reduction and body sculpting and are extremely happy with the outcome as well.” —Charlotte, NC, dermatologist Charles Brown, MD
“Over the past few years, I’ve noticed a major uptick in patients seeking noninvasive solutions for the aging neck, specifically for tightening of the skin without a necklift or for fat reduction without liposuction. For the former, radio frequency can help if the laxity isn’t too far advanced, and there are a couple of devices I prefer to use: Infini and ThermiTight. When it comes to noninvasive fat reduction in the neck area, I will typically recommend Kybella or CoolSculpting, depending on several patient-specific factors such as lifestyle, budget and/or goals.” —Charlotte, NC, dermatologist Gilly Munavalli, MD
“By combining the treatments Ultherapy and Sublative RF we are able to use ultrasound and radio frequency to improve the skin from the inside out. Performing the procedures the same day yields optimal results. Ultherapy uses ultrasound technology to target laxity, lift drooping brows and tighten the skin around the eye. Sublative uses radio frequency to improve fine lines on the eyelids and under eyes and crepey skin, tone and texture; shrinking pores; and reducing scars and stretch marks. Both noninvasive treatments use the body’s own natural healing process to stimulate collagen growth at multiple depths, which gives the skin its youthfulness by keeping it firmed and toned.” —Baton Rouge, LA, dermatologist Ann Zedlitz, MD
In the Northwest, the top treatment is a tie between Botox Cosmetic and fillers for aging and hollows, and lasers treatments for uneven skin texture.
“Patients come into my office seeking many noninvasive rejuvenation procedures for an overall refreshed yet natural appearance. We often start with Botox Cosmetic to relax the frown and crow’s-feet lines, and fillers like Juvéderm Voluma are used to lift the cheeks and replace lost volume. Once the midface is lifted, then less filler such as Juvéderm is needed for nasolabial folds and marionettes. Tear troughs are a common area of hollowness, which can be corrected with Belotero or Juvéderm Volbella. Lips can be rejuvenated with Juvéderm, Restylane or Juvéderm Volbella. Lasers are recommended for texture, pigment and pore size—the most popular being the Picosure laser, which involves very little to no downtime for the patient.” —Fresno, CA, dermatologist Kathleen Behr, MD
“Toxin procedures, such as Botox Cosmetic, still remain the most frequent noninvasive procedure requested by my patients. Most commonly, patients are requesting treatment for frown lines, forehead lines, and crow’s-feet, but more frequently, patients are starting to request treatment in neck lines, while also requesting toxin procedures to prevent the formation of fine lines. Filler procedures are the second most frequent noninvasive procedure requested by my patients (they usually request filler to help treat their mid face and under-eye area). Patients want to look more refreshed and less tired and address the hollowness in these areas (cheeks, midface and tear troughs), so using filler is very helpful and provides natural-looking results. Lip filler also remains popular, as does filler to nasolabial and melolabial folds (laugh lines). Laser procedures remain quite popular. IPL treatments are frequently used to treat dark spots. Vbeam or Excel laser treatments are used to treat redness or broken blood vessels, which are commonly seen on the nose and cheeks. For texture and fine lines, patients are opting for laser treatments with less down time such as a Clear + Brilliant laser or a Fraxel laser instead of fractionated CO2 procedures.” —Los Angeles dermatologist, Jeanette Black, MD
Light and laser treatments for glowing skin coupled with Botox Cosmetic to prevent signs of aging is the cocktail of treatments taking over the Southwest.
“Patients of different ages have different concerns. Someone in their 30s may want a minimal downtime pick-me-up, such as a freshening glycolic facial chemical peel or nonablative light treatment (like IPL, Cutera Excel V, radio frequency, or ultrasound) to rejuvenate skin and create a healthy glow. For younger patients seeking to target specific dynamic lines, Botox Cosmetic delivers. And while dermal fillers are preferred to address deeper perioral lines and facial volume, we’ve seen an increase in patients seeking fillers to add volume to their lips, define their Cupid’s-bows, and attain a more glamorous, ‘celebrity’ pout. Individuals above the age of 40 (or with more mature and sun-damaged skin), often come in with a more ‘global concern,’ asking what I can do to improve their skin. Blotchiness and pigment irregularities are common concerns, like brown spots and/or rosacea—most are looking to improve the texture and quality of their skin. My current go-to procedure for those who want a global improvement in color and texture, fine lines and wrinkles with minimal-to-modest downtime is a procedure utilizing the Sciton Halo device.” —Tucson, AZ, dermatologist Gerald Goldberg, MD
“My most common requested procedure is Botox Cosmetic (by name). There has been a rise in patients asking for preventive and natural treatments. For instance, I am seeing a greater number of women in their 20s and men in their 30s who come in looking for preventive measures against aging. In some cases, I discuss the use of a neuromodulator (Botox Cosmetic, Dysport or Xeomin) to help prevent static lines (those lines that are apparent without facial expression). For women in their 30s and 40s and for men in their 40s and 50s, I discuss the use of fillers or collagen stimulators to maintain their facial structure and shape. I have also seen a significant increase in potential patients asking about noninvasive body contouring. Patients are curious to what procedures we can offer without surgery or even liposuction.” —Houston, TX, dermatologist Suneel Chilukuri, MD
Laser resurfacing and Botox Cosmetic are sweeping the Midwest.
“Many of my new consult patients come in to the office asking for a ‘laser’ procedure or ‘laser resurfacing.’ Generally, these patients have some expectations that lasers are what they need and end up finding that the use of Botox Cosmetic, fillers or some other assortment of truly noninvasive options are better suited for them due to time considerations or cost factors.” —Omaha, NE, dermatologist, Joel Schlessinger, MD
“Botox Cosmetic and Dysport in the glabella, forehead and eyes. Filler would be second, then IPL for the face and chest.” —Prospect, KY, dermatologist, Tami Buss Cassis, MD
“The procedures people request the most in my office are, as always, Botox Cosmetic and fillers. The most popular facial laser treatment is a combination of Forever Young BBL (Broad Band Light), Halo and platelet-rich plasma (PRP). BBL turns on a more youthful gene expression in the skin, as well as correcting reds and browns, and when combined with Halo, which is a laser resurfacing treatment, a more youthful glow is restored in the skin while diminishing pore size and fine wrinkles. PRP, known as the Vampire facial when done with microneedling, uses your own natural growth factors to speed healing from laser resurfacing treatments by a day or two, as well as boosts the results. On the other side of the spectrum, my patients have also shown a huge wave of interest in laser vaginal rejuvenation. As women age, the vaginal mucosa becomes thin, dry and fragile. After menopause, this process becomes even more pronounced and can eventually lead to vaginal irritation and painful intercourse. Laser vaginal rejuvenation restores youthful moisture, tissue resiliency and pleasurable sensation to the vagina. The is not painful and takes about five minutes and three days of restricted activity to renew your love life.” —Chicago dermatologist Dr. Quenby Erickson
Noninvasive fat reduction and filler in all areas of the face and neck are all the rage right now in Florida.
“The most common noninvasive procedures asked about and performed in my office all revolve around creating a natural-appearing improvement for both their face and body. For body treatments, the most commonly sought-after treatment is noninvasive fat reduction and shaping. With the newest Cool Advantage applicators from CoolSculpting, our patients get a simple, effective and efficient treatment to create a more desirable shape of just about anywhere on the body and face. We are also seeing more inquiries for body skin tightening, for which we are using Ultherapy, Profound microneedling radio frequency and Cellfina with good success.” —Delray Beach, FL, dermatologist Dr. Janet Allenby
“Botox Cosmetic—now not only for forehead, crow’s-feet and frown lines, but for the neck, too! Fillers in general are always popular. I think more and more women in their 20s to 30s are loving lip enhancement, women from 30 to 50 want a refresher, while those 50 and up want to prevent saggy skin and/or treat it—all can be done with fillers. It’s a blend, but the trend is baby Botox and baby fillers (one syringe) and take it up a notch every decade!” —Coral Gables, FL, dermatologist Dr. Janice Lima Maribona
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