With the hustle and bustle of everyday life, just getting to your doctor’s appointment is half the battle. But once you’re there, why not combine a couple treatments to make the most of your time and reap even more skin-perfecting benefits? These are the most popular nonsurgical in-office combos recommended by top dermatologists to maximize results, as well as the ones you should steer clear of to avoid potentially unwanted side effects.
Neurotoxins and Fillers
“My favorite and most common in-office combo is doing both neurotoxin injections like Botox and filler injections on the same day,” says Riverside, RI dermatologist Tiffany Libby, MD. “Patients love being able to see the immediate improvements with filler, and it only gets better as the Botox settles in one week later.” Nanuet, NY dermatologist Heidi Waldorf, MD calls this same-day combo a “no-brainer.”
Neurotoxins and Superficial Chemical Peels
“For my patients who are only doing Botox (neurotoxin), I love combining superficial chemical peels with their treatments for that immediate, little-to-no-downtime glow for their skin,” Dr. Libby adds.
IPL + Laser Resurfacing
“My most favorite procedure is a combination of both surface and deep tissue remodeling, such as combining IPL with fractional resurfacing or erbium laser resurfacing,” says New York dermatologist Julie Russak, MD. “With IPL, you’re addressing discoloration on the surface of the skin, such as red and brown spots, and at the same time, the deeper lasers improve skin texture and laxity.”
Neurotoxins + Laser Resurfacing
“Laser resurfacing and neurotoxins are an excellent combination: I do the neurotoxin before applying the topical anesthetic for the Fraxel or Viva MD laser,” Dr. Waldorf explains. “The toxin effect kicks in as the patient heals, the patient doesn’t recreate the wrinkles of muscle expression, and they get better results from resurfacing.”
Radio-Frequency Microneedling + HydraFacial
Dallas dermatologist Rebecca Marcus loves to combine radio-frequency microneedling with a HydraFacial. “Radio-frequency microneedling is a fantastic treatment for skin tightening. It also helps minimize the appearance of pores. A HydraFacial is a skin-boosting, glow-producing treatment that also makes pores appear smaller. The HydraFacial has immediate effects, whereas the radio-frequency microneedling effects start to kick in after about a week or two, with full results seen after three months while collagen production kicks into high gear. By doing the HydraFacial on the same day, you can start to see glowing, luminous skin right off the bat. We can even add on Botox afterwards if someone really wants to get everything done in one day, and when it kicks in one to two weeks later, the skin is that much smoother and more youthful-appearing.”
Radio-Frequency Microneedling + CoolPeel
Another combination Dr. Marcus favors is radio-frequency microneedling with CoolPeel, “which is basically a light sprinkling of CO2 laser. The CO2 in a scattered, diffuse pattern provides a very mild resurfacing, which allows for the skin cells to turnover without significant downtime. This procedure is amazing for clearing dark spots. We can even add on IPL for a triple treatment that targets pigment, broken blood vessels and skin tightening all at the same time.”
Thermage + Ultherapy
“I like combining Thermage around the eyes with Ultherapy for the skin around the orbital bone and the forehead to get tightening and lifting, both of the skin supporting the brow and eyelids, and the eyelids themselves,” says Dr. Waldorf.
Biostimulating Fillers + Skin Tighteners
Dr. Waldorf likes to combine injections of biostimulators like Radiesse and Sculptra Aesthetic with noninvasive skin-tightening procedures like Ultherapy or Thermage. “I recommend doing the skin-tightening treatment first though, so that the filler doesn’t either impede the ability to see the skin’s layers on the ultrasound (Ultherapy) or change the skin impedance (Thermage).”
Deep Lasers + Neurotoxins
“One combination treatment you should never do in the same day is a deep, high-energy laser and Botox—or other neurotoxins—as it can lead to spread of Botox in areas that, in theory, can lead to unwanted results,” Dr. Russak says. Dr. Libby agrees: “I would recommend against doing Botox and laser resurfacing treatments like Fraxel or CO2 on the same day. If they are being done to different areas of the body, that is generally fine. But laser resurfacing treatments like Fraxel or CO2 often cause mild-to-moderate swelling, and this may cause the Botox to diffuse and cause unwanted side effects.”
Deep Lasers + Fillers
“Although many doctors do it, I don’t like combining more significant resurfacing treatments like Fraxel or Viva MD on the same day as fillers,” says Dr. Waldorf. “There is a small risk of skin infection—staphylococcus—after resurfacing, especially in patients with a history of atopic dermatitis, eczema or allergic rhinitis, who may have bacterial colonization (not infection) in their nose. I prefer not to introduce that risk to filler injection.”
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