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The Best Low-to-No Downtime Treatments to Hit The Market Since The Pandemic Began

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The Best Low-to-No Downtime Treatments to Hit The Market Since The Pandemic Began featured image
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It may have seemed like time stood still while we were staying at home during lockdown, but as we finished Netflix and even tried our hand at sourdough bread recipes, the development of new aesthetic treatments, completion of clinical trials, and FDA clearance of established European aesthetic offerings quietly soldiered on. The outcome: several promising new low-to-no downtime treatments, including those that help release the dimples of cellulite for smoother skin, stimulate muscle contractions for stronger abs, and fill dynamic facial lines in a way that’s harder to spot (thanks to hyaluronic acid chains that move like real skin). Below, find eight aesthetic innovations that may have slipped in under the radar since being added to your dermatologist’s roster of services, but offer outstanding results in body contouring, injectables and more.

RHA Collection (Resilient Hyaluronic Acid) Dermal Filler

What it is:

Touted as the first advancement in HA fillers in more than a decade, RHA (Resilient Hyaluronic Acid) dermal fillers are made from resilient fibers and longer hyaluronic acid chains than other dermal fillers to mimic to our skin’s own HA. But don’t confuse RHA’s strength for bulk or a stiff look once it’s injected into the skin. Because these chains contain less crosslinking than other hyaluronic acid fillers on the market, they’re more adaptable and soft. The result: fillers ideal for barcode lines near the mouth and nasolabial folds, among other areas on the face, because they naturally move with our every expression.

What it treats:

”In my experience both in the trials and in practice, RHA filler is best suited for most dynamic areas of mid and lower face. It works well on those who have experienced volume loss, deeper lines, and wrinkles from nasolabial and marionette areas—and who have some structure and losses around the mouth,” says Beverly Hills, CA dermatologist Ava Shamban, MD, investigator for the first U.S. trial for RHA filler. Off-label uses of Revance’s RHA Collection (which comprises three types of RHA filler) include treatment for lips and even tear troughs, Dr. Shamban adds. “This product is smooth, similar to our own naturally produced HA and adapts well into our tissue. It helps to rebuild some structure and replace volume losses without adding any bulk.”

Who it’s best for:

Those who want the line-deleting effects of filler without the look of having had injections. Otherwise, patients looking for a higher volume look with stronger edges, sharper contours, or more contrast will likely benefit from other fillers on the market. Like with other fillers, patients with allergies to bacterial proteins, hypersensitivities and bleeding disorders are not good candidates for RHA. Ditto for those with anaphylaxis or have any previous allergies to other HA products, Dr. Shamban notes.

What to expect:

Say goodbye to the sausage roll effect and filler that makes the face look muzzled. Because RHA filler moves with facial expressions, this may be your most undetectable filler yet. Like with other fillers on the market, RHA injections last up to 15 months, per the company’s clinical studies.

What it costs:

Costs vary based on provider rates and patient needs, but estimates average about $600 or more per treatment.


Clear + Brilliant Touch Laser

What it is:

A laser treatment that uses ablative and nonablative wavelengths for both superficial and deep treatment of the skin to even tone and texture, reduce the appearance of pore size, and boost firmness.

What it treats:

Made to treat skin the face, neck, and decolletage, Clear + Brilliant’s newest offering is safe for use on all skin tones. “All patients can use this treatment,” says Dr. Shamban. “Specifically, for patients who are Fitzpatrick IV and V, and those who [have] olive, brown, and more highly melanated [skin] and don’t want to take the risk of any post-inflammatory hyperpigmentation or other types of potential rebound pigmentation from certain laser treatment, this would be a best choice.”

What to expect:

Clear + Brilliant has long served as a go-to for those looking for a more gentle and affordable laser treatment and while this iteration of the laser treatment more comprehensively treats superficial and deeper layers of the skin, Dr. Shamban says it’s still positioned as a more gentle laser option with minimal downtime. (Heat-related outcomes, such as redness or mild swelling, typically last only about an hour or so after treatment, she says.) Optimal results are best achieved in multiple treatments. “A series of four to six treatments, done about two-to-three weeks apart, are ideally recommended for a full and final result. Each treatment will have cumulative benefits that will be seen starting after the official ‘healing’ within a week or so following the procedure,” notes Dr. Shamban.

Who it’s best for:

The dermatologist counts this treatment as an ideal choice for those with more sensitive and reactive skin, “as it should be well tolerated by most,” she says. Conversely, those with highly sun-damaged skin and a deep, residual laxity, deep lines and wrinkles beyond the superficial when the skin is static, may want to opt for a different format and/or power treatment,” Dr. Shamban says.

What it costs:

Average cost ranges from $400 to $800, depending on the location and provider.


Coolsculpting Elite

What it is:

CoolSculpting is nothing new—the low-downtime treatment has been selectively targeting, freezing and killing treated fact cells (aka cryolipolysis) for more than a decade. But what is new is a revamped machinery with upgraded tech: namely, more efficient handpieces that not only engage some 34-percent more of the tissue, but are larger in size, too—and it’s making a significant difference in patient results. “I’m personally seeing quicker results on patients,” says Delray Beach, FL dermatologist Dr. Janet Allenby, who has used the CoolSculpting technology since it launched. 

What it treats:

CoolSculpting Elite is FDA-cleared for the treatment of visible fat bulges areas under the chin (submental) and under the jawline (submandibular), thigh, abdomen, and flank, along with bra fat, back fat, underneath the buttocks, and upper arm. “For fat reduction, it is my experience that Coolsculpting is the most effective nonsurgical treatment,” says Dr. Allenby.

What to expect:

“The new machine design also allows us to treat more areas at once and in the same amount of time as the older version, which reduces the patient’s cost and time in my office. Sessions can include multiple applicators at once and [those using] the most commonly used applicator is done in 35 minutes,” says Dr. Allenby. Generally, two-to-three treatment sessions are needed to achieve optimal results, depending on the area treated and the patient’s starting point and goals. Sessions are typically spaced about six weeks apart.

“The great part is that once that fat is eliminated it is gone forever,” says Dr. Allenby, adding, “Bodies and fat distribution do change as we age, it is common for patients to have small tweaking treatments periodically over the years.”

Who it’s best for:

As Dr. Allenby notes, like all body-contouring treatments, this one is geared to improve small bulges that diet or exercise don’t address. For that reason, those with a BMI over 30 aren’t considered the best candidates for CoolScupting Elite, as they would likely need an unknown number of treatment cycles to get the kind of results most people are after. Additionally, those with cryoglobulinemia, cold agglutinin disease, or paroxysmal cold hemoglobinuria shouldn’t receive treatment.

What’s more, Dr. Allenby recognizes CoolSculpting Elite can cause Paradoxical Adipose Hyperplasia (PAH) in some patients. The dermatologist has seen three such cases among her own patients in 10 years of treating with the technology, while Allergan marks the incidence rate at 1 in 4000 ( or .025 percent). Despite recent headline-making cases in which CoolSculpting resulted in PAH, Dr. Allenby favors the treatment to surgical options, such as liposuction (which can offer equivalent results, but with a higher risk of side effects that includes death). “My confidence in CoolSculpting has not changed, as it is even more rare to not be able to manage PAH,” she says. PAH can be treated noninvasively with radio frequency treatments in some patients, or surgically, such as with abdominoplasty, she says.

What it costs:

Costs vary significantly depending on the body part addressed. That said, Dr. Allenby provides a general ballpark cost of about $2,000-$3,000 per treatment plan. “Surgery can potentially be in about the same dollar range. The difference is that this treatment is done quickly without life interruption, or scarring, needles or cutting involved,” she says. “The results are smooth and consistent and the treatment can be modified to suit the patient’s needs.”


BBL Hero (Broadband Light High Energy Rapid Output)

What it is:

Think of BBL Hero as supercharged Intense Pulsed Light (IPL): it works four times as fast to zap sun damage from skin. But that’s just the start. “It contains technology advances which allow for customized delivery of high energy, at high speed—all with cooling that can keep up,” says Beverly Hills, CA plastic surgeon Sheila Nazarian, MD. “The net result: outstanding results in less time, while keeping the patient comfortable.”

What it treats:

Acne, brown spots, redness/rosacea and scarring with different wavelengths of light and two lamps. Treatment can be done virtually anywhere on the body. “I prefer this treatment to others, as the multiple wavelengths offer the ability to really customize the treatment for the patient’s specific skin type and concerns. I treat a lot of patients with skin of color and I find this device to be very safe while also delivering clearer, more even skin,” says Manhattan Beach, CA dermatologist Nina Desai, MD. Adds Dr. Nazarian, “almost anyone, at any age, can benefit from these treatments … and see results as early as one week after treatment with continued improvement over a couple weeks.”

What to expect:

Unlike the snapping sensation delivered by other forms of IPL, this treatment delivers a rolling movement, which some (including this author) find to be less painful. “The smooth, gliding treatment, combined with the ability to fine tune the energy delivery and the enhanced cooling together provide an overall more comfortable patient experience,” says Dr. Nazarian. Rather than a typical IPL protocol of three-to-four treatments, BBL Hero can achieve desired effects in one-to-two treatments (though those with more damage to correct may need additional treatments).

Who it’s best for:

Dr. Nazarian calls BBL Hero a “fantastic” treatment for vascular conditions, such as rosacea, but it’s cleared by the FDA to treat up to Fitzpatrick V skin tones only, and as such, is not cleared for deep tones. “The new technology advancements make it safer than ever for darker skin types, but as with any device selecting an experienced practitioner is important,” notes Dr. Nazarian. “Patients who have a known history of hyperpigmentation should take caution and work with their practitioner on selecting the best treatment.”

What it costs:

At about $500 per treatment, BBL Hero’s cost is nothing to sneeze at, but given optimal results can be had in two treatments, it can be more cost effective than other IPL options on the market.


Evolve by InMode

What it is:

A triple-modality body contouring treatment that uses Tite (bipolar radiofrequency), Trim (radiofrequency and a suction vacuum) and Tone (electrical muscle stimulation, or EMS) modes to tighten skin, remove superficial fat, and tone muscle.

What it treats:

The Evolve Tite mode, commonly used to treat skin on the arms, thighs, and abdomen, addresses crepiness all over the body. ”For patients with thinner or delicate skin and  less than an inch to pinch in the desired area(s) of treatment, I use Tite mode to smooth and tighten the skin. For patients who are thinner, but bothered by loose skin, Tite also helps improve the contour of superficial fat,” says Los Angeles, CA dermatologist Heather J. Roberts, MD.

“I prefer Evolve Trim when patients have focal areas of stubborn fat that are unresponsive to diet or exercise on the stomach, back/bra strap, thighs, or hips. Many of these patients are genetically predisposed to holding onto fat in these areas, even if they are otherwise fit,” she says. “I generally do combination treatments using Trim and Tight modes to get faster results in both permanent fat destruction and improved skin quality. Evolve Tone can be used synergistically with the other Evolve technologies to fine-tune results  … and achieve strong and visibly toned abdomens, buttocks, arms.”

What to expect:

Evolve treatments last about 30-60 minutes, with treatment plans typically comprising a series of 3-6 treatments, spaced two weeks apart. The Tite modality delivers a warming sensation to the skin; Trim delivers a warming sensation plus gentle pulling; and Tone delivers energy to the muscles to induce contractions. “Evolve provides the ability to treat multiple areas of the body simultaneously, so patients can get results in different parts of the body without spending hours in a treatment room,” Dr. Roberts says.

Who it’s best for:

Evolve can be used on all skin tones and types, Dr. Roberts says.These treatments are best suited for those with a BMI less than 30. It is not suited for those with any electrical implant in the body, current or history of skin cancer or other severe medical conditions, those who are pregnant or nursing, or those with an impaired immune system,” she notes. The dermatologist calls the trio of treatment modalities, “an effective, painless, no-downtime procedure that offers body shaping and skin tightening without the need for injections, anesthesia or any cutting of the skin and resulting surgical scars.”

What it costs:

Pricing varies, depending on the area of the body treated and number of modalities used, but expect to pay about $1,000 – $2,000 for a series.


InBrace

What it is:

This new orthodontic treatment made to straighten teeth provides an alternative to traditional braces and Invisalign—all with the help of a single wire installed to the interior side of the teeth, completely out of view. Here’s how it works: The individual loops in InBrace’s multi-looped system are customized for each patient, with tooth movement data programmed into the wire itself prior to insertion. The loops give the wire the flexibility to be inserted comfortably on the first visit, while the wire’s material (which is similar to that used in braces) works to move the teeth into the desired position. “These loops allow for programming in each wire, resulting in fewer wire changes,” says New York, NY cosmetic dentist Sharon Huang, DDS. That means no monthly visits to the orthodontist for wire tightening.

What it treats:

Straightens alignment of teeth over a six-month to two-year period.

What to expect:

Repositioning teeth isn’t exactly a painless pursuit and those who try InBrace shouldn’t expect otherwise. “Patients will experience pressure and discomfort especially in the beginning of their treatment,” notes New York, NY orthodontist Nicholas Freda, DMD. “It may also have a temporary effect on speech, since the wire is in the tongue space. There may be irritation and abrasion on the tongue from the hardware rubbing on the tongue when speaking.”  A diet of soft foods (think: pasta, rice, yogurts, smoothies—and some acetaminophen) is required for a few days after the wire is installed into the mouth. At some point during wear, chewing may cause the wire to de-bond—something that can be reset by a dentist.

Who it’s best for:

Mild-to-moderate orthodontic cases are especially attuned for InBrace, according to Dr Huang. Ditto for, “adults who don’t trust themselves to maintain the Invisalign compliance or would like a fixed, non-removable option,” Dr. Huang says. Meanwhile, children with a mix of adult and primary teeth and patients with moderate-to-severe crowding and impacted teeth may not be best candidates for this treatment. (Another lingual wire system, called Brius, is suited for mild-to-complex cases, Dr. Freda says).

What it costs:

Expect to pay between $5,000-$7,000 for the treatment.


CoolTone

What it is:

A body-contouring and strengthening treatment that taps Magnetic Muscle Stimulation, or MMS technology, to cause strong contractions in the muscle layer, strengthen muscle fibers and ultimately tone and firm muscles. “Being that MMS is 50-percent more powerful, we have seen results much quicker than with High Intensity Focused Electro-Magnetic energy (HIFEM),” Dr. Allenby says.

What it treats:

The abdomen, buttocks and thighs are most commonly treated with CoolTone — and Dr. Allenby has been impressed with the results. “CoolTone will not only help to strengthen, tone, and firm the muscles in the treated areas, but it also helps improve the overall functionality of our bodies,” Dr. Allenby notes. “We have seen it alleviate lower back pain when treating the abdomen.”

What to expect:

Dr. Allenby says she has seen results in her patients as soon as two weeks following a first CoolTone session, and continued improvement up to two months after treatment. For optimal results, count on completing six-to-12 sessions over a three-to-four week period, with frequency of treatment varying by treatment area. (Treating glutes can take two-to-four more sessions, on average, than treating the thighs and abdomen, for example).

Who it’s best for:

Like with other body-sculpting treatments, this one is best for those who have a lower BMI and some muscle definition established. “Patients that have some mild skin laxity in the glutes or thighs can see improvement with building the muscle mass in those areas, as it helps to fill in the laxity of the skin,” Dr. Allenby says.

What it Costs:

About $350 per session.


HydraFacial Keravive Scalp Treatment

What it is:

You probably already know about HydraFacial’s gunk-sucking and nutrient-depositing powers, used to produce clean, serum-spiked skin (and a container of grimy water teeming with dead skin cells); The same signature Vortex Technology is used in the company’s latest treatment for the scalp. Akin to steam-cleaning a carpet, suction is used to pick up dirt, oil and dead cells from the scalp and/or hair follicles and stimulate circulation. Meanwhile, the brand’s signature peptide complex solution is deposited onto the scalp to stimulate the skin and hair follicles with growth factors and skin proteins.

What it treats:

Dry and/or irritated scalp; skin and follicles congested with product buildup or lacking adequate circulation. The practice of running the treatment tip over the patient’s head physically exfoliates and stimulates the scalp, while chemical exfoliants are used to help lift and dissolve dead cells. “It’s an efficient way to dislodge and remove impurities, debris, and dead cells while creating a direct path to deliver hydration infused with more active ingredients,” says Beverly Hills, CA hair restoration specialist Dr. Craig Ziering. “Once the scalp is clear and exfoliated, it is more likely to receive topical nutrition and hydration [it needs], another key factor to hair density, quality, strength, elasticity and luster.”

What to expect:

Dr. Ziering is careful to underscore what this treatment can do—exfoliate, boost circulation, and infuse nutrients—and what it can’t. “This [treatment] does not actually contribute to growing hair—and to assume or suggest otherwise is incorrect. If follicles are miniaturized, damaged, scarred, or otherwise not functioning, this type of topical treatment will not resolve those issues,” he says. That means those who have pattern baldness, or androgenetic alopecia, won’t find a miracle cure in this service. “What it does is maintain our best scalp conditions so that healthier, better-quality hair can grow,” Dr. Ziering says. ”This is more for appearance and maintenance than anything else.”

Who it’s best for:

Those looking to address poor scalp conditions (including dehydrated skin, dead skin build up, clogged follicles, flaking, itchy scalp or eczema) and amplify hair health. “Most often, even before the first visible signs of actual hair loss [appear], poor scalp conditions or a less-than-optimal follicular vitality can lead to dull, dry dehydrated, thinner-looking hair or damage and breakage,Dr. Ziering explains.

What it costs: ​​

One treatment typically rings in at about $500 − $700 and includes a 3.4 oz bottle of Keravive Peptide Complex Spray for daily, home use (valued at $150).


Resonic Cellulite Treatment

What it is:

Originally made and used for tattoo removal, this technology employs sound waves to disrupt stiff, fibrotic tissue in the dermis without breaking the skin (as is needed with other cellulite treatments). “The sound wave physically changes the fibrous [bands] that tether the skin down (without ever breaking the skin). This allows the skin to rebound and regain a smoother texture,” says Chevy Chase, MD dermatologist Elizabeth Tanzi, MD. “It revolutionizes the industry’s approach to cellulite.” The dermatologist also praises the “game-changing” technology for delivering results without any heat, thermal energy, needles, or anesthesia and for carrying “no lasting side effects to the skin.”

What it treats:

Smooths cellulite, or dimples in the skin, without downtime or bruising. “In clinical studies, we saw results after a single treatment,” says Dr. Tanzi. “However, it’s important to keep in mind that sometimes the ‘ripples’ in the skin are not cellulite. These ripples can be related to laxity, and it’s unclear if the Resonic treatment will help improve laxity. Therefore it’s important to be evaluated properly by a physician to determine if you are a good candidate for treatment.”

What to expect:

Both buttocks and thighs can typically be treated in one, 45-60 minute session. “Clinical trial participants found treatment to be tolerable,” Dr. Tanzi says, noting that an average level of perceived pain in trial sessions was rated at 2.4 on a 10-point scale. Post treatment, some may experience mild-to-moderate temporary redness of the treatment site, mild pain, heat, and pinpoint redness. “While every patient is different, the recovery was found to be non-existent for the patients that my practice treated as part of the clinical study, and they did not experience any bruising or soreness,” she says, adding, “Clinical trial results for Resonic showed significant results in just one session.”

Who it’s best for:

Dr. Tanzi calls the treatment, which is FDA-cleared for use on buttocks and thighs, “effective on all body and skin types, including darker skin tones, for the treatment of cellulite.” Despite seeing impressive results achieved in a single session, she advises managing expectations. “It’s important to remember that there is no ‘cure’ for cellulite,” Dr. Tanzi says. “Although I am optimistic that the Resonic treatment will help people look better and feel more confident, I do not expect this treatment to completely eradicate all dimples and ripples.”

What it costs:

About $2,500 to $3,500 per treatment.

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