The No-Fear Guide To Lasers, Lipo, & More

Scaredy_Cats_Guide_Intro_SlideDesigned by Austin Watts
Scared of the derm? We won't judge you — besides the obvious needle fears, in-office skin treatments can sound intimidating, especially if you've never done it. (Seriously, a "chemical peel" just sounds terrifying, right?) The good news for those of us who've considered these treatments is that while, yes, they are serious procedures that need to be completed by a professional, treatments such as Botox, injectable fillers, and even lipo have become so advanced that there's really nothing to be scared of. We promise.
We're not saying you need to try any of these treatments, but based on the hushed "Don't tell anybody that I'm asking, but..." questions we get, we know some of y'all are curious. Read on to find out about the most buzzed-about treatments in the medi-spa world — and what you need to know if you're considering them.
Scaredy_Cats_Slide_3Illustrated by Austin Watts.
The treatment: Botox Cosmetic
The fear: You'll look like a wax figure — and it's gonna hurt.
When we think of intimidating in-office skin treatments, the first product that comes to mind is Botox Cosmetic. We've all heard horror stories of women with frozen faces, but Dr. Ellen Marmur, a board-certified dermatologist and associate clinical professor at Mount Sinai Medical Center, set us straight on exactly what to expect from Botox — and it wasn't what we thought.
The most important thing to keep in mind about Botox, she says, is that it's temporary. "Botox creates a chemical blockage of nerve receptors, causing the person to be unable to move that muscle. But, the receptor sheds like your hair sheds — gradually — so you get a gradual recovery. It's like getting your hair dyed; it grows out," Dr. Marmur explains. So, lose any ideas of your face being rendered expressionless permanently.
As far as the pain involved in going under the, uh, needle, Dr. Marmur insists that the injections simply feel like acupuncture. "It's a tiny injection, smaller than a flu shot," Dr. Marmur explains. The exact amount of pain and/or pressure that you'll feel, however, depends on where you're being injected. (The most painful area is above your eyebrows.) This fact points to why knowledge of facial anatomy is so important, and why, according to Dr. Marmur, you should receive injections only from a doctor, and never from a technician.
The anatomy of the face also comes into play when deciding how much (and how often) a patient should receive Botox injections, says Dr. Marmur. "There are 40 different muscles in the face, and they all interconnect," she explains. "So, you need to come back in a couple of weeks, and make sure that other muscles aren't overcompensating." Dr. Marmur has a surprising method for determining if a patient has received the correct amount of Botox. "I chat with the patient for a while, and they don't realize that I'm actually examining them and seeing how expressive they are," she explains. Speaking to the patient allows her to see what the patient's face looks like in real life, which is a more accurate way of determining if the Botox has been given correctly. So, if you try Botox and your derm gets chatty, that's why!
The treatment: Injectable Fillers
The fear: You'll look like an emotionless chipmunk.
Injectable fillers tend to conjure up images of scarily smooth, flat, expressionless faces — but, according to cosmetic dermatologist Dr. Paul Jarrod Frank, this image is outdated. Quite simply, says Dr. Frank, fillers "can help to diminish lines, correct volume depletion, indented scars, hollow eyes and temples, or enhance lips, with natural-looking, safe results — and they can be done in minutes." As with Botox, many of the most popular fillers are temporary, and they fall into three categories: volume fillers, wrinkle fillers, and fine line fillers.
Fillers may be made up of artificial or natural substances that are injected into the skin, and can be used to contour the face to make it appear more youthful. They can last for anywhere from six to eighteen months. As for the ouch factor? The experience of having fillers injected can vary greatly according to several variables, from the amount used to the pain tolerance of each specific client, explains Dr. Frank, but most people will be able to resume daily activities almost immediately. All in all, says Dr. Frank, the process should be quite comfortable, and the biggest risk is minimal bruising at the injection site.
So, we know what you might be thinking. When a filler wears off, won't that make wrinkles and sagging skin even more noticeable? Thankfully, Dr. Frank says that this is a total myth — to the contrary, many fillers actually stimulate the skin's own ability to produce hyaluronic acid and collagen, making skin more resilient over time. According to Dr. Frank, most of his patients start using fillers in their 30s — but, if patients are looking to fill acne scars or treat dark circles, it's perfectly okay to start using fillers earlier.
Scaredy_Cats_Slide_2Illustrated by Austin Watts.
The treatment: LED light therapy
The fear: You'll end up zapped like a baked potato.
If lasers intimidate you, step into the light instead. According to celebrity facialist Joanna Vargas, LED light therapy is a tried and tested method of anti-aging skin care. "Even NASA and Navy SEALs have used it for muscle regeneration and the healing of wounds," she says of light therapy. In recent years, the treatment has started to be used for aesthetic purposes — and the results, according to Vargas, can be incredible.
So, the lowdown: LED (that's Light Emitting Diode) therapy has multiple skin care benefits, according to Vargas, from increased collagen and elastin production to the elimination of sunspots, reduction of deep wrinkles, and filling of fine lines. LED, she says, is essentially a light bulb with a low-level power output that is safe, non-damaging to skin, and — huzzah! — completely painless, unlike laser and Intense Pulse Light therapies.
LED light therapy works on cells in the human body in a similar way that sunlight interacts with plants in the process of photosynthesis. "Cells in the human body use light and convert it into ATP, the fuel that powers life on a cellular level," says Vargas. "When light therapy is used, this triggers cellular activity, producing ATP, which the tissues use to carry out healing and rejuvenation in the treated area." The results of light therapy are cumulative, meaning that the more that someone receives it, the more rejuvenated their skin will be.  
The treatment: Chemical peels
The fear: You'll end up molting all over your coworkers.
We all have that scene burned into our retinas: the one from Sex and The City, in which Samantha receives a chemical peel and attends Carrie's book party with skin that looks like steak tartare. As a result, many of us have sworn off chemical peels for life — and who can blame us?
Well, according to Dr. David Colbert, founder of Colbertmd, even the name chemical peel is complete misnomer. "A chemical peel is the application of a solution that dissolves the bonds between skin cells, allowing them to slough off a thin layer, which results in a newer, fresher visible epidermis," he explains. "Most light peels don't result in actual peeling — and the 'chemical' is actually a fruit acid from sugarcane, not some unknown drug from chemistry set." Modern chemical peels are much gentler than many of us think, insists Dr. Colbert. "Most in-office peels are very superficial," he says.
There are different levels of peels, says Dr. Colbert, that patients can receive depending on their desired levels of exfoliation — so if you're not looking to ditch three layers of skin, you don't have to. "A superficial peel is done with various fruit acids at various concentrations," he explains. "There is a light stinging and itching sensation, so, at my office, we use a small fan to minimize discomfort — but the peels only last for a few minutes at a time." The next level, Dr. Colbert explains, involves Beta, or salicylic acid, peels, which will cause more of a burning sensation, as well as more flaking of the skin after the peel is received. The final common form of peels (and the one that Dr. Colbert says was probably referenced in that famous SATC episode) is a TCA, or trichloroacetic peel, which is somewhat more painful, and requires downtime of about a week.
So, for the scaredy-cat considering a superficial peel, Dr. Colbert insists that they're nothing to be frightened of — and the results (clearer, smoother, skin) are more than worth it. One can receive a gentle peel during a lunch break, return to work, and experience only minor irritation for a couple of days. (Dr. Colbert does, however, note that peels do increase sun sensitivity — so if you receive a peel, be sure to load up on that SPF, and avoid direct sunlight whenever possible.)
Scaredy_Cats_Slide_1Illustrated by Austin Watts.
The treatment: Body shaping
The fear: You'll end up misshapen — and bedridden for weeks.
So, liposuction: terrifying and painful, right? Well, according to board-certified plastic surgeon Dr. Sharon Giese, new methods of body shaping use some aspects of traditional liposuction, but are much less invasive. In her New York City practice, Dr. Giese works with two different methods of body shaping: Vaser Liposuction, and VaserShape.
The former, according to Dr. Giese, is not as aggressive as traditional liposuction. The treatment involves a dermatologist inserting a small, Q-tip-sized probe under the skin, which sends in ultrasound energy (which, Dr. Giese explains, is essentially heat). This is when it gets a little bit gross: The ultrasound energy melts fat cells, and the doctor gentle removes the melted fat with a syringe. Icky, yes — but, insists Dr. Giese, the process is much more gentle than one would expect. "With Vaser Lipo, the patient will feel just a little bit of pressure — and the treatment will only last for about forty-five minutes. Most of my patients simply take Tylenol."
VaserShape, on the other hand, combines the fat-melting technology of Vaser Lipo with collagen-stimulating technology that tightens the skin. Dr. Giese recommends VaserShape because the treatment is customizable. Plus, the tightened skin means that the patient will see more immediate results than with liposuction.
So, is newfangled liposuction for you? According to Dr. Giese, the ideal patient to receive Vaser Lipo or VaserShape has one to five centimeters of fat in the areas that they'd like to have treated. The plastic surgeon says that she often sees people who have lost a significant amount of weight and are looking for extra definition, as well as women who have recently given birth. We were amazed to hear that there's actually a "high def" option, where technicians can contour the body so that muscle definition is more prominent. Who knew that lipo had gone so high-tech?
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