In Hollywood, as unnatural butt lifts and overplumped lips (mostly) fall out of favor, a host of aesthetic treatments promise to give more natural-looking results, whether that means resetting brows, lifting breasts with no implants or getting face-lifts earlier than ever.
The town’s top plastic surgeons and medical pros share with The Hollywood Reporter what’s new and what their SoCal patients are requesting right now, from vertical vectoring for a non-surgical mini face-lift to regenerative medicine including harvesting stem cells from your hair follicles to create highly advanced skincare topicals. These are the latest doctor-approved treatments designed to deliver agelessness.
Related Stories
Brow Resets, Both Surgical and Nonsurgical
Forget the term “brow lift.” “Vertical lifting of the brow makes patients look surprised,” says ocuplastic surgeon Dr. Guy Massry. “The goal is to create shape, arch and contour; it’s about resetting and recontouring the brow, not lifting.” Massry uses a vector technique and lifts up and out toward the temples while elevating the tail of the brow, improving shape, arch and contour for a more natural appearance. And if you’re simultaneously having upper eyelid surgery for hooding (an $18,000 procedure), Massry does the brow reset first. “This gives a better eyelid surgery outcome,” he adds.
Do your forehead and eyes feel extra heavy or droopy, but you prefer to avoid surgery? Dr. Ava Shamban, founder of Althaea Skincare, sees solid results with Daxxify (from $650). “It’s a botulinum toxin that has a peptide envelope around it which may contribute to its longevity,” she says. “Using it on label gives a nice lift to the brows.” With injections, artistry and placement are essential, so choosing a highly experienced practitioner like Shamban is of the utmost importance.
No More Chipmunk Cheeks
“As far as cheeks and cheek filler, there is a greater trend toward a more natural aesthetic,” says facial plastic surgeon Sarmela Sunder of Sunder Plastic Surgery. “There has been a shift away from filler and toward surgery. Whereas a few years ago, patients may have had six to eight syringes of filler to try to create an illusion of lift to try to avoid surgery; now patients are opting to use one to two syringes of filler and let surgery do the heavy lifting.”
Earlobe Filler
“Years of wearing earrings can literally weigh you down, creating stretched-out earring holes and aging earlobes. Side sleepers also get unsightly creases and deformities,” says Shea Denmark, aka The Beverly Hills Sculptress. “Earlobe filler involves the injection of dermal fillers into the earlobe to add volume or plumpness or correct any of these deformities, restoring a youthful appearance. It also creates a framework of support to prevent further aging. This is great to preventatively, before the stretching ever begins.” Expect some redness which will resolve. Denmark adds that the injection ($475 to $850 or more) is pain free and takes about 15 minutes.
Stem Cells for Hair and Skin Regeneration
Your very own hair follicles might just contain the fountain of youth. And you can have this precious nectar harvested and cryo-preserved to utilize throughout your life for advanced hair and skin rejuvenation. “We’re preserving a client’s younger self by extracting stem cells from the hair follicle — via 50 hairs precisely plucked from the back of the head — locking in their age and health at that time. [They] are then grown in the lab to accumulate high volumes of the patient’s own growth factors for topical application on the scalp and skin,” says Drew Taylor, CEO of personalized regenerative medicine company Acorn Biolabs. Cost: starting from $945 for follicle collection and a $190 annual fee for banking the patient’s material.
Under-Eye Bags: Dissolving Filler Before Lower Eyelid Surgery
“I love my under-eye bags!” said no one ever. Lower-eyelid surgery is one of the most common procedures to correct those puffs of unwanted baggage, but if you’ve had filler injected under the eyes or in the cheeks, it should be removed before surgery. “If it’s not dissolved, the surgery will be more complicated and less predictable, with a longer recovery,” says Dr. Massry. “Filler and surgery don’t go well together.” Cost for filler removal: $1,000.
Thicker, Fuller-Looking Hair
One of the leaders in hair restoration, BosleyMD, just unveiled their latest breakthrough, Revive+ Densifying Foam, which promises to boost fullness in a mere 45 days when massaged into the scalp twice a day. Developed with AI technology and a cinch to apply, it reactivates dormant follicles by supporting the health of the mitochondria, extending the hair-growth cycle. Whether you’re treating hair loss or simply want to maintain thicker looking hair, this over-the-counter, at-home foam may be used by both men and women, is affordable ($40) and reportedly won’t cause any irritation. Should further intervention be required, Dr. Ben Talei is opening a hair-restoration clinic in Beverly Hills this summer where treatments that are non-surgical (as opposed to hair transplants) will include light therapies, regenerative medicine from Acorn Biolabs and PRP (platelet-rich plasma) injections into the scalp. “I myself suffer from hair loss and love that we have these options which can be done once or twice per year with a high success rate,” says Talei.
The “Refined” Nose
“Current trends in nose shapes include a refined and slimmed appearance. Clients are asking for a lifted tip and refinement — they want to keep their natural identity, but just want a straighter, slimmer, lifted look,” says facial plastic surgeon Dr. Kay Durairaj. Her favorite technique for nonsurgical, filler-based rhinoplasty involves lifting the nasal tip, otherwise called liquid rhinoplasty ($2,500). “This is my signature Tinkerbell Tip Lift. It creates a refined aquiline profile with sharpening and upward tip projection to give the patient a perky nasal tip. I can also camouflage a large nasal hump by increasing the projection of the tip.”
Nonsurgical Face-Lift
As we age, our faces fall, jowls and nasolabial folds appear and cheeks get heavy. A nonsurgical treatment that Dr. Durairaj prefers is vertical vectoring ($3,500-$4,500) using collagen biostimulators or dermal fillers such as Sculptra or hyper-dilute Radiesse. “Think of collagen loss like a factory slowing down, where there is decreased production,” she says. “I can laterally lift the face with these treatments, and I’m saying this as a surgeon. This gives a lot of lift, builds a new foundation, looks natural and the results are long-lasting.” Expect two to three sessions spaced six weeks apart on average.
Naturalistic “Quiet Luxury” Veneers
Chances are you’ve been blinded by one too many celebs flashing their big, blazing white choppers. Veneers are ubiquitous in Hollywood, but it’s crucial to see a cosmetic dentist who values appropriateness in size, color and fit along with considering skin tone, face shape, jaw size and how one’s lips move. “It’s about quiet luxury with veneers and not having a signature look, as each patient is unique and individual,” says Dr. Jon Marashi. “Just as overfilled lips are out, so are oversized, extremely white teeth.” One of the newest advancements Marashi uses is a digital scanner (a pen wand that contains a camera) to take high-res images of the teeth in less than a minute instead of those uncomfortable trays filled with goop. The cost for the most advanced veneers? About $4,400 per tooth.
Perky Breasts Without Implants
Conventional cosmetic wisdom says that maintaining perky breasts without using implants can be challenging — due to gravity — but this hasn’t deterred Dr. Lisa Cassileth. “The pocket lift proves them wrong,” she explains. “First, the breast tissue is lifted with the support of an absorbable mesh, leaving behind strong fibrous tissue, which acts as a bra, holding the breast tissue up over time. Second, the breast tissue can be positioned high up if a full aesthetic is desired.” Cassileth is also a proponent of exosomes and PRP for minimizing scars: “Their safety and efficacy can be captured to create an invisible scar, using our treatment regimen. This is a great tool for avoiding scars associated with breast lifts.”
Another approach is fat transfers. Explains Dr. Payman Danielpour of Beverly Hills Plastic Surgery Group, “Many clients are opting not to get implants and are having fat transfers to enhance their breasts. So I’m doing a ton of breast lifts with auto augmentation, where the breasts are fuller and lifted but without the use of implants. Many clients don’t want foreign materials in their bodies. By doing a fat transfer, you can still volumize and lift the breasts without a foreign body. And patients also have the benefit of having some liposuction at the same time in the area where the fat was removed from — whether inner thighs, flanks, belly.” He adds that, “I get asked for the European look as far as breasts. What’s in is a more natural look that’s unassuming and looks like nothing was done.” Fat transfer augmentation costs start at $18,500.
Boosters for Plump, Dewy Skin
If your skin looks dull or increasingly crepey, a skin booster such as Skinvive is one of the newest hyaluronic acid injectable treatments that can help. “While not quite a filler, it improves the overall luminosity and plumpness of the skin, reduces the appearance of fine lines and wrinkles and offers lasting hydration for up to six months,” says nurse Laura Fischer, of SkinSpirit Beverly Hills, who uses it on lower cheeks, necks, torsos and the back of hands.
Exosomes for Healing and Restoration
Prepare to hear a lot about face and body exosomes. “Regenerative medicine in aesthetics is the new frontier, and exosomes are all the rage,” says Dr. Sunder. “These extracellular vesicles are thought to carry signaling molecules from the cells [to accelerate healing].” Common uses include topical application after microneedling and laser treatments to aid in healing and decrease downtime, along with being injected into incisions to improve possible scarring as well as the scalp to support hair growth.
Toned Stomach, Thighs and Derriere
While Ozempic continues to reshape Hollywood, for those who are shying away from taking that and similar drugs for weight loss, there are in-office alternatives. Dr. Macrene Alexiades, founder of Macrene Actives Skincare, is a fan of InMode’s Forma Plus and Profound by Candela. “These are the device versions of Ozempic and the best for fat removal and tightening the skin,” she says of her in-office procedures. “I can get rid of those banana rolls — that extra tissue under the butt — and decrease the circumference of the abdomen and thighs.” Alexiades sees solid results and reproducibility with both treatments: “I’ve conquered the face and am now doing it with the body.” Costs: from $5,000-$6,000 per Profound treatment and from $600 per treatment with Forma Plus.
Minimally Enhanced Butts
“The Brazilian Butt Lift is completely out in Beverly Hills,” says Dr. Danielpour. “Miami and other parts of the country may be a different story, but it’s definitely out here. We are actually removing fat from the butt. Clients don’t want overly large buttocks.” But that doesn’t mean clients don’t want reshaping: “We are doing more surgeries than ever, but it’s about subtlety.”
Neck Tightening
Is your neck lax? Or are you tired of staring at a burgeoning double chin? EmFace’s new Submentum applicator could be the answer. In 20-minute weekly sessions over four to six weeks, it’s designed to lift and tighten the region under the chin. “It utilizes electromagnetic stimulation to contract the muscles with radio-frequency [heat], and there’s no pain or downtime,” says dermatologist Glynis Ablon, who says she is seeing great results treating “the ‘gobble’ people complain about.” Cost: from $1,000 per session and packages are also available.
Toned-Down Lips
“Clients are definitely asking for more subtle and toned-down lips. The most important thing for lips is to maintain individual identity. This is done by making an effort to enhance natural contours without over-exaggerating any one feature. This gives the lips a more natural form of enhancement,” says Dr. Durairaj. For clients who do want to modify their lip shape, Dr. Kay’s Angelina Jolie-inspired lip cleavage technique ($900) is a highly requested procedure that gives the lower lip cleavage. “I create two pillows of volume with a center divot.” Another technique that is popular is her “Lipstick Liner.” This creates an accentuated border around the lips without giving the lips too much volume. “I also love using a microdroplet technique for a ‘lip gloss’ effect to give the lips hydration,” she says.
Snatched Jaws With Earlier Face-Lifts
“Patients are wanting a more youthful, refreshed look and opting to have surgeries at a younger age so that the results don’t look as drastic,” says Dr. Sunder. “The goal for most patients with a face-lift, especially in their early 40s and early 50s, is to restore the jawline and neck to what it looked like a few years ago. In general, this [gives] a more taut and lifted appearance. Compare this to 10 to 20 years ago, when people tended to wait until they were older and the jawline and neck were really lax before they opted to intervene. Oftentimes, those are the patients who look ‘operated on.’ ” Fees for face-lifts vary and can run anywhere from $15,000-$75,000 depending on complexity of the procedure.
Platelet Rich Fibrin Plus Topical Estrogen for Targeting Deep Wrinkles
You’ve likely heard of PRP (platelet rich plasma), but how about PRF? “Platelet rich fibrin — which is centrifuged and extracted from your blood — has high concentrations of autologous growth factors and significantly more than PRP,” says oculoplastic surgeon Dr. Kami Parsa. For his Estrolux treatment, Dr. Parsa “initiates a controlled superficial injury to the skin” with treatments such as micro-needling, radiofrequency microneedling or CO2 laser resurfacing. A compounded estrogen cream is then applied over the next four to six weeks at night. “During perimenopause, there is a reduction in estrogen levels, and topical estrogen has proven to play a beneficial role in aging skin in perimenopausal and postmenopausal women by influencing collagen production, skin moisture and elasticity, improving crepey skin and thickness, and reducing wrinkles,” says Dr. Parsa.
Refining Cellulite
While heaps of doctors tout Sofwave as a treatment of choice for non-surgical lifting of the face and neck, the latest FDA approvals are for non-surgical lifting of the skin on the arms and improvement of the appearance of cellulite. “It treats knees and elbows off label as well, which are gaining in popularity,” says Dr. Tess Mauricio. “Using their proprietary Superb ultrasound technology, Sofwave is a regenerative treatment that increases collagen and elastin formation in the skin and the best part is most patients do not have any downtime and see immediate improvement, which just gets better over time.” Cost: from $1,200.
Combatting Vaginal Dryness
Mirconeedling with RF (radiofrequency) including InMode’s Morpheus8 and Vivace Ultra are some of the most popular treatments for refining the skin on the face and body. Did you know it can also help relieve menopausal vaginal dryness? “Morpheus8-V is being used with success for GSM [genitourinary syndrome of menopause, aka vaginal dryness] along with some mild to moderate overactive bladder symptoms,” says Dr. Suzanne Gilberg-Lenz, gynecologist and author of Menopause Bootcamp. “The caveat is only allow a gynecologist or urogynecologist to perform this treatment.” Gilberg-Lenz is also a proponent of vaginal estrogen. “It’s the greatest tool and the data on safety and efficacy is abundant, robust and clear.” Cost: from $800.
Bye Bye Bunions and Hammer Toes
There’s nothing like a bulbous bunion or hammer toe to ruin a red carpet or summer sandal look. Austin-based podiatrist Dr. Anne Sharkey has a remedy. “MIS or minimal invision surgery, can correct bunions and hammer toes with nearly invisible scarring thanks to micro incisions that you don’t see after healing,” she says. The 60-to-90 minute X-ray guided procedure, which involves some discomfort and swelling, is done on an outpatient basis. Patients return to wearing soft-soled shoes such as sneakers in three weeks and high heels within three months. And if an unsightly toenail fungus is rearing its head, Sharkey suggests Jublia, a prescription topical medication and Formula 7 is her preferred over the counter treatment.
A version of this story first appeared in the May 22 issue of The Hollywood Reporter magazine. Click here to subscribe.
