All Your Laser Hair Removal Questions Answered

Another summer, another season of bikini waxing/shaving woes. What's a girl to do? This girl decided to try laser hair removal, and after two treatments, I'm delighted by the results. So, I sat down with the woman who made my summer easier, Berenice Rothenberg, to ask her some of the questions I had about laser hair removal.

Rothenberg has been offering hair removal treatments on the Upper East Side of Manhattan for over 40 years and approaches hair removal much like a scientist. When you go in for your consultation, instead of plopping you down on cold chair and telling you to strip down, she sits you in a cozy office and shows you a slideshow of the different types of hair follicles you may have and what happens to your skin when the laser beams hit. I heard about her from a friend of mine who knows more about the beauty industry than anyone I know. (She's the same friend that had introduced me to Dr. Jon Turk of vampire facials past.)

What's the biggest mistake people make when getting laser hair removal?

There are two big mistakes people make. Not seeing someone who is licensed or certified with experience, and not coming back enough times to complete the full treatment.

Related: An At-Home Hair Removal Device That Actually Works

How many treatments are usually necessary?

It varies from person to person. Typically, it requires more than two or three treatments. The process is only effective during your hairs' growing cycle, [which is influenced by one's] hormones and genetics.

Does hair fall off instantly?

Some hair falls off instantly right after the treatment and some hair takes up to 10 days to fall off. The reason is because most hair follicles have more than one hair and when a beam of light (the laser) passes through the skin disabling the hair follicle, the hair that leaves the epidermis falls off instantly and the hair that is under the epidermis will take from 5 to 10 days to leave the epidermis.

How do you know if laser hair removal is safe for your skin?

I always give a consultation before I treat a client so I can analyze the person's hair, skin type, and sensitivity while doing a patch test.

Related: 5 New Haircuts To Try For Summer

What areas of the body respond best to laser hair removal?

As long as the hair is dark, all areas respond well to laser.

How long should you go without shaving/waxing before you get laser?

To minimize the sensitivity of the skin, I recommend shaving two days before a laser treatment. If you're someone who waxes, go 7 days before your treatment.

Is it true that you shouldn't be on antibiotics if you're getting laser?

It depends on what kind of antibiotics and how long you've been taking them. A person may become more sensitive to light while taking antibiotics, which is why it's recommended to talk to your physician before any laser treatment.

Related: The Perks of Working Out with a Celebrity 'Body Designer'

How far in advance of a beach vacation should you get your first laser treatment?

Two months before a beach vacation.



What Women of Color Need to Know About Getting Injectables

In the past, when people complimented me on my skin, I would credit my glowing complexion to my relentless commitment to skincare (three steps: cleanse, hydrate, and protect) and sleep (minimum of seven hours per night). However, there was another “secret” that I wasn’t so keen to share: my bi-annual Botox appointment. As a woman of color, the topic of injectables wasn’t something that came up at brunch on a regular basis. I figured that everyone else who looked like me just wasn’t that into it—or not doing it at all. 

According to Carlos Charles of Derma di Colore in New York City, he finds that roughly five to 10 percent of his clientele are requesting injectables, but notes they skew older and with lighter complexions. 

“This is mainly because of the differences in the pattern of aging in light versus darker skin tones,” he explains. “In lighter complexions, signs of aging such is fine lines and volume loss can occur earlier, since these are likely due to an increased susceptibility to the damaging effects of ultraviolet light. Also, the pattern of aging in darker skin is typically characterized less by fine lines or wrinkles, but more by overall volume loss later in life.”

"WOMEN OF COLOR TYPICALLY START NEUROMODULATORS [LIKE BOTOX] A BIT LATER THAN CAUCASIAN PATIENTS."

As a beauty editor, I have written about injectables in the past, however, it started to feel weird to promote something that I actually never tried. After years of avoidance, and now in my early 30s, I finally buckled after seeing a male friend undergo the treatment and come out looking like a new man. After two appointments, I found myself loving the results. I looked like a better, more well-rested version of myself sans crow's feet or a wrinkled forehead (which happens when my stress level climbs). 

So, why aren't more women of color talking about getting injectables? Ahead, we hear from dermatologists on the stigma of getting botox or fillers, the procedures themselves, and more answers to burning questions.

Who is the average patient getting injectables?

Michelle Henry, a dermatologist and dermatologic surgeon based in New York City, estimates that roughly 50 percent of her clients are of color, and of that pool, about 25 to 30 percent of them are requesting injectables. “Women of color typically start neuromodulators a bit later than Caucasian patients, because melanin is protective against UV damage that contributes to the formation of fine lines and wrinkles,” she says. Henry adds that she most of her patients still fall within the late 20s and early 30s regardless of ethnicity.

What areas are people getting fillers/Botox?

For those not super familiar with the filler-game, there are a ton of options available, but it can be confusing to understand what they do. To brush up, I caught up with Melissa Doft, a New York City-based, board-certified plastic surgeon to give me the run down on which injectable does what. Consider this your new cheat sheet the next time you go to the derm—or even plastic surgeon. 

“Hyaluronic acid-thicker versions (like Voluma or Restalift) are great for adding volume to the cheeks, jawline or chin. Medium thickness injectables like Restylane, Juvederm or Belotero are excellent for around the mouth to fill in the laugh lines and nose for a liquid rhinoplasty,” Doft explains. “More common ‘thinner versions’ like Vobella or Refyne, work well for lips, ear lobes or tear trough—the groove between your lower eyelid and the cheek."

Fran E. Cook-Bolden, a New York City-based dermatologist, cosmetic surgeon and assistant clinical professor at Mount Sinai Health Center says that the areas most commonly treated among women of color include: "the forehead, the area between the eyebrows (known as the glabellar area), the area around our eyes (known as crow’s feet), particularly the area beneath our eyes after years of joyful smiles or squinching to read cell phone messages and lastly, the chin to correct dimpling or a cleft in the middle of the chin."

Will people notice that I got fillers or Botox?

Naturally, when I had my first Botox appointment, I was nervous about what the outcome would be. Despite knowing my administer’s background, I was fearful that I’d look like a weird, altered version of myself versus a more, youthful refreshed one. And, turns out I wasn’t that far off to wonder if people “knew” what I had done.

According to Harold Lancer, a board-certified dermatologist based in Beverly Hills, who counts clients including Beyoncé, Kim Kardashian West and Jennifer Lopez as clients (note: Lancer did not confirm any of the women above have undergone cosmetic procedures), there is a chance that the human mind can subconsciously detect irregularities. “If you look at someone, any body part, and it doesn’t match the rest of the surrounding environment you know something is wrong,” he explains. 

“When using injectables, the anti-aging goal is subtle changes that leave patients looking refreshed and relaxed—as if they have just returned from a relaxing retreat or vacation,” Cook-Bolden adds.

Is there a stigma toward injectables in communities of color?

Beyond the logistics of fillers—why is everyone so hush-hush about getting them? You and I both know many of our faves over 40+ who looks suspiciously amazing. Is it their skin care regimen? Does black really not crack? Or do they have a not-so-secret secret that they simply aren’t disclosing?

“I think there is still a lot of stigma around cosmetic procedures in communities of color,” shares Henry. “There is still a sense that in changing one’s appearance, they are rejecting their ethnicity or heritage. However, this is starting to change and women of color are starting to benefit from cosmetic procedures with less guilt and stigma.”



Botox, Cosmetic Fillers, and the Meaning of Beauty

With Botox, I'm like a gateway drug for women of a certain age: Dani, Susan, Daphne, Lorin, Nancy, others whom I can't recall—when I've happened to reveal that I avail myself of the needle, these women's very mobile eyebrows have risen in surprise. "You do?" Or rather, "You do?" It's hard to pinpoint exactly what about me suggests I'd never touch the stuff, but I'd guess it's some combination of my no-bullshit mien, my feminism, and a midwestern blondness that semiotically speaks "natural," though my hair color hasn't been for quite some time. (It also might be due to my expert dermatologist; my face isn't frozen; I don't look "done.") 

The topic typically arises when a female acquaintance compliments me. "You look great," or even, "Your skin's so good." It's at these times that I matter-of-factly offer up the Botox. I say how my forehead was looking "rough"—rough, not wrinkly, was how I perceived it—and how, after a while, I made an appointment with a dermatologist who is a go-to guy around the offices of ELLE, where I work as an editor (maximizing one's attractiveness is the warp and the woof of the place, if you hadn't guessed). How when I saw this doctor, I secretly prayed that he'd gush, "You look so gorgeous and young, you don't need anything," but instead he told me that he knew exactly what I meant by "rough," that a lot of his patients used that term. How he set me up—it stung just a little—and afterward his receptionist handed me a tiny, folded-up piece of paper where he'd scrawled what I owed, and I literally gasped; tears sprung to my eyes. "I'm spending $800 on this, and people are starving in Africa," I blurted. 

At this point in my testimonial to friends, I usually laugh. Ironically, abashedly, because my compassion for my fellow man did not keep me from getting another fix, and another—or from eventually expanding my Botox regimen to include the lines around my eyes. As for my interlocutors, once I spill, I can see the sugarplums dancing in their heads, their eyes how they twinkle. If she can do it, I can too! 

One of my closest confidantes—who's slightly older than me and used to say "Just wait" when I insisted I'd never cosmetically enhance—thinks that my readiness to admit I use Botox is cringingly confessional, not to mention sad for me. "You think the only reason you look good is the Botox?" she says, kindly. But that's not it. I know that my physical charms go beyond my smooth forehead. (For the record, I am, and always have been, in the middle on the comeliness continuum: attractive, but no beauty.)

The main reason I'm loose-lipped about my affection for the botulinum toxin is that I'm embarrassed by my vanity. Botox, Botox, Botox—if you say a word enough, you forget what it means. By copping to my willingness to spend now about $3,000 a year to keep wrinkles at bay, I'm trying to inoculate myself against feeling that it's reprehensible and weak to care so much about how I look, particularly when appearance is determined largely by genetic luck and when, worse yet, millions of people don't have a roof over their heads. (Confessing is also an inadvertent recruitment tool; if every woman I know is doing it, then we can all be morally suspect together. Nothing sounds more dreadful to a drunk than hanging out with a bunch of teetotalers.)

There are those for whom youth and beauty are practically job requirements: performers, anchorwomen, high-profile people in glamour industries like magazines. Granted, research suggests that a fair face and a firm body confer benefits in most realms of life, but the cost of not being pretty darn good-looking is simply higher for, say, a big-time editor than it is for a banker. If public women keep shooting up, the standards of beauty won't have a chance to change, it's true, but it's not fair to make any one individual bear the brunt of this. Who'll stop Botox first, Katie Couric or Diane Sawyer? I assume both use, but I don't know for sure because for most women Botox is seen but not spoken of, unless you're Heidi Montag, who seems to have taken "plastic surgery guinea pig" as her job title. Pulling the plug on Botox is the classic collective action problem.

That's because, perhaps unfortunately, people take their main calling cards (their large vanities?) for granted. Getting attention for them is nice, but...carry on about aspects of people that they either cannot or have not cultivated, however, and watch them glow. The simplest example: Which would a model prefer to be lauded for, her brains or beauty?

One day not long ago, as I was looking in the mirror, my hands went reflexively up to either side of my face; I pulled back the skin at my cheekbones, stretching away the grooves that make parentheses around my mouth. Oooh, I look like I'm 30, I thought, half thrilled at the effect, half lamenting the slack state of affairs. Botox doesn't address this marker of aging—that would require a cosmetic filler or a face-lift, I learned from my derm's procedure-pushing nurse—and I perform this small ritual of wrinkle-ablation fairly frequently. 

"Mommy, what are you doing?" my 11-year-old daughter asked, ending my reverie. I'd forgotten she was there. 

"Oh nothing," I said, too casually.

"Mom-my...tell me the truth."

"I'm just seeing what I looked like when I was younger."

"Do you think you look bad now?"

"No, not exactly, but...get dressed. It's time for school."

Edie gazes at me sadly—is she upset because I'm getting older and she'll eventually lose me, or disappointed that I don't practice what I preach? I'm not sure. It's fun to look pretty, I tell Edie and her seven-year-old sister, Tess, but what matters most is how you treat people, how you use your brain, how hard you work. 

My parental rhetoric may not win awards for persuasiveness, but I do believe my girls will be better people, and happier ones too, if they put interior development before exterior. And I'm not one who thinks you should avoid setting standards for your child unless you follow them religiously yourself—isn't that one of the joys of adolescence, rebelling against your hypocritical parents? Still, there are limits to "Do what I say, not what I do," and I worry that I'm bumping up against them as my girls grow older and more aware.

"Looking around here, I can tell this group isn't exactly, umm, unconcerned about appearances," Anne Kreamer began, during a discussion group about Peggy Orenstein's new book, Cinderella Ate My Daughter, a provocative and readable take on the potentially deleterious impact of the hyperfeminization of young girls. Kreamer herself is an author of a polemical memoir on her decision to stop dying her hair—talk about a slice of life—and so has an ax to grind (scissors to sharpen?). Nonetheless, her comment made me feel like hiding my unnaturally blond head.

Regretfully, however, Kreamer had a point under her gray-haired self-righteousness: How do each of us draw the line between what is desirable and/or acceptable physical improvement, to use the most benign term, and what is not? To me, the question has only taken on urgency as I've dared to reckon with the influence I have on my daughters. 

Orenstein's book, the reason Kreamer and a passel of publishing types had gathered in the first place, brought the issue home. A thorough reporter and breezily accessible writer, Orenstein strongly argues that the princess-in-pink juggernaut for toddlers that morphs into the Hannah Montana/iCarly/Lady Gaga juggernaut for preteens that morphs into the juggiest juggernaut of our time—the Internet and Facebook—for teens is warping girls' sense of self. Taken individually, she writes, none of these are "inherently" dangerous, but each is "a cog in the 24/7, all-pervasive media machine aimed at our daughters—and at us—from womb to tomb." 

Orenstein trains much of her focus on young children, and while she hastens to point out that nobody has ever proved that "playing princess specifically damages girls' self-esteem or dampens other aspirations, [t]here is...ample evidence that the more mainstream media girls consume, the more importance they place on being pretty and sexy. And a ream of studies show that teenage girls and college students who hold conventional beliefs about femininity—especially those who emphasize beauty and pleasing behavior—are less ambitious and more likely to be depressed than their peers. They are also less likely to report they enjoy sex." Yikes. More sobering news: In a survey of 2,000-plus school-age children, "the number of girls who fretted excessively about their looks and weight...rose between 2000 and 2006 (topping their concern over schoolwork), as did their reported stress levels and their rates of depression and suicide." 

A common retort to warnings that the youth are in peril, or going to hell in a handbasket, is: Hasn't it always been thus? For this subject in particular, a skeptic might cite Peter the Hermit, from 1274 a.d.: "The young people of today think of nothing of themselves.... As for the girls, they are forward, immodest, and unladylike in speech, behavior, and dress." Or for a more contemporary comparison, weren't girls in the 1950s equally obsessed with pulchritudinous presentation, though there was no such thing as the Internet, toy marketing by gender (a brilliantly successful strategy to optimize sales, according to Orenstein—think pink Legos), or a round-the-clock celebrity-news cycle? In other words, old fogies always believe that change is irksome, so I should relax.

Perhaps, but just because my daughters might have been been equally burdened by you-are-your-shell propaganda had they been born at another time doesn't mean I want to stop nudging them toward what I consider fuller, more sustaining identities. And Orenstein contends that there is a distinction between today and yesteryear. "The warnings of the past were concerned with girls' becoming too sexual," she told me in an interview. What she's addressing is their becoming too sexualized. "The culture encourages girls to view femininity, sexuality, identity as something they perform for the benefit of others, and that gives them less freedom under the guise of giving them more. It encourages girls to define themselves so narrowly, to hang their self-worth on looking a certain way." 

Okay, I'll admit it, I do think that the emphasis on looks was less pervasive when and where I came of age, in suburban Cleveland of the 1970s. Maybe it's just a question of balance. In those years when modern feminism went mainstream, all the attention lavished on other parts of female identity, on breaking the age-old female mold, might have worked to neutralize the appearance fixation: You can be anything you want to be, girls—find a career! Your sexual pleasure is just as important as the boys'—read all about it in Our Bodies, Ourselves. I am woman, hear me roar!

Yes, I wanted boys to like me, and I knew looking as blond and zit-free as possible—and losing the braces and gaining a butt to fill out my Jordaches—was essential to the task, but I wasn't bombarded by images, and rhetoric, of girls and young women who seemed to take looking hot as a central preoccupation. (And we all know media is influential—the only question is the degree to which it shapes how we feel, think, act.) I was also a hard-core tomboy, with a hard-core-tomboy-loving dad, spending hours a day playing basketball and volleyball and everything else under the sun, activities that took me far away from perseverating on my appearance.

My daughters are more physically delicate than me, and the eldest, at least, is temperamentally less aggressive, and they're growing up in a fancy part of New York City, where organized team sports are an afterthought for girls. They have many wonderful opportunities I didn't have, but one disadvantage is that they don't have the chance to lose self-consciousness during sweaty, rough combat on the field or court. Like their friends, Edie and Tess dance and do gymnastics, which of course are sports, but they're ones that demand girls remain ever cognizant of how they're seen. (A caveat: Edie plays in a police basketball league in which I coach, and while she seems to be cottoning to it as she gets older—one reason she plays, I know, is to make me happy—it meets only once a week, too infrequent to have much impact.)

In any event, the woman I've become, the mother my girls know, is far less jocky and far more girly than she used to be. It's a result of age, extra disposable income, evolving standards of appropriate female upkeep, and age. When I moved to New York at 30, I'd never had a manicure or pedicure, never dyed my hair, never had a bikini wax—how is that last possible? The only makeup I wore was mascara and blush, and I let my long blond hair air dry, except in the dead of winter when my natural curl went limp and I fired up the blow-dryer. Suffice it to say that I devoted scant thought to personal grooming. Again, it wasn't that I didn't want to look pretty, but, owing to the gift of genes, I was thin and blond and young, which seemed like enough. 

Now in my midforties, I still eschew manicures and wear light makeup, but I get bikini waxes in the summer and semiregular pedicures the year through. I have my hair colored every few months and blown out nearly weekly in the winter and fall. My girls say, "Mom, what color would your hair be if you didn't dye it? Mom, why don't you just let your hair go gray—isn't it better to be yourself?" 

"Yeah, yeah," I reply, brushing them off. And, occasionally, "Get off Mommy's case!" I feel ashamed at their questions; I wish I could show Edie and Tess, not just tell them, that it's what is on the inside that counts. They don't pester me about the pedicures, by the way, because they get them too sometimes, with me. I both can't quite believe that I allow this and that I spend a moment berating myself for it. 

As for the Botox, they've never asked. I know it'll come, however. Edie recently inquired as to whether I'd had breast augmentation, spurred by a People magazine story on the aforementioned Montag. Perfect! I thought (as soon as she asked). That's something I'd never do, for real. "Of course I've never had a boob job," I told my daughter, putting my pique on. "That's ridiculous."

Now who's the self-righteous one? 

At different times, I have these two thoughts with equal clamoring intensity. Thought one: I don't want to die, I don't want to die, I don't want to die. Thought two: I know I could get my stomach back, I know I could get my stomach back, I know I could get it back. 

The first thought is like a plea, ragged with sadness and desperation. No one can answer it, I know; no one can help. The second is fierce, like I'm challenging an enemy to a duel: My stomach has always been great, still is, better than most women's. I could get it back—six weeks, tops. Most women couldn't do it, but I'm tough. 

Man, talk about misdirected anger. Casting my fellow women as adversaries distracts me, of course, from facing my real foe, which is infinitely tougher than me, tougher than us all. 

This bitter little fantasy will go on for a while; I'll imagine hiring one of those drill-sergeant trainers, blowing him away by my endurance, by my epic number of crunches. I'd kill it. By then, I'm usually smiling; one of the blessings of growing older is that I've been able to get some perspective on my crazy, compensatory ferocity. Do I really want to spend the decades I have left doing sit-ups? I think not. A few things I'd rather do: coach basketball, write, hang out with my family, throw parties, play piano duets with my daughter, go to dinner with my friends, collect shells in jars, play doubles tennis with my husband. And that recently traitorous stomach? The truth is, it's been good to me. I don't need to punish it...punish myself. 

Ah, but that still leaves the Botox: It's so quick and effortless and makes me feel so good. I don't have the willpower to stop, though I do wonder if I've stepped onto the proverbial slippery slope and will find a way to rationalize adding filler to my routine to plump out those hated creases around my mouth. Just another injection, right? 

Then again, maybe I'll resist, because not all slopes must be slid down, and because I can draw lines—I'm a grown-up. Where I draw the line, obviously, will be subjective; it won't be the same as Anne Kreamer's or Peggy Orenstein's or yours or yours, but I'll draw it in the spirit of acknowledging the ambiguity in which we must live. And when my girls are old enough to understand, that's part of the message I'll try to get across. That being able to tolerate warring parts of oneself is better than striving for absolute purity of mind and deed. Also: That looking good can bring enjoyment and excitement to your days—and nights—but it also may feel too necessary, like a mandate or question of survival. That growing old is deeply scary and distressing at times, but other times it feels all right, like something you can handle. And, always, I'll tell them, pretty is as pretty does.



The Fillers of Tomorrow

Currently, fillers are enhancing more than just the lips and cheeks. This year, the FDA approved Restylane Lyft for use on the backs of the hands, making it the only HA dermal filler (Radiesse is also FDA-approved for the hands) to receive approval for an area other than the face. And off-label uses on areas like the earlobes, nose, chin, knees, and even the buttocks prove that fillers are some of the most efficient tools for temporary rejuvenation. On the horizon are more durable options—currently in development are fillers that utilize HA in combination with silk-derived proteins or hydrogels. “Hyaluronic acid hydrogels are obtained by a special cross-linking process of HA molecules,” says Short Hills, NJ facial plastic surgeon Alexander Ovchinsky, MD. “Due to an innovative preparation method, they do not contain any detectable residual cross-linking agent and are easier to inject. These new hydrogels show good stability against enzymatic degradation, which should translate into increased longevity.”

You May Also Like: 2 Rare, But Real, Side Effects Everyone Should Know Before Getting Fillers

But the future is also now—the FDA has recently approved two new fillers doctors can add to their toolboxes. “A group of HA fillers called Teosyal and Teosyal RHA were just approved,” says Dallas dermatologist Elizabeth Bahar Houshmand, MD. “Teosyal can plump lips and address wrinkles, under-eye hollows and scars; while Teosyal RHA is best for the most mobile areas of the face like the cheeks, nasolabial folds and forehead.” Also approved was HA filler Revanesse Versa. “Other HA fillers absorb water after they are injected and can change a bit in the first few weeks, but with Revanesse, what you see at the time of injection is what you get,” Huntington Beach, CA dermatologist David Rayhan, MD says. Dr. Houshmand says it differs in that it uses special cross-linking technology, which, per the company, helps the HA particles stay closer together so they are smoother and rounder. “This results in significantly less swelling, but studies are needed for valid comparison to support this claim.”

There’s really no substitute for the plumping power of dermal fillers, but many filler curious patients are now turning to over-the-counter topicals first. And while there’s no cream or serum that can do what fillers can do, topicals that contain hyaluronic acid can attract water to the skin and cause a very temporary “plumping” effect that gently stretches out fine wrinkles by causing miniscule amounts of tissue swelling. But don’t expect results anywhere close to the immediate rejuvenation effects fillers injections can give. “If on a scale from 1 to 10, fillers are 10, the best results you can achieve from using OTC topicals is a 2 on the same scale,” says Fort Lauderdale, FL dermatologist Dr. Matthew Elias. While the best creams won’t quell the desire for a filler fix, adding them as part of a daily maintenance routine can only improve the skin’s appearance. “Good moisturization can ‘plump’ to decrease, but not resolve, the appearance of fine lines,” Ashburn, VA dermatologist Stephanie Daniel, MD adds. “Look for products with hyaluronic acid, retinoids and antioxidants, as these will work best over time.”



The “Lip Flip” Is the Under-the-Radar, Crazy-Looking Treatment Derms Actually Endorse

When it comes to changing lip shape or achieving a plumper pout, the go-to request that may immediately roll off most patients’ tongue is filler. According to data from the American Society for Aesthetic Plastic Surgery, injections of hyaluronic acid fillers (in the lips and elsewhere) ranked as the second most popular nonsurgical procedure of 2017. But, there’s another under-the-radar option for patients looking to achieve the look of a more voluminous lip, and the technique and product may surprise you: micro-injections of neurotoxin in a treatment doctors call the “lip flip.”

“There are many different techniques for the lip flip, but it’s most commonly done with Botox,” says Fort Lauderdale, FL dermatologist Matthew Elias, MD. During the procedure, a very small amount of neurotoxin (Botox Cosmetic, Dysport, Xeomin) is placed into the muscles around the upper lip. “The procedure weakens the muscle around the mouth that causes lips to turn inward over time,” explains Augusta, GA dermatologist Lauren Ploch, MD. “It’s fairly low-risk but there is the potential of minor bruising or swelling that resolves quickly as with other injections. It’s a great low-cost and low-downtime alternative to fillers.”

You May Also Like: The Fillers of Tomorrow

“It works really well for folks who still have an upper lip that's turned inward toward the gum. It evens the upper lip so you get more lip show without any filler. It's very subtle but needs to be done by a very experienced injector,” adds Brookline, MA dermatologist Papri Sarkar, MD.

The lip flip technique, although unanimously loved by dermatologists we surveyed, has mostly stayed out of consumer awareness. But recently, a variation of the procedure has gained popularity on Instagram, where trending videos of the treatment have garnered hundreds of thousands of views and more than a few enthused responses. As with most medical advice found on social media, however, the learning is the same: 15-second looping videos may be transfixing to watch, but rarely tells the full—or safe—story.

The Instagram version of the lip flip shows a practitioner creating a pattern of controlled injury to the area of the upper lip using a tool called the Plasma IQ pen. This intentional wounding mechanism creates two outcomes: stimulate collagen production to lift the upper border of the lips and shorten the distance between the nose and the lips. Dermatologists, however, are wary about risks of undergoing the treatment, especially when a much safer alternatives—including Botox Cosmetic—can achieve similar results. “The Plasma IQ pen uses ionized gas to shrink tissue by damaging it through thermal energy,” says Dr. Sarkar. “I can see why this works and it should work well on lighter skin, but in darker skin types it is likely to cause hypo or hyperpigmentation (light or dark spots) and if done too aggressively, can cause scarring.”

In addition to the heightened risk of scarring and post-procedure discoloration, Jericho, NY dermatologist Sarika Banker, MD adds that the treatment also takes a while for the effects to show. “Botox would work more quickly than trying to achieve lift via collagen stimulation,” she says.

In addition to Botox Cosmetic, doctors say that there are other proven technologies that can achieve the look of the lip flip. According to Germantown, TN dermatologist Purvisha Patel, MD, the procedure can also be done using CO2 laser and Ultherapy. “A CO2 treatment can create scar tissue to lift the vermilion border. Ultherapy uses heat to thicken the collagen to help lift the vermilion border. Botox, as others have said, also can temporarily cause the vermilion border to flip.”

Bottom line? Consult your board-certified dermatologist or plastic surgeon, not just your Instagram feed, before making any kind of cosmetic medical decision. And don't be surprised if your doctor suggests Botox, instead of filler, to achieve your perfect lip look.

Top Doctors Reveal the Cosmetic Procedures Their Friends and Family Always Ask About

We have our own (very long) list of queries we love asking all-knowing doctors whenever we visit them, but what about those who have unlimited access to their brilliant minds? Their most pressing questions—many of which we'd love to ask ourselves—below.

“My friends are always asking me about Ultherapy. They want to achieve facial and neck tightening without surgery so they can pursue their daily activities without concerns related to recovery or appearing unnatural.” –Washington D.C. dermatologist Tina Alster, MD

“My friends and family ask me about botulinum toxins because they want to see a difference in their wrinkles. They’re also curious about fillers and 'liquid facelifts.’” –West Palm Beach, FL dermatologist Kenneth R. Beer, MD

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“I’m mainly asked about breast augmentation because my friends know it is one of the most common procedures I perform. Their questions are generally about recovery or how I increase the size of the breasts in a very natural, proportional way.” ­­–Grand Rapids, MI plastic surgeon Bradley Bengtson, MD

“Platelet-rich plasma (PRP) injections to the scalp. Ideally, at least three treatments—one every six weeks—should be done, followed by maintenance treatments. This pairs well with marine-based hair supplements like Viviscal and Nutrafol.” – Scottsdale, AZ facial plastic surgeon Kelly Bomer, MD

“I am getting more and more questions about whether platelet-rich plasma (PRP) injections really work to regrow hair (they do!). I also get asked about Emsculpt, a muscle stimulator that burns fat and redefines muscles, especially in the abdomen and buttocks.” ­–Eagan, MN dermatologist Charles E. Crutchfield III, MD

“Right now the hottest procedure I am being asked about is Emsculpt. What was once pure fantasy—nonsurgically and effortlessly donning six-pack abs or firming the derrière without the time, energy or sweat needed to pound it out—is now a reality.” –Chicago facial plastic surgeon Steve Dayan, MD

“One procedure all of my friends ask me about is the IntraGen skin-tightening device. People want a natural way to tighten their lower face, jawline and neck without doing an invasive procedure. IntraGen works on all skin types, males and females, and has no downtime.” –Montclair, NJ dermatologist Jeanine B. Downie, MD

“I get questions like, ‘When is the right time to get my eyes done?’ The answer—although somewhat vague—is that it depends on many factors, including what your concerns are and what you expect from a particular procedure. The solutions can vary.” –Boca Raton, FL oculoplastic surgeon Steven Fagien, MD

“Many of my friends ask about laser resurfacing. They really want to see improvement, particularly in the etched-lines around their mouth, as well as around their eyes, but they are concerned about the downtime. Laser resurfacing is really the right tool for the job!” –Denver dermatologist Joel L. Cohen, MD

“Porcelain veneers. There is still confusion about whether to get crowns, veneers or bleaching to achieve a whiter smile. My advice is to do the most conservative treatment possible and make sure your dentist provides alternatives.” –Atlanta cosmetic dentist Ronald Goldstein, DDS

“Emsculpt. It is the first device in the space that actually builds muscle. It utilizes high-energy electromagnetic energy to cause muscle contractions, which results in muscle growth in the abs and glutes, as well as fat reduction.” –Newport Beach, CA plastic surgeon Sanjay Grover, MD

“When friends and patients ask what they can do to appear more alert and generally happier, I suggest an endoscopic temporal lift as a minimally invasive solution to reversing the droop around the eyes and brow that can make them appear tired or angry.” –New York City facial plastic surgeon Andrew Jacono, MD

“Because I am known to have helped develop the ‘2.0’ version of thread lifting, it is by far the most common procedure I’m asked about. I perform facelifts also, so friends want to know how the two compare.” –Chicago plastic surgeon Julius W. Few, MD

Blepharoplasties. The surgery has evolved into an individually customized procedure that can help smooth the lower eyelid– cheek area. Upper eyelid blepharoplasty can also include a small lifting of the eyebrows.” –Eugene, OR plastic surgeon Mark L. Jewell, MD

“Everyone always wants to know about veneers!” –Beverly Hills cosmetic dentist Laurence R. Rifkin, DDS

“I'm constantly asked about facelifts and CoolSculpting. My friends are curious about how CoolSculpting works and sometimes worry that their results may not end up how they'd imagined, but we’ve never had such an effective fat-removal device!” –Park City Utah plastic surgeon Renato Saltz, MD