Non-surgical solutions for body rejuvenation

Just as we can make improvements to the face, neck, and decolletage, there are several non-surgical options for cosmetic improvements to the body.  Whether it’s wrinkles, laxity, hyperpigmentation, scars, unwanted fat, stretch marks, visible blood vessels, or cellulite, there’s a non-invasive treatment to address it.  There are many aspects of the body that people seek to improve, so I’m going to outline each modality, and for each one list the parts of the body it’s suited for treating.


Photo Credit: Getty Images

Do you have stubborn fat deposits that won’t budge no matter how much you diet or exercise? CoolSculpt is a versatile treatment to sculpt the body by eliminating unwanted bulges.

The scientific name for this procedure is cryolipolysis. Cryolipolysis is the process of causing irreversible damage to fat cells by freezing them. Fat cells are more susceptible to the effects of cold than other cells (like our skin cells). The damaged fat cells die, are metabolized and eventually eliminated by the body as waste.

CoolSculpt is FDA approved for the abdomen, “love handles,” thighs, “bra fat,” back fat, under the butt, upper arms, and double chins; but can target almost any bulge that has enough fat for the applicator to adhere to.  It’s recommended for people close to their ideal weight with stubborn fat deposits.

Photo credit: Dr. Gerald Pierone Jr., Patient before and After CoolSculpt treatment
Photo credit: Dr. Gerald Pierone Jr., Patient before and After CoolSculpt treatment

During treatment, a vacuum-like applicator uses suction to target fat cells. Cooling plates bring the temperature of the fat cells down just low enough to damage them. Patients experience a cold sensation for about five minutes, followed by numbness. Most areas require 40-60 minutes of cooling. You can return to work or your regular routine immediately after treatment. Improvement to the treated area becomes noticeable after a few weeks, but full results appear after about three months.  A 20-30% reduction of fat is typical with one treatment.


Kybella is a fat-dissolving injection made from a synthetic version of deoxycholic acid, a salt found in human bile that aids in digesting fat. It breaks down fat cells by destroying the cell membrane. When injected into subcutaneous fat, Kybella dissolves it, so it can be cleared from the body. The unwanted fat is broken down and excreted by the body as waste over the course of several weeks.

Kybella is approved for use underneath the chin, but many practitioners use it “off label” in other areas where fat accumulates. It can be used for the abdomen, “love handles,” outer thighs, back fat, bra bulges, armpit fat, upper knee fat, and the fatty folds under the butt.

“Off-label” use of a product refers to when a product is used in a manner beyond what it was approved for. For example, Botox is a drug that’s successfully used off-label in the treatment of many things, including excessive sweating.

The ideal patient should be close to their ideal body weight and concerned with a small area of excess fat  they can’t eliminate through diet and exercise. A series of treatments is recommended, usually at four to six-week intervals.

After Kybella injections, swelling is normal for about 48 hours. The recovery process is minimal, especially when compared to the surgical alternative (liposuction).

Photo credit: One Aesthetics, Winter Park. Before and after two Kybella treatments
Treating “banana rolls” with Kybella. Kybella is injected into multiple points across the area.



Ultherapy encourages fibroblasts to make healthy new collagen by way of focused ultrasound energy. It delivers this energy to the foundational layer of the skin without cutting or disturbing the skin’s surface. The result is tighter, lifted skin.

The treatment can be slightly uncomfortable, so an over-the-counter anti-inflammatory can be taken beforehand. The sensation is brief and indicates that collagen-boosting energy is being delivered.

The practitioner places the Ultherapy applicator against the skin, and ultrasound imaging guides them in delivering the energy into the tissue below. Depending on the area treated, Ultherapy takes about 30-90 minutes.

After the procedure, you can return to your everyday activities with possibly some temporary redness or mild swelling. Very rarely patients will have slight bruising or fleeting numbness in treated areas.

The full results of Ultherapy become visible 2-3 months after treatment as new collagen forms and begins to lift and tighten the skin. Ultherapy is often combined with microneedling or PDO threads for enhanced results.


Photo credit: Dr. Gerald Pierone Jr., Before and after 3 Ultherapy and three microneedling treatments


Microneedling is sometimes referred to as “collagen induction therapy.” It improves acne scars, wrinkles, enlarged pores, stretch marks, and tightens lax skin. In clinical studies, patients rated their skin as 60-80% improved following a series of microneedling treatments. It can be used anywhere on the body you want to improve the overall quality and appearance of the skin.

The way microneedling stimulates collagen is by causing minuscule and controlled injury to the skin to activate the wound healing response.

Photo credit: NY Daily News

After numbing cream is applied, the practitioner uses a device that looks like a pen to create hundreds of tiny “micro-channels” in the skin.  “Micro-channels” is a fancy way of describing itty-bitty needle-holes. In other words, you are systematically pricked all over the treatment area by teeny, little needles. Though it sounds like it might be painful, it’s not, and some even report that it tickles. The tiny pricks in the skin activate the body’s healing process, leading to the regeneration of fresh, healthy skin. Plus, as each tiny hole heals, there is a subtle tightening effect that occurs.

Applying PRP or growth factors after microneedling will give a boost to results. Thanks to the micro-channels created, active ingredients can penetrate layers of the skin they couldn’t ordinarily reach.

There is no real downtime with microneedling. You may be a bit pink or swollen after a session, but most see their skin return to normal within 24 hours. Microneedling can be combined with other collagen building treatments like Ultherapy for enhanced results.


Photo Credit: Dr. Gerald Pierone, Jr., Before microneedling (stretch marks)
Photo credit: Dr. Gerald Pierone Jr., After microneedling (stretch marks)

PDO Threads

Polydioxanone (PDO) is an absorbable material that’s been used for years in cardiothoracic surgery. It’s one of the safest materials that can be implanted in the body. PDO gets absorbed by the body in 4 to 6 months, leaving behind no scar tissue.

Different types of threads have different uses. Smooth threads are injected in a net or mesh formation and can be used anywhere on the body where the skin is thin or lax. (Watch a video that shows the injection of smooth threads in this post.) PDO threads are preloaded into a hypodermic needle. Your injector will make you numb before inserting the needle into the skin. As the needle is removed, the thread stays behind.

The presence of the threads initiates the healing response. As the skin heals around the threads, it creates new collagen, causing lax skin to become more plump, resilient and tight.

Photo credit: Dr. Gerald Pierone Jr., Before and after both smooth and suspensory threads to improve “bat wings.”
Photo credit: Dr. Gerald Pierone Jr., Before and after suspensory threads to lift the breasts

The other type of PDO thread is the suspensory thread. These threads have tiny barbs on them that provide lift. (See suspensory threads in action in this post,) Suspensory threads work well to lift things that sag like the upper arms, breasts or butts.

The thread acts as scaffolding, holding things in place while your skin repairs and rebuilds. Once the “scaffolding” dissolves, the underlying tissue has repaired itself to keep the re-positioned skin in place on its own. Think of how dissolvable stitches hold a wound closed. Once they dissolve, the wound has healed shut. That healed wound is an example of your skin producing extra collagen.

Close up view of a “barbed” thread

Collagen takes up to six months to grow, so the results from your PDO thread treatment gradually get better and better with time. Restrictions will vary depending on where you’ve had threads injected. You should avoid any strenuous exercise, but you’ll be fine to go about most other daily activities. Your injector will give instructions specific to your treatment area.


The Aerolase laser is FDA approved for a vast array of concerns. It’s commonly used on the body to improve visible blood vessels, cherry angiomas (red moles), acne, scars, hyperpigmentation, toe fungus, warts, lax skin, wrinkles, and to remove unwanted hair. The Aerolase is the perfect complement to many other treatments to take your results to the next level.

A series of 6 treatments is recommended; one a month for six months, ideally. Specific issues like visible veins may require as many as eight sessions to correct.


Photo credit: Aerolase (visible blood vessels)
Photo credit: Aerolase (cherry angiomas)
Photo credit: Aerolase (visible blood vessels)
Photo credit: Aerolase (Skin rejuvenation/tightening)

The Aerolase works on all skin tones. It’s the safest laser in the industry for darker or tan skin. It’s also the most comfortable laser treatment on the market. It features a quick 650-microsecond pulse that allows the skin to cool between pulses. It never becomes hot or uncomfortable.

Following an Aerolase treatment, you can return to your normal daily activities. At most your skin will be a little pink temporarily. Some results are immediately visible, while others can take time to develop (like the growth of new collagen to tighten and firm skin). Check out this post for my experience with the Aerolase.



Sculptra encourages natural collagen production to restore and increase volume. It’s often used to help gradually fill out and plump areas of the face, but it’s not your standard dermal filler. It adds volume by stimulating collagen, so results aren’t immediately visible like with dermal fillers.  It’s sometimes called a “volumizer.” The gradual results you see are your own pumped-up collagen.

Surgical procedures to enhance the backside have become very popular. Sculptra offers a non-surgical alternative to this trend. In addition to adding volume to the backside, the increased fullness brought about by Sculptra fills out any dimpled areas. If you’re not looking for a bigger booty, you may still benefit from some conservatively placed Sculptra to smooth cellulite. There is no real downtime after getting Sculptra injections but remember that results take some time to become noticeable: Usually around four to six months.


Photo credit: (Before and after Sculptra)

Just about any part of the body can be improved with non-surgical techniques. Here’s a before and after of Sculptra treatment to the knees. Lax skin of the knees can also be treated with Ultherapy or threads. The “after” image is the result of increased collagen, which can be achieved through many of the methods outlined in this post. Your provider will recommend the best treatment for your specific concerns.

Photo credit: (Before and after Sculptra to knees)


Are there any aspects of your body that you’d consider seeking non-surgical treatment for? If there’s something specific I haven’t covered in this post, or you have a question, leave me a comment or send me an email.

Stay tuned for March when I’ll write about treating hyperpigmentation and scars–including acne scars. And I also plan to write about acne and its treatment. Subscribe to receive a reminder for these posts!

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