Board-certified Alexander Zuriarrain, MD, FACS, says demand up for improved looks; offers tips.

Advancements in aesthetic plastic surgery, such as microneedling and intense pulsed light therapy, are enhancing the safety and efficacy of skin rejuvenation and facial, neck, and body contouring, according to Alexander Zuriarrain, MD, FACS, a board-certified plastic surgeon and owner of Zuri Plastic Surgery in Miami.

Particularly noteworthy are the recent development of two new aesthetic procedural system—Morpheus8, which combines adjustable radiofrequency with microneedling, and the Lumecca Intense Pulsed Light Therapy workstation. “Their names may sound interstellar, but they are down-to-earth, advanced technologies, enabling surgeons to achieve far-better cosmetic results,” says Zuriarrain.

“We have become a nation obsessed with aging backwards by restoring the youthful structure and luster of our skin. Improved, energy-based technologies—such as the laser; high intensity light, microwave, and ultrasound; and radiofrequency—are quickly gaining popularity as minimally invasive cosmetic tools for tightening skin, reducing adipose (fat) tissue, smoothing out wrinkles, and eliminating unsightly skin blotches, marks, and hyperpigmentation,” Zuriarrain adds.

Experts note that systems like the Morpheus8 and Lumecca Pulsed Light Therapy—both manufactured by InMode—employ, and, in some cases, combine several of the newest cosmetic approaches while giving plastic and aesthetic surgeons much greater precision and control during procedures.

For example, the Morpheus8 offers microneedling with radiofrequency that can be customized and adjusted to various depths of skin penetration in order to achieve maximum results, Zuriarrain explains. “Unlike some of the other technologies, the Morpheus8 also can be used on the face, neck, and body, and is effective for all skin types and tones,” he adds.

Microneedling strengthens the skin’s underlying structure by pricking the skin using small needles and stimulating production of collagen, elastin, and skin tissue cells, Zuriarrain explains. Radiofrequency (RF), on the other hand, tightens skin “by thermal healing of the reticular dermis” (area that cannot be reached by microneedling), thus “triggering a healing cascade [that] leads to collagen formation,” say authors of a 2019 article in the Aesthetic Surgery Journal. In fact, radiofrequency has “evolved to meet rising demand” and its use for cosmetic purposes is increasing at the rate of about 10% a year, these scientists contend. 

Physicians writing in an August 2022 issue of the Journal of Cosmetic Dermatology conclude “the adjustable depth and microneedle pin configurations available with the InMode Morpheus8 allow clinicians to address varied tissue targets and regions of concern on the face. The ease of use for practitioners, minimal post-treatment recovery time, and enduring results make fractional RF microneedling an increasingly attractive option for patients desiring minimally invasive options.”

Meanwhile, Zuriarrain describes the intense pulsed light therapy, or photothermolysis, generated by the Lumecca system, as “quite effective” for removing age spots; hyperpigmentation and pigmented lesions like spider veins, port-wine stains, and vascular lesions; rosacea; and for repairing sun-damaged areas of skin. The technology works best on skin of lighter tones, he says.

Zuriarrain calls the demand for minimally invasive cosmetic procedures using the Morpheus8 and similar tools “unprecedented.” He says the demand is particularly pronounced among younger adults who want to avoid the downtime and scarring risks of traditional surgeries or who are not candidates for surgery, such as patients with recurrent skin laxity issues.

Building self-confidence, looking younger, and improving appearance for video calls and Zoom meetings are among the key reasons for seeking cosmetic procedures. Zuriarrain’s experience is that patients over age 45 are the ones most likely to request facelifts and eyelid surgery, while those under 30 oftentimes are requesting lip augmentation.

Tried-and-True Tips

Zuriarrain advises fellow plastic surgeons to follow these tips when consulting prospective patients:

  • Ask patients to carefully consider why they want to undergo aesthetic surgery, or facial, neck, or body modeling and contouring. What they hope to accomplish? After all, cosmetic or plastic surgeons should first determine whether the patient’s goal is even achievable.
  • Remind patients to keep their expectations low—or, at least, reasonable. After all, cosmetic procedures can achieve highly desirable results but are not miraculous. Years of aging and sun damage cannot be undone in a few aesthetic surgery sessions, no matter how high-tech the surgeon’s tools.
  • Tell patients to protect their skin in the days and weeks following cosmetic procedures, such as limiting sun exposure.
  • Encourage patients to follow a healthy lifestyle—such as eating nutritiously, exercising, and avoiding smoking and excess alcohol.”

“Finally,” [patients should] understand that nothing is forever. No matter how great the results of any cosmetic procedure, the aging process will continue to do its work and eventually the skin they’ve had smoothed and tightened will wrinkle, sag, and even develop age spots and blotches again,” Zuriarrain says.