These days, going to the doctor for a cosmetic procedure requires navigating an obstacle course of rules—avoid the waiting room, complete paperwork online, and take a temperature check, for starters. And it’s for your own safety, which is, of course, a good thing. However, because the in-person visits can get so tricky, some dermatologists are planning to do several procedures in one visit, both delivering results and minimizing trips to the office.
That’s what New York City board-certified dermatologist Dr. Melissa Kanchanapoomi Levin has planned—she refers to it as “stacking” procedures. (Though she cautions, “There should be a master plan with a cosmetic consultation,” versus just showing up with a plan to get multiple procedures.)
“I am a firm believer in treatment to completion, so it is extremely common for us to use multiple modalities and products to optimize patients’ time in our office,” says Dr. Janet Allenby, a board-certified dermatologist in Delray Beach, Florida. It makes sense, considering that many providers are facing a deluge of patients after months of being closed. So instead of trying to snag several appointments for different procedures, do them all at once. Here are five in-office treatments that pair well together, depending on your concerns.
For lifting: Sculptra + threads
While thread lifts are a quick, nonsurgical option to lift areas of the face, the results are notoriously short-lived—that’s one of the big drawbacks. For that reason, Dr. Allenby likes to pair PDO threads (short for polydioxanone, a material that eventually dissolves in the body) with Sculptra, an injectable filler that spurs collagen growth. Sculptra “optimizes the lifting and longevity of that lift,” she explains, and ultimately serves as an anchor for the threads, thus extending their life span. On top of that, “I use Sculptra to widen the upper face, to improve the inverted triangular shape of youth,” says Dr. Allenby.
For brightening: injectable fillers + IPL
Along with swelling, bruising is one of the most common side effects of injectable filler. Dr. Allenby tries to preempt that by pairing injections with intense pulsed light therapy, or IPL. “I will often use IPL photofacial after filling, to reduce the brown and red pigments of the skin while at the same time reduce the bruising potential, since it clears a bruise quicker,” explains Dr. Allenby. It can be an easy way to ensure a more even skin tone after your visit, however, IPL may not be safe for all skin tones, so it’s best to consult your doctor.
For facial tightening: Ultherapy + hyaluronic acid filler
Facial tightening demand is on the rise, thanks to video meetings. “It’s the whole Zoom phenomenon of seeing yourself at an angle that you’re not used to,” Dr. Levin explains. “So for the jawline, chin, and lower face, tightening has been a more common request.” For a same-day treatment, Dr. Levin pairs Ultherapy with a dermal filler, in that order. “If the patient needs more deep tightening, Ultherapy allows me to get all the way down to the muscle,” she explains. She typically finishes with an injectable hyaluronic acid–based filler, which offers more immediate payoff.
For body tightening: Ultherapy + biostimulatory fillers
When you’re talking about skin laxity on the body, there’s not just one quick fix. It may take a few different treatments to get the best results. “I’ll always assess for fat first,” says Dr. Levin. A certain amount of CoolSculpting, for example, can help the overall result in skin tightening in addition to fat freezing, she says. (One 2014 study found that it may indeed offer an incidental reduction in skin tightening.) That being said, the CoolSculpting would need to be done three months before the combo of Ultherapy and biostimulatory filler (which stimulates greater collagen synthesis compared to hyaluronic acid filler) .
After fat freezing, “I’ll go into either biostimulatory fillers—the main one I use is hyperdiluted Radiesse—and then a skin tightening procedure that relies on heat energy, which is Ultherapy or microfocused ultrasound,” she says. When diluted, Radiesse can create a gel mesh within skin, to offer structure and support to sagging skin. Meanwhile, the Ultherapy jump-starts collagen production at a deeper level. Done in a single visit, the two procedures plump and firm slack skin.
Related: CoolSculpting vs. Emsculpt: What’s The Difference?
For body contouring: CoolSculpting + CoolTone
For the right candidate, pairing cryolipolysis with muscle toning can be a winning move. “Being lean with nice muscle tone is in,” says Dr. Allenby. Both are nonsurgical and involve minimal to no downtime, which makes them a natural pairing. And now might be an especially good time to try them together. “Since these procedures can provide more shape changes than we can ever achieve on our own, it is especially an advantage right now, when it is so difficult to go to a gym, with our COVID restraints,” says Dr. Allenby.
