Are These ‘Low-Downtime’ Treatments Worth It? A Plastic Surgeon’s POV
Minimally invasive aesthetic treatments are tempting! Less downtime, lower cost, and the promise of results without major commitment. Who wouldn’t want that? Sign me up!! …Well, not so fast. Let’s take a closer look at some popular “less-invasive” treatments and why I, as a plastic surgeon, would not get them or recommend them to my close friends or family.
1. Thread Lifts
What it is: A nonsurgical alternative to a facelift. Absorbable sutures are placed through small incisions under the skin to “lift” the face.
Why I don’t love it: Thread lifts can create an unnatural pulling in the face, and in some cases, the sutures can even become visible. Results are minimal and temporary, usually lasting less than a year. You may read that threads stimulate collagen production which can lead to tightening, but aging is a complicated, multifactorial process that is not comprehensively or powerfully addressed with “threads” alone. It's kind of like trying to fly from Indy to NYC in a paper airplane… It just won’t get the job done!
2. Sculptra
What it is: Sculptra is a “collagen stimulator,” not a traditional hyaluronic acid filler. It’s made from poly-L-lactic acid (PLLA) and works by encouraging your body to produce collagen over time which is why it’s often referred to as being more “natural.”
Why I don’t love it: I’ve unfortunately seen real complications, even when it’s used appropriately. Improper dilution (rare, but I’ve seen it) can cause firm nodules that are tough to treat. I’ve also seen patients experience swelling that can be prolonged and refractory to treatment.
The “natural” marketing around Sculptra is tempting. I almost got it myself a few years ago! But in some patients (not all), it leads to sandy deposits and scarring that can make future surgery, especially facelifts, very challenging. Not worth the risk, in my opinion.
3. Filler: Proceed with Caution, Especially Under the Eyes
What it is: Fillers are used to restore volume in areas like the lips, cheeks, and under the eyes. Most fillers are hyaluronic acid-based, which means they’re similar to, but not the same as, the hyaluronic acid your body naturally makes. They’re also hydrophilic (“water-loving”), which can make them prone to swelling as they draw in more water than your natural hyaluronic acid.
Why I don’t love it: The hydrophilic nature of these fillers can lead to a plumping effect, but it can also cause problems—particularly swelling. I’ve heard too many patients say, “I wish I had never gotten under-eye filler.” This area is sensitive, the skin is thin, and the lymphatic drainage system can be easily affected. That can lead to puffiness or increased visibility of the filler, even after it's been dissolved. And sometimes, that puffiness doesn’t fully go away. If you do choose to have under-eye filler, choose an experienced injector who respects the challenges of this anatomic area.
I’ve had lip filler done (conservatively!), but I’ve chosen to steer clear of cheek and under-eye filler for myself. Cheek filler can be a great option for the right patient and is something I enjoy offering—but personally, I’m holding out for a surgical fat transfer to add a little volume to my cheeks using my own fat.
4. Facial Radiofrequency Tightening (FaceTite)
What it is:
FaceTite is a device with two probes—one sits on the surface of the skin, and the other travels just underneath it. Radiofrequency energy is delivered between the two, producing heat that destroys fat cells and (in theory) tightens the overlying skin while boosting collagen production.
Why I don’t love it:
There aren’t many great candidates for this treatment, especially when it comes to the face. Most patients with visible signs of aging have concerns that go beyond what radiofrequency alone can fix. For patients with looser skin, the results tend to be minimal.
The results just aren’t that impressive. I recently saw a patient who tried FaceTite, didn’t love the outcome, and ended up choosing surgery about six months later. My honest take? Save your money for a treatment that delivers more powerful, long-lasting results.
It can create a lot of internal scarring, which makes future surgery more difficult. If there’s even a small chance you’ll want surgery down the road, this treatment can complicate things more than it helps.
5. Energy-Based Liposuction (VASER, Renuvion)
What it is: Traditional liposuction uses suction to remove fat. SAFELiposuction, the technique I was trained in, has allowed traditional liposuction to have, you guessed it, safer and better outcomes. SAFELiposuction has done this without adding an additional energy source to traditional liposuction. Energy-based devices like VASER (which uses ultrasound) and Renuvion (which combines radiofrequency with helium plasma) have been introduced as add-ons, or standalone treatments, with the promise of extra skin tightening alongside fat removal.
Why I don’t love it: These methods can lead to contour irregularities or deformities (think: visible unevenness in the skin and fat) and cause internal scarring. That scarring can make future secondary or corrective procedures more difficult, more expensive, and riskier overall.
In my experience, skin tightening can be achieved beautifully with SAFELipo, without the added complications that these energy-based devices can bring.
Want to learn more? I talk about this in my SAFELipo blog post.
So, What Do I Recommend?
Don’t get me wrong—I’m not anti-all minimally invasive treatments. I’m a fan of neurotoxins, I love conservative filler in the right setting, and you’ll never hear me stop talking about sunscreen and skincare.
But my TLDR? Be just as thoughtful about minimally invasive treatments as you would be about surgery. “Less invasive” doesn’t always mean lower risk or better long-term outcomes. Some of these treatments can cause permanent changes, scarring, or make future surgery more complicated.
And if your gut is telling you that your aesthetic goals might need surgery? You deserve a consult that actually helps you make that call.
P.S. If you want to read more, this Allure article offers a great take on injectables and their effects on future facelifts.
To learn more about personalized options for your aesthetic goals, book your consultation with Dr. Meredith Kugar, today.
