The hottest trends in plastic surgery and skincare

Dr Shafer returns to discuss the latest developments in cosmetic surgery and skincare

Dr David Shafer is a NYC double board certified plastic surgeon, a Diplomate of the American Board of Plastic Surgery and a Member of the American Society of Plastic Surgeons.

MicroNeedle Technology

One of the most exciting new developments I have seen this year is the innovative MicroNeedle® fine touch™ technology from Aquavit pharmaceuticals. The gold plated needles are finer than a human hair and just a few millimeters long, but the technology allows the doctor to comfortably inject Botox Cosmetic or dermal fillers or customized vitamin solutions into the superficial layers of the skin in a way previously impossible.

As a supplemental treatment to your usual filler to toxin treatments, the MicroNeedle treatment adds a fine touch of product to enhance the radiance and glow of the skin under the eyes, around the mouth and areas where it is extremely important to avoid an overfilled or frozen appearance which can occur with overzealous filler or Botox injections.

A unique application of the MicroNeedle technology is the use of pre-formulated or customized vitamin solutions to enhance your skin’s health. Whether B complex, multivitamin or even mesotherapy treatments, the quick and painless system allows direct application of nutrients to your skin. Through Aquavit, we have created specialized formulations for skin rejuvenation, skin health and anti-aging, and are in the process of developing more advanced testing systems to tailor individual formulations to each patient based on specialized testing.

For my patients, the treatments target their fine lines, combat the oxidizing effects of the environment and promote rejuvenation. The most common area of treatment is the face. However, other areas of treatment include the neck, back and hands.

Hand Rejuvenation

A telltale sign of aging is a patient’s hands. While much attention is often given to rejuvenating one’s face, the hands are frequently neglected or ignored at the plastic surgeon’s office. However, many of the same treatments used to rejuvenate, resurface and volumize the face can also be used in the hands.

Hand volume loss is important as a person ages. The loss of volume reveals unsightly veins, tendons and bones, aging the hand well beyond the rest of the body. Quick and simple treatments normally used in the face for volumizing can easily be applied in the hands. Dermal fillers such as Juvederm®, Radiesse® and Sculptra® are offthe- shelf fillers that quickly, but temporarily restore volume and help camouflage the underlying structures of the hands.

A longer-term solution is fat grafting. In this procedure, fat cells are harvested through a mini-liposuction procedure from elsewhere in the body. The fat cells are then processed in a centrifuge to concentrate and purify the cells before they are injected into the hands. These living cells are then incorporated into the subcutaneous tissue of the hands and maintain volumes for years if not permanently. The hands are just as susceptible to the environmental effects of the sun and oxidation as the rest of the body.

Long-term exposure results in wrinkles and age spots. Resurfacing procures can help restore a smooth and youthful glow. The easiest and least expensive treatments are chemical peels, just as one would use on their face. The chemical exfoliation helps remove the outer layers of the skin and promote new fresh skin below.

For deeper, more intense treatments, laser resurfacing or IPL can penetrate to the deeper layers for a longer lasting effect. Age spots and other discolorations are similarly treated. I have found our V Beam Perfect Pulsed Dye Laser to be particularly effective on age spots on the hands and arms


Another question I often get from patients before I perform a facelift is if I can do anything to help their earlobes. Earlobe repair is common in the younger population from heavy earrings pulling through the skin or from other issues related to piercings.

However, as one ages, the skin of the earlobe loosens and the volume recedes just as it does in the rest of the face. The resulting wrinkled, deflated earlobes compound to the aged look of the face and do not support the weight of even modest earrings. In patients requiring earlobe rejuvenation, I assess both skin redundancy and volume depletion. For patients with only volume depletion, quick and simple treatment is dermal filler injections.

My preferred treatment is Juvederm – usually half a syringe in each ear lobe gives a nice result. However, if a patient is going to be under anesthesia for any reason, such as a facelift, then I would suggest fat grafting. During the surgery, 1 cc of fat would be injected into each earlobe at the completion of the procedure. The added volume is the icing on the cake, giving the patient the perfect final touch of rejuvenation.

For patients with redundant skin, a minor procedure can be performed in the office under local anesthesia. During this procedure, the excess skin is removed and volume added as described previously at the same time.