Today’s cosmetic dermatology patients are all about “prejuvenation.” They want to maintain their youthful good looks by intervening early with minimally invasive procedures and taking good care of their skin. When it comes to procedures, they want natural-looking results with zero downtime, and this is almost entirely possible given the growing array of techniques and technologies currently available, says Dendy Engelman, MD, a dermatologist at Manhattan Dermatology & Cosmetic Surgery and Director of Dermatologic Surgery, Metropolitan Hospital, both in New York City. Here, Dr. Engleman shares more about what her patients want and what is truly possible.

What are the most popular minimally invasive procedures in your practice?

Dendy Engelman, MD: Popular minimally invasive procedures in my office include injectables like neurotoxins and fillers, platelet rich plasma (PRP), microneedling, and lasers.

There are a variety of laser-, light- and energy-based treatments that are effective in numerous ways to improve youth and beauty. They include: ablative laser treatments, non-ablative laser treatments, broad-band light or intense pulsed light (BBL or IPL) and other energy modalities (radio frequency, ultrasound, and thermal energy treatments). Some work better when paired with other technologies. PRP plus Fraxel and PRP plus microneedling, Vanquish (radiofrequency for fat reduction) and EmSculpt (high-intensity focused electromagnetic energy) are popular combinations in my practice.

What trends are you seeing in your cosmetic practice?

Dr. Engelman: We now see younger patients getting regular treatments that are preventing more invasive procedures and surgeries in the long run. The new way of thinking is that if you perform smaller procedures as maintenance you can avoid the need for corrective procedures that usually involve more drastic measures. Realistic expectations must be discussed prior to the procedure. While an invasive procedure may deliver dramatic results, the downtime and pain management can be measured against minimally invasive procedures and their results.

What are your patients’ top concerns?

Dr. Engelman: Signs of aging—wrinkles, textural changes, hyperpigmentation—are some of their biggest concerns. Additionally, I have a lot of patients who are concerned with body contouring. They live healthy lifestyles, eat well, exercise, but still have problem areas. Thankfully, I have many body contouring devices that can target their areas of concern—thighs, abdominal region, love handles, etc.

Is there any new body-contouring device that you are particular excited about?

Dr. Engelman: The newest frontier in this space is a device called EmSculpt that uses electromagnetic energy to decrease the adipose layer and increase the muscular layer. This is the first and only non-invasive muscle and fat body shaping procedure. This has just become available and I am thrilled with the results! It is the equivalent of doing 20,000 crunches in 30 minutes and it only requires four treatments in two weeks to see significant results. It is a painless procedure that has been tested in five clinical studies with measureable results.

What role does skincare have in your practice?

Dr. Engelman: While it depends on the product and ingredients, I am a firm believer in science backed skincare. There are great products available that diminish deep wrinkles and crow’s feet, smooth texture, and boost moisture.