Avoiding Facial Volume Loss from Laser/ Radiofrequency Treatments, and Procedures They Can’t Replace

Avoiding Facial Volume Loss from Laser/ Radiofrequency Treatments, and Procedures They Can’t Replace

why did I lose facial volume after laser
radio frequency treatment we are continuously seeing people who are
distressed by facial volume loss after treatment with thermal energy devices
this reflects a growing trend in the aesthetic field I feel that thermal or
skin heating devices such as the various branded laser and radiofrequency
technology are often aggressively promoted as substitutes for surgical
procedures such as facelifts and neck lifts
although these devices can modify the skin through collagen stimulation and
remodeling which can be beneficial for facial aging they are not in any way
replacing surgery I’ve observed the effects of these devices being overused
for people who are not candidates for this type of technology yet these
devices continue to be aggressively and deceptively marketed as alternatives to
surgery in the state of New York people who perform lasers and radio frequency
device procedures do not have to be licensed physicians or nurses this means
that unlicensed individuals can perform procedures which can permanently change
and even damage your skin regardless of who uses these devices improper and
overly aggressive use can cause facial volume loss I’ll discuss the role of
laser or radiofrequency technology in my practice and how you can understand the
indications for this technology so you don’t overcook your skin I’m Dr. Amiya
Prasad. I’m a Board-certified cosmetic surgeon and Fellowship-trained
oculofacial plastic and reconstructive surgeon I’ve been practicing in
Manhattan and Long Island for over 20 years I started using fully a blade of
co2 lasers in the early 1990s since that time I’ve continued to use light and
radio frequency based technology in my practice to help people improve the
appearance of their skin prior to the introduction of the co2 laser the gold
standard for treatment of lines wrinkles and skin discolorations was chemical
peels with chemical peels whether superficial medium or deep there is an
ablation of different levels of skin with regeneration of new skin a certain
amount of collagen was created in response to the peel which then improved
the skin texture quality and color the benefit that co2 lasers have over
chemical peels is a skin tightening effect caused by thermal energy
delivered to the skin by the laser the idea behind laser treatment is to
apply a specific amount of heat from a laser device to cause the skin to
contract and to induce collagen production through a controlled injury
response these principles are relevant when treating the skin which is about
two millimeters in thickness there is a general perception that facial aging
only affects the skin which is why anti-wrinkle creams and skin procedures
are so popular the reality is that facial aging is more significantly
associated with bone loss and weakening with sagging of the supporting soft
tissue in clinical practice I’ve often seen people in their 40s and 50s who
feel that they may need some type of tightening procedure this is because
they pull upwards on the cheeks and show me how they look better the basis for
this perception is that soft tissue volume is being repositioned through
this action and improving the appearance of areas where volume has been lost in
my opinion neither surgical lifting nor heat in
skin-tightening is the optimal approach to this type of situation if there is
volume loss you restore volume however it’s important to restore volume in the
most anatomically beneficial way volume loss is managed by the placement of
injectable fillers in my practice I prefer the hyaluronic acid fillers such
as the Restylane and Juvederm family of products traditional place where the
fillers is within the skin at the level of the dermis or just below the skin I
approach facial volume loss differently since a significant amount of volume
loss is at the bone level I perform a procedure called Structural Volumizing
this method is based on applying the principles used for the placement of
facial implants such as cheek and chin implants these implants are routinely
placed on the bone and below the facial muscles as a surgeon I’ve performed many
of these procedures and I’m familiar with this space I place long lasting
fillers such as Juvederm Ultra Plus or Juvederm Voluma to restore volume at the
cheeks chin and jaw angle this method of restoring volume lost by aging is much
more impactful than any thermal energy procedure once you understand this
principle you’ll recognize why heating up the skin
makes no sense when the underlying issue is the facial bone volume loss for
people who are in their 50s and older sagging of the supporting tissue called
the smash and platysma muscle results in gels and loose neck skin the optimal
procedure for this type of situation is a facelift or face a neck lift surgery
this group of people is particularly susceptible to the false promises of
thermal based non-surgical face lifting in addition at this time of your life
your skin is thinner and the layer of youthful fat under the skin continues to
diminish in my practice I help many people
over the past two decades overcome their fear of facelift surgery by performing
these procedures and my certified office operating facilities under local
anesthesia with light intravenous or IV sedation by avoiding both general
anesthesia and institutional facilities such as hospitals where you can feel
like a number my patients are able to undergo more
definitive surgery with quicker recovery the science behind thermal induced
collagen remodeling as well as thermal induced fat reduction is sound and can
be effective the problem is that people who are looking for a solution for
volume loss and deeper tissue sagging of being sold procedures which don’t
deliver an often result in making you look worse than you did before it is
often the case that after thermal treatment is not successful the
practitioner will often dial up the heat intensity or prolong heat exposure to
the skin excessive use of heat or prolonged exposure to thermal energy
devices can result in loss of fat below the skin a layer of fat under the skin
is important for the appearance of smooth and youthful skin this means that
the treatment makes the skin end up looking older other complications
include skin burns blistering scarring and prolonged redness during
consultation it’s routine for patients to ask me about different devices which
they hear about I suggest to them to first take an overview of the problems
which concern them before determining the options
which suit their needs I take an inside-out approach this means
understanding the presence and extent of one bone volume loss too
soft-tissue volume loss three support tissue and skin sagging and four skin
quality in terms of wrinkling discolorations and vessels based on
understanding of the potential benefits of thermal energy devices in improving
skin thickness and smoothness I developed strategies to achieve these
goals with significantly lower risk we use a variety of lasers in our practice
such as fractional co2 fractional erbium nd AG Q switch as well as radio
frequency devices such as peleve when it comes to aging skin there is usually a
combination of issues such as wrinkles and discolorations if we focus on the
typical objectives of a therapy which is to both stimulate the production of new
collagen and improve the arrangement of the collagen bundles skin looks younger
and thicker and more even than we could look at all the ways these objectives
can be achieved we should also factor in what is the
potential capacity of a person’s skin to produce collagen this capacity to
produce collagen will be limited by factors such as age sun damage smoking
and previous treatments for many people who come in for consultation they’ve
previously had chemical peels lasers and radiofrequency treatments this means
there may be no effect or benefit from thermal energy treatment or even
potential breakdown of the skin’s integrity this is why a proper
examination by a highly experienced physician is important before signing up
for a treatment in my practice I routinely combine technologies to
improve the skin let’s consider a common situation such as skin affected by
chronically excessive sun exposure and aging for the fine lines I use
fractional and fully ablative RB co2 laser for discolorations I use a
q-switched laser for dermal thickening I will use limited heating with long
pulsed erbium as well as nd-yag laser technology the technology used with long
pulsed nd YAG can be used for both skin remodeling and tightening as well as fat
reduction for many patients I will also do a procedure called skin boosting this
is where I combine PRP or platelet-rich plasma combined with hyaluronic acid and
use a device to deposit this mixture directly into the dermis and this is
done without any bleeding or bruising this combination will stimulate the
collagen production and improve the skin without heating many people who come to
our office upset and angry about facial volume loss from overuse of a thermal
energy device performed elsewhere are relieved to have a rejuvenated
appearance by a rational approach from the inside out
most often a combination of structural volumizing with skin boosting and an
epidermal treatments such as hydro facial results in a natural and improved
appearance deceptive and high-pressure marketing in the aesthetic field is not
going away anytime soon the key is to find a doctor you can trust and who you
feel understands your cosmetic concerns to help you look your best I hope you
found this information helpful thank you for your question you

About the Author: Earl Hamill


  1. Thank you dr. Amiya Prasad , my question what your secret to keep your face the same for many years since first show , your never again , I like your show

  2. Is it safe to do micro needling after a laser treatment? How long would you suggest to wait after laser to do microneedling? What frequency is safe and what depth of needle is safe and still effective? Thank you.

  3. Hi Dr Prasad, are you planning to open a clinic in uk? I would love you be your client but you are soooo far away for me.

  4. Hello doctor i hope everything is fine ❤😊 .. im 19 and my hair is thinning where can i have your stem cells injection ??? Im living in middle east at the moment

  5. Hi dr i like u so much ❤is it same to use hyfo after filling under eyes or should i wait ?? Reply plz .from lebanon all of love

  6. dear Dr. kindly advise
    a.what method is more efficient to do vampire prp? Inhectablr or dermapen? it's not on the video's subject but appreciate your reply

    b. with what method could I improve my skin tonus more with colagen to have a more healthy face look.

    thanks in advance!!!!

  7. Hi Doctor thank you so much for the information. I am 21 and I recently developed frowning fine lines.. what is the best treatment for them? Thanks in advance.

  8. thank you for the fantastic video ! what is the device you use to deliver PRP and HA and would it cause any bleeding/bruising?

  9. Awwww now I am disappointed. I was considering an HIFU treatment but now I am not sure. I am a thin woman of 45 years old and I certainly do not want to lose fat from my face. On the contrary, I want more volume!! I don't wish to have surgery, first it's way too expensive for me. Second I am scared of the posible mistakes, side effects and complications of surgery. I was considering fat grafting but you need quite a lot of downtime to heal plus the bruising and side effects as well. I also don't want lumps under my eye area (I saw your video about this) and over filling my face with fat that could be permanent. Fillers are expensive too and not long lasting either. I don't have the money to do this procedure every time they have dissolved. I feel there is no hope for my sagging, loss of volume and wrinkles now 😔 😢 unless I have lots of money and courage. I guess all I can do is keep using my Retina A, vitamin C and dermarolling. You videos are honest, great, informative and helpful. Thanks Dr!

    P. S. I live in Mexico. If I could afford it, I would go see you for an evaluation to help me chose the best option according to my budget and my skin needs.

  10. So a rf device can help stimulate collagen but due to heat also causes fat loss? Also makes me question how heat causes fat loss bc if so than putting a heating pad on my hips should cause fat loss. Or is it the combination of heat and rf that causes fat loss.

  11. Yikes! Interesting! So basically they try to sell you a square peg for a round hole 😝 Thanks for the heads up! 👍😜

  12. I just got an at home heating device that also uses red laser therapy. It says to use 3 times a week no more than 15 minutes. It sounds like your saying that would be too much. Should I return the device? I'm just trying to eliminate crows feet, forehead wrinkles and bags under my eyes. Also are the red laser masks part of the class of device your warning about? Thanks for the education.

  13. Hi, can Fractora in some way replace fract. CO2 when it comes to results for reducing acne scars? Thanks!

  14. Hi Dr. thanks for such a information. Please let me know if Q-switch laser is safe. I am using it for skin texture repair, after acne. I got scheduled with 12 treatments every two weeks taking one. I already had 8. Please let me know if is safe or if u recommend me a better option. Thank you.

  15. Thank you Dr. Prasad! In addition to the solutions you offer in this video do you ever repose the lost fat with facial fat transfers? or is that something you do not do? Thank you! all the best to you!

  16. I am 23 and I lost all the volume I look like a joke and now I see I'll have to go through life with burned, damaged skin

  17. You are such a brilliant doctor, you take all the time to explain things at great length. I hope to see you some day!

  18. For someone only interested in fat loss for specific face areas (with no side effects), would a targeted rf application be a good idea? Thanks in advance 🤗

  19. Hello… I did radio frequency twice and after 1 year I started getting skin depression under my eyes and they have gotten more pronounced in 1 more year… do you know what can be done? I've searched on the internet and only found out about fat grafting. I'm 24 and I look sickly.

  20. Hi doctor, I did Ultherapy twice last year and I feel like my skin is getting thinner and thinner and sagging. 😔 I hope you can give me some advices that how can I restore my skin like before? Thanks a lot!

  21. Why do we see celebrities with bad looking faces due to fillers? Is that because the skin stretches every time and you need a bigger filler that in the long term will end up in sagging even harder ??how many years you can use a filler before it looses its effectiveness?5 years?

    And also what do you think of mini injectables such as Profhilo???

Leave a Reply

Your email address will not be published. Required fields are marked *