6 Facial Treatments Doctors Said They Would Never Get

Would you get a facial treatment your doctor would never get themselves?

We usually trust our doctors and listen to their advice on minimally and noninvasive procedures. Reputable dermatologists and plastic surgeons stay up to date on the latest trends and can easily understand when something works or isn’t worth the trouble, depending on potential side effects.

HuffPost spoke to four doctors about the treatments they wouldn’t get themselves and why.

What they are: Injections that add volume to the creases of skin that come down from the corners of the nose to the mouth

Potential side effects: Fillers may change your face shape over time.

Can filler in the nasolabial area make the cheeks look puffy or change your face shape? Dr. Shereene Idriss, a board-certified dermatologist known for commenting on various skin issues and treatments on social media, has warned against injecting filler directly into the pyriform fossa, the hollow just outside the outer corners of the nose, saying repeated injections there could make you “look muzzly and off.”

Dr. Usha Rajagopal, a plastic surgeon and medical director at San Francisco Plastic Surgery and Laser Center, expressed similar concerns. “While nasolabial fillers can create amazing results when done correctly, I’m wary of the potential for migration, which can make the cheeks appear puffy,” she said. “It’s critical to ensure that the provider is well-trained, as improper injection techniques can lead to complications, such as hitting the angular facial artery, which can be devastating.”

On the other hand, Dr. Daniel Friedmann, a board-certified cosmetic dermatologist at Westlake Dermatology, was skeptical that filler could migrate significantly from the nasolabial area.

“For nasolabial filler to move into the cheek, it would have to cross connective tissue and have to do so seemingly against gravity,” he said. “When injected into the cheek, hyaluronic acid filler can spread 3-4 mm in each direction horizontally and 1 mm in each direction vertically, but that’s all. The only filler that has ever been shown to spread and travel considerable distances was liquid silicone, whose use has been (rightfully) taboo for decades.”

“Well-placed filler can make a remarkable difference, and I would do and have done it everywhere except my jawline, lips and nose,” said Dr. Corey L. Hartman, a board-certified dermatologist and founder of Skin Wellness Dermatology in Birmingham, Alabama.

What they are: Facial peels with a high concentration of acids, like high levels of glycolic, TCA, phenol acid and others

Potential side effects: These peels can cause pigmentation and damage to dark skin.

Peels should only be performed by highly experienced doctors. Those with dark skin can experience side effects when using stronger peels.

“I avoid anything that goes beyond the stratum corneum [the uppermost layer of the skin], such as TCA peels (30% concentration) or high glycolic peels,” Rajagopal said. “As a woman of color, I would not be a candidate for intense peels due to the risk of post-inflammatory hyperpigmentation (PIH). While these peels can work wonders for the right patients—such as those with type 1 skin or fair skin with significant wrinkles—they require careful evaluation by an expert.”

What it is: Masseter Botox involves injecting botulinum toxin into the masseter muscle to minimize the jaw pain and grinding of the teeth associated with TMJ disorders, which involve the temporomandibular joint that connects the skull to the teeth. Many people also get this treatment for its face-slimming effects since it makes the muscles around the jaw slimmer.

Potential side effects: jowls, muscle atrophy

“For younger patients with a strong bone structure and collagen, Botox can be a great option for slimming the face. However, after turning 40 and experiencing bone resorption, I wouldn’t recommend it,” said Rajagopal. “For those who truly need Botox for their masseter muscles, we must treat it as a functional issue.”

In such cases, she said, low-dose Botox treatments can be effective. But she said overusing Botox can lead to “muscle atrophy, thinning the face, and accentuating marionette lines.”

“People who already have jowling may have a slight risk of the treatment making their jowls worse, but that would likely only involve older patients, over 50 years old,” Friedmann added.

Dr. Saami Khalifian, a board-certified dermatologist at Som Aesthetics, highlighted the importance of finding a licensed provider when it comes to masseter Botox. “Half of my patients that get masseter Botox are actually getting it for facial-slimming effects, and the other half is getting it directly to treat the temporomandibular joint disorder.”

This type of Botox application can involve a trickier injection technique, so it’s essential to be treated by a licensed provider.

What they are: People who want a more permanent filler solution may pick silicone fillers, which aren’t regulated and can be very dangerous.

Potential side effects: Inflammation, migration, surgery for removal

Khalifian issued a warning about using silicone-based fillers.

“I see a lot of patients in my office who ask me to reverse the filler they’ve had done in other countries. Sadly, a lot of time, it’s a silicone-based filler, which isn’t reversible with hyaluronidase [the product used to dissolve fillers] and requires surgical removal.”

Similarly, he’s not a fan of FDA-approved Bellafill, “which is a PMMA [polymethyl methacrylate, a synthetic resin], and also irreversible. Many patients can react to the product years later, and there is little you can do about it,” Khalifian said.

What it is: There are laser treatments that are suitable for all skin tones, but typically, thermal-based lasers (like CO2) aren’t suitable for dark skin.

Potential side effects: pigmentation or other damage to dark skin

Similarly to intense peels, certain types of laser treatments, usually those that are thermal and ablative, may cause big problems for dark skin. Treatments that use such lasers usually target rejuvenation, hyperpigmentation and wrinkles.

“Intense Pulsed Light (IPL) and Broad Band Light (BBL) are wonderful procedures, but as a heavily melanated person, I would never get them as they are not designed for me,” Hartman said. “These light devices are unable to distinguish between the pigment that needs to go [if treating hyperpigmentation] and the normal pigment in the skin and can do major damage if used in patients with darker skin tones.”

What it is: Essentially, internal stitches are threaded through the skin and pulled up to create a face-lifting effect with minimal downtime.

Potential side effects: Pain, infection

Threads (barbed sutures or PDO), often used for a “fox eyelift” or a mini facelift, are supposed to last six to 12 months, but many people see the product sticking out the sides of their face long after, never fully dissolving, which can cause intense pain, infection and other side effects, according to a few TikTok videos.

Other than that, the lifted effect is short-lived, explained Friedmann. “Thread lifting works very well for only an extremely short period of time since the tissue quickly relaxes. I position them as an adjunct way of building collagen in the skin since that effect will last many orders of magnitude longer than any tightening benefit.”

Rajagopal agreed that extreme caution should be taken when using thread lifts, as the practitioner needs to be highly skilled with a deep knowledge of facial anatomy.

Botox is high on the list of the experts we spoke to: “It changed the game for minimally invasive treatments in dermatology when it was first approved in 1989. The clinical research that has been done to showcase how Botox can be used in aesthetics has proven it a safe and effective treatment,” said Hartman.

“Botulinum toxin and soft-tissue filler injections, when combined, can produce dramatic, cost-effective improvements in the age-related production of facial fine lines and volume loss,” added Friedmann.

“I have been a strong advocate for Botox for over 15 years, and I believe in the importance of using it judiciously,” Rajagopal said.

Another favorite of the experts who spoke to HuffPost is micro-coring, a treatment that removes microscopic plugs of skin for the treatment area to improve firmness, sagging skin and elasticity. “[It’s] another innovative procedure that shows great benefit and can be safely performed on darker skin tones,” said Hartman.

Friedmann likes combining a micro-coring treatment (like Ellacor) with a CO2 resurfacing laser to target muscle contraction lines around the mouth, but, as noted above, the CO2 laser isn’t suitable for dark skin.

Khalifian and Rajagopal love biostimulators like Sculptra. Biostimulators are injectables that help stimulate the skin’s collagen and can last for up to two years. Khalifian also likes to combine biostimulators with lasers and vitamin-packed IVs for their synergistic effect.

“I also believe in skin-tightening devices like Sofwave and Ultherapy to help improve the lower face,” said Hartman.

Remember, before trying any treatment, even noninvasive or minimally invasive ones, it’s important to consult a qualified doctor.

“A thorough examination is essential to determine whether you’re a good candidate and to assess the appropriate depth for treatment. Without this careful evaluation, treatments can potentially be detrimental,” warned Rajagopal. “It’s crucial to use these treatments thoughtfully.”