Dr. Schwarzburg Explains Surgical Procedures And Their Minimally Invasive Alternatives

Categories: Miscellaneous
Tags: Agnes RF, Attiva RF, Botox, CoolSculpting, dermal fillers, non-surgical procedures, PDO thread
Differences between surgical vs minimally invasive cosmetic treatments

Cosmetic surgery has been around for decades and hasn’t always had the best reputation. Many of the treatments available to the general public are often still associated with botched surgery outcomes that are mostly the result of the work of an untrained or unskilled professional or outdated surgical procedures that have since been replaced with updated and advanced medical technology, available at clinics such as Skinly Aesthetics.

While there are a number of cosmetic procedures that still require surgical intervention, medical innovations have allowed for a safer and less invasive approach for many cosmetic treatments. These minimally and non-invasive options offer patients and physicians safe alternatives that can accomplish the same results, without the surgery. Dr. Schwarzburg explains these treatments more in-depth to see how they compare to their original surgical counterparts. 


Lip enhancements date back to the early 1900s and started off with what is known as fat grafting or lipofilling. Lip lipofilling is a procedure in which fat is harvested from one part of the body using liposuction, purified, and then re-injected into the lips. Lip lipofilling can lead to uneven and lumpy results that are irreversible unless the fat is surgically removed from the lips.

Today, lip fillers are much safer in that the primary compound used to inject the lips is typically a hyaluronic acid based filler. Hyaluronic acid is naturally produced by the body, making it less likely to result in rejection. It also comes in many different forms, all of which are designed for different areas of injection and results. Hyaluronic acid fillers are dissolvable through the application of hyaluronidase, which reverses its effects.

If you plan on getting hyaluronic acid lip injections, be sure to get them injected by a skilled professional. There are some DIY lip fillers going around, which utilize a needle-free pressurized device to press the filler into your skin. While this may sound appealing, it is actually quite dangerous as described by many medical professionals.

Youthful woman demonstrating the appeal of non-surgical procedures


Butt enhancements have also become increasingly popular over the course of the past 15 years driven largely by social media and celebrities being frank about the aesthetics of their bodies.

One of the most common surgical butt enhancements is a Brazilian Butt Lift (BBL), which uses fat grafting to transfer fat from one part of the body – usually the abdomen, thighs, and arms – to another part of the body, namely, the buttocks. While this sounds ideal, BBL fat transfers have a long list of possible risks and side effects and a 3% mortality rate, making it the most deadly elective cosmetic procedure in the world.

To avoid these risks, many people are opting for non-surgical alternatives: Sculptra, Hyaluronic acid and Radiesse liquid butt lifts. Sculptra (Poly-L-lactic acid), Hyaluronic acid fillers and Radiesse (Calcium Hydroxylapatite) are injectable dermal fillers that are used to increase the size of a patient’s buttocks. Sculptra and Radiesse work by stimulating the body’s own collagen production, which creates volume over a period of 2-4 months, while Hyaluronic acid based fillers expand in soft tissues immediately creating a significant amount of volume, up to 1000 times its original weight. Sculptra and Radiesse are heavily dependent on the patient’s intrinsic response to collagen stimulation.


Surgical facelifts are still common practice, especially among patients with excessive loose skin due to aging or weight loss.

Surgical facelifts involve incisions using a scalpel along the hairline followed by the repositioning of the underlying tissue. The skin and deeper layers of facial tissue (including the muscles) are then lifted while the excess is trimmed away after the lifted skin is repositioned back on the face. The risks and side effects include bleeding, bruising, swelling, possible infection, nerve damage, and asymmetry.

For those interested in a less invasive approach, a few nonsurgical alternatives exist. 

First is a PDO thread lift. A PDO (polydioxanone) thread lift can be used in all the same areas as a traditional facelift and works through the insertion of barbed threads made of the same material as surgical sutures, using a cannula.

Once inserted, the threads are carefully pulled upward along with the skin, as the skin is held in place by the barbs attached to the threads. Risks and side effects include bruising and swelling, puckering of the lifted skin, as well as the possibility of nerve damage if performed incorrectly.

The recovery time from a thread lift was much more tolerable. While the surgical facelift results do last longer, the simplicity of the PDO thread procedure is very appealing. PDO threads are overall better for someone with mild sagging.

Agnes RF and Attiva RF are the newest alternatives to surgical facelifts and involve controlled tissue coagulation at the subdermal level that leads to skin tightening and lifting. Because of the minimally invasive approach there is no recovery, and downtime includes minimal swelling and bruising that can be easily covered with makeup. Both of these RF technologies are comparable to PDO thread lift, but with much-improved safety and downtime profile. 

An even less invasive approach to lift the skin of the face is a liquid facelift. A liquid facelift involves various forms of injectables including neurotoxins (like Botox) and dermal fillers.

Neurotoxins are often used in cosmetic medicine to prevent and eliminate lines and wrinkles in the face. Some of the most commonly injected areas include the frontalis muscle, which forms horizontal forehead lines when contracted, the glabellar complex made of procerus and corrugator muscles located in between the eyebrows, which forms frown lines, also called 11s lines, and the orbicularis oculi muscles around the eyes which contribute to the formation of crow’s feet. Dermal fillers are used to add volume to certain areas of the face to create a fuller, more youthful appearance. The most commonly used dermal fillers for the face are hyaluronic acid based fillers, which is a lubricating polysaccharide naturally produced by the body for smooth gliding along the joints. 

Common areas injected with dermal filler for a liquid nonsurgical facelift include:

  • The under eyes (tear troughs) to eliminate dark circles
  • The cheeks
  • The smile lines (nasolabial folds)
  • The marionette lines (folds that run from the corners of your mouth down your chin
  • The chin
  • The jawline (for definition and reduction in mildly loose skin)
  • The forehead
  • The temples
  • The lips

An additional non-invasive method of skin lifting is Ultrasound therapy, which uses microfocused ultrasound energy to cause controlled thermal coagulation to deeper SMAS layers of the skin. This causes the body to produce collagen rich microscarring, resulting in a lifted and tightened appearance. Collagen, a naturally occurring protein, gives skin its youthfulness, keeping it firm and toned.

For this to work you may need to get several sessions over the course of three to six months, each of which has been described as incredibly painful.

The plus side is that it is non-invasive, meaning that nothing physically punctures the skin. The tool used is a small device that is glided across the skin and emits ultrasound energy which reaches deep layers of the superficial muscular aponeurotic system.


Surgical rhinoplasties are still commonly performed, especially to correct deviated septums or unwanted asymmetry and size.

In surgical rhinoplasties, a physician makes incisions within the nostrils and sometimes across the base of the nose. Depending on the patient’s desired result, the inner bone and cartilage are reshaped using a scalpel and a surgical instrument called an osteotome.

While surgical rhinoplasties are safe and effective, not everyone feels comfortable undergoing surgical procedures, especially with the risk of unwanted permanent results.

For those who don’t have concerns that require surgical intervention, an injectable liquid rhinoplasty may be an option. Injectable rhinoplasties typically are used to contour the nose or even out a bumpy bridge through the injection of hyaluronic acid based dermal fillers, such as Juvederm. While there are other dermal fillers available, hyaluronic acid based fillers are typically preferred in the case that someone wants to reverse the treatment with hyaluronidase.

This procedure offers patients a minimally invasive alternative to surgical rhinoplasty.

When it comes to jaw and chin implants, which are still utilized in some cases, most cases do not warrant the need for a surgical implant when it comes to shaping the jawline. Implants are foreign materials in the body, meaning that they do pose a risk for infection and migration in which case they would have to be surgically removed.

If only minor adjustments need to be made, dermal fillers can be used to add volume and definition to a patient’s chin and jawline. The physician chooses the type of filler to be used on a case-by-case basis but typically the choice lies between a dense hyaluronic acid-based filler or Radiesse. Both types of fillers are safe and typically accepted by the body with minimal risk of side effects or complications. Based on the type of filler used, the results can last anywhere from 6 months to 2 years.


Liposuction is a common method used to eliminate unwanted fat by surgically inserting a tube into the area of concern and virtually sucking the fat out of it. While this does work, the treatment itself is invasive and involves 2 – 4 weeks of post surgical downtime in which you are unable to engage in your typical everyday activities.

Fortunately, medical technology has allowed for a much less invasive alternative: Cryolipolysis.

Cryolipolysis known underthe brand name CoolSculpting is a non-invasive treatment for fat elimination and is derived from the Greek roots (cryo, meaning cold, lipo, meaning fat, and lysis meaning dissolution) and uses advanced freezing technology to freeze fat cells in the treated area without damaging any of the surrounding tissue or skin. Results can be seen within 1 – 2 months since your body requires some time to metabolize the now dead fat cells. Depending on how much fat you start with, you may need anywhere from one to four sessions for your desired result.

In areas with smaller pouches of fat, such as the double chin, there is an injectable alternative to liposuction called Kybella. Kybella is an injectable solution made of deoxycholic acid, a compound naturally produced by the body in the digestive system to break down fat. As a purified version, Kybella is used in areas such as the double chin and other small pouches of fat around the body to break down and eliminate unwanted fatty tissue. 

GLP-1 agonists such as Semaglutide and Tirzepatide have emerged as frontrunners for medical weight loss. They decrease appetite, reduce contractions of the stomach and stabilize insulin levels leading to 15-20% weight loss over a period of 2-5 months. The side effects are minor and infrequently involve minor nausea and constipation. 


There are a lot of minimally invasive cosmetic treatments that can be used to enhance certain features and parts of your body. While some results do require surgical intervention, medical technology has opened many doors to achieve results that were once only possible using surgical methods. Most of the above-mentioned treatments are safe and effective, though some of them do not leave you with permanent results. For most people, however, getting the same minimally invasive treatment every few months is preferred over the longevity and downtime that comes with plastic surgery. As always it is important to choose an experienced and knowledgeable provider who knows anatomical intricacies to deliver the best possible results. Dr. Schwarzburg is one of the leading non-surgical specialists in New York getting your consultation at his private clinic in New York is the first step to a new you!