Botox, fillers: Inside the new ‘no-knife’ cosmetic surgery center on New York’s Billionaires’ Row

Cosmetic procedures have mixed reputations. And how they’re depicted on TV to TikTok tends to cloud what many people still think surgery is like: lots of cuts and incisions with a knife, weeks of bruising under a mummy-like exterior of bandages, and a painful, isolated recovery. 

But those days are nearly gone thanks to a variety of emerging energy-focused devices and skilled techniques. And these new, non-invasive procedures are not only FDA-approved but growing in awareness and popularity.

Toning and sculpting on the abdomen are on the vanguard of this movement, starting with EMSculpt, a body-contouring treatment that generates 20,000 muscle contractions in 30 minutes. Through a combination of radiofrequency energy and HIFEM (highly focused electromagnetic energy), the procedure is touted to simultaneously destroy fat, build muscle, and tighten skin. 

But non-invasive procedures on the face are more—pardon the pun—on the cutting edge. As popularized at Dr. Darren Smith’s plastic surgery and medical spa on the so-called “Billionaires’ Row” in Midtown Manhattan, get ready for the “Good Energy Lift.”

Smith, who has had his practice for five years and counting, says he been laser-focused on providing the most optimum results for any patient need—without necessarily going under the knife.

“We wanted to build something that would be patient-centric,” Smith says. “We really feel like we can help anybody deal with whatever they want to deal with.”

Dr. Smith’s med spa is seeing an uptick for what he’s dubbing the ‘Good Energy Lift,’ procedures, surgery using lasers and energy rather than the traditional scalpel-centric methods.

Courtesy of Darren Smith, MD

A few of his go-to devices are FaceTite and BodyTite (bipolar radiofrequency energy that tightens and firms skin while removing unwanted fat) as well as VASERlipo (pairs traditional liposuction with an energy source to enhance the results of liposuction). With these two or three energy-based treatments alone, Smith can perform neck lifts, ab lifts, blepharoplasties (eyelid lifts), and more.  

As Smith describes, the differences between traditional plastic surgery techniques and using energy-based devices can achieve the same aesthetic goals, yield the same (if not better) results that last longer at the same price points (though still very expensive price points, which can ring up for thousands of dollars per session, depending on the targeted area and service over time.)

“What we’re doing, some of it I’m calling it ‘minimally invasive’ and ‘non-invasive,’ instead of a face-lift or neck-lift—this big thing with two weeks of recovery,” Smith explains. Now, with literally two- to three-millimeter punctures, we can get an energy device under the skin that will make skin shrink in a very real way. You can’t get a face-lift result like that. But you can make a real change for somebody with 48 hours of downtime and a third of the cost instead of two weeks of downtime and triple the cost—and for a lot of busy New Yorkers that don’t want to take two weeks out of their crazy lives.”

On average, Emsculpt Neo can decrease fat volume on a patient by 30% and increases muscle volume by 25%.

Courtesy of Darren Smith, MD

Smith highlights the differences between these procedures versus more popular and well-known outpatient services, like Botox and Juvederm fillers (both of which are also offered at the med-spa). With Botox, for example, there is minimal downtime (if any so long as there isn’t an adverse reaction) but the results only last for a few months. And while a face-lift could dial back someone’s appearance by 10 to 15 years, Smith points out not everyone wants that drastic a change. Instead, using FaceTite presents a slightly more natural reduction around five years.

Smith, who is a cranial facial surgeon in addition to being an aesthetic surgeon, prides himself on performing natural facelift results, shying away from some of the face and body trends that are so prevalent (and often harmful) on social media.

“We’re very into doing this stuff because you [the patient] want to do it, and there’s something that you wish could be a little different. It’s it should be like icing on the cake. I never want anybody to feel like they have to look like Kylie [Jenner],” Smith says. “If you want to look a little refreshed, maybe you’re bothered by a bump on your nose, whatever. But it should be you’re doing it for you—not because you’re part of this race. That’s something we take pretty seriously.”

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