Posted April 08, 2025 in Bio Stimulator injectables, Botox, Dermal Fillers
A Double Board Certified Plastic Surgeon’s Med Spa Procedures Edition
When it comes to med spa treatments, not all procedures deliver on their promises. Over the years, I’ve seen too many patients disappointed by treatments that fall short of expectations. Evaluating these procedures by their “Worth It” ratings on RealSelf—as well as my own clinical experience—here are the top five I simply cannot recommend:
1. Thread Lift
RealSelf “Worth It” Rating: ~20%
Why I Don’t Recommend It:
Thread lifts are advertised as minimally invasive facelift alternatives, but in reality, they frequently deliver only modest and short-lived improvements. Patients often experience uneven lifts, minimal longevity, and complications that lead to revision procedures. In my experience, the inherent limitations of the technique create a poor risk-to-reward ratio.
2. Kybella
RealSelf “Worth It” Rating: ~35%
Why I Don’t Recommend It:
Kybella is designed to break down submental fat (under the chin) with injections, but outcomes can be unpredictable. Many patients report inconsistent results, including asymmetry and, in rare cases, nerve injury that affects lower lip movement. While some do achieve a slimmer chin profile, overall satisfaction remains low compared to other more reliable techniques.
3. Vampire Facial (PRP Therapy)
RealSelf “Worth It” Rating: ~42%
Why I Don’t Recommend It:
The “Vampire Facial”—which uses your own platelet-rich plasma (PRP) to rejuvenate the skin—is hugely popular on social media. However, its clinical outcomes are highly inconsistent, and many patients find that the dramatic claims are not backed by reliable, long-term improvement. Furthermore, while traditional PRP may seem attractive, it is important to note that alternative treatments such as Platelet-Rich Fibrin (PRF), Platelet-Derived Growth Factor (PDGF), and exosome facials have been shown to deliver more consistent, potent regenerative effects with improved overall outcomes.
4. Non-Surgical Nose Job (Liquid Rhinoplasty)
RealSelf “Worth It” Rating: ~50%
Why I Don’t Recommend It:
Using dermal fillers to reshape the nose might appear to be a quick, non-surgical option, but the results tend to be temporary and often unnatural. Achieving true facial harmony is challenging with fillers, and many patients require frequent touch-ups to maintain their look. The unpredictability and risk of an overdone appearance make the non-surgical approach less appealing compared to a surgical rhinoplasty when looking for lasting results.
5. Ultherapy
RealSelf “Worth It” Rating: ~55%
Why I Don’t Recommend It:
Ultherapy promises skin tightening and lifting using ultrasound technology. Although it is non-invasive and low-risk, the results are frequently modest and vary significantly from patient to patient. Many patients find that the improvements do not justify the cost or the mild discomfort during treatment—especially when compared to other more effective surgical alternatives.
Final Thoughts
In my practice as a double board certified plastic surgeon, patient satisfaction is paramount. These med spa procedures, despite their appealing marketing, often fall short when scrutinized through the lens of real-world “Worth It” ratings on RealSelf and clinical outcomes. If you’re seeking truly transformative and lasting results, it’s crucial to consider all treatment options and consult with a qualified specialist who can design a plan tailored to your unique needs.
Your aesthetic journey is personal—make sure every procedure you choose works in your favor.