How A New Generation Of Doctors Are Using Patients' Own Bodies To Fight Wrinkles And Hair Loss
Wouldn't it be great, these people may be wondering, if there were alternative treatments that tapped the body's own regenerative processes for softer-looking results? Well, good news: The future is now. Functional medicine doctors are bringing their integrative approach to noninvasive aesthetics, harnessing new technology that uses a patient's own biological material (mostly their blood) and other cutting-edge naturally-derived molecules. Most importantly, these practitioners pride themselves on offering a customized experience that delves deeply into their patients' medical history—not merely an assessment of their visual appearance. 'Comprehensive lab work, an analysis of symptoms, and other diagnostic tools allow us to create a plan that meets you where you are to help you live as vibrantly as possible,' says Raheleh Sarbaziha, MD, an integrative aesthetic physician based in Beverly Hills. It's more like visiting your GP than a dermatologist.
Meet the experts: Raheleh Sarbaziha, MD, is an integrative aesthetic physician based in Beverly Hills. Alexander GolBerg, MD, DO, is a double board-certified functional and aesthetic physician in New York City. Nadia Musavvir, ND, is a licensed naturopathic doctor based in Miami. Steven Williams, MD, is a board-certified plastic surgeon in Oakland, CA and the immediate past president of The American Society of Plastic Surgeons (ASPS).
Yes, many of them are still using muscle relaxing injections like botulinum toxin and hyaluronic acid fillers—after all, they're effective in the right hands—but the focus is on addressing the root cause of the visible signs of aging rather than just masking them with surface-level fixes. Some of these treatments—stuff like PRP, PRF, NAD+, exosomes, and peptides—may be familiar to you. Some may feel completely foreign. Either way, we've got a bird's eye view into all of these advancements from the physicians leading the charge.
Meet the new era of undetectable aesthetics.
The guiding philosophy
For the uninitiated, functional medicine, which has been around for decades, is characterized by a merging of traditional Western practices with personalized lifestyle recommendations that may encompass a supplement regimen, an anti-inflammatory diet, and IV therapy to treat everything from vague concerns like low energy and brain fog to conditions as varied as anxiety, depression, autoimmune disorders like lupus, and seasonal allergies. The goal is to address what's happening below the surface, rather than focusing solely on symptoms, by tapping the body's natural healing processes. 'Functional medicine is about regaining function and supporting the body so it can operate at optimal levels during all stages of life,' says Dr. Sarbaziha. And that approach extends to the health and vitality of your skin and hair: It's about treating the body as a single, integrated system and rejuvenating the entire system at the cellular level. Hair loss, for example, isn't viewed as just a scalp issue. The goal of the functional medicine doctor is to identify what's happening inside the body that's causing the shedding. A significant piece of this puzzle is the idea that when your mitochondria—the energy centers of each cell—are firing on all cylinders, your body functions more efficiently, says Alexander GolBerg, MD, DO, a double board-certified functional and aesthetic physician in New York City. 'When the body can produce sufficient energy and heal properly, it also improves skin health,' he says.
Just as important as optimally functioning mitochondria is a healthy gut. 'This is so key because when the gut is healthy, it's reflected in the skin,' says Dr. Sarbaziha. 'When inflammation is low, hair starts to regrow. When hormones are balanced, your mood, energy, and glow return. Everything in the body is connected, part of the same ecosystem.'
The fact that you'll leave these offices looking better is almost a by-product rather than an end goal. 'As we improve and optimize cellular function, we also improve appearance,' says Nadia Musavvir, ND, a licensed naturopathic doctor based in Miami. 'Reducing systemic inflammation, for example, tends to lead to decreased redness and puffiness and a slower rate of collagen breakdown.'
A new approach to aging.
For the most part, traditional cosmetic treatments performed by a dermatologist or plastic surgeon are focused on improving visible changes that have already occurred. They've got it backward, according to functional medicine doctors. 'With traditional anti-aging procedures, the internal reasons for changes in the skin are not addressed,' Dr. Musavvir says. 'I have patients who've done aesthetic procedures, and although they may look younger than their chronological age, their cellular age is older.'
It's a nuance that's not addressed during a routine Botox appointment, but will likely be the focus of a consult with a functional aesthetics doctor. You'll discuss your skin and hair concerns and goals and, after a physical assessment, be bombarded with questions about your medical history, lifestyle, and current skincare routine. From there, baseline blood work, a hormone panel, and nutrient testing will be ordered to devise a unique-to-you treatment plan. 'We're not trying to simply freeze or fill away the signs of aging; we're working with the body to address them internally too,' explains Dr. Sarbaziha.
That's not to say fillers and neurotoxin injections aren't on the menu—they're just typically combined with regenerative treatments like peptides, polynucleotides, exosomes, and platelet-rich plasma and fibrin (PRP and PRF). 'We want to stimulate collagen, improve blood flow, support skin structure, and reduce inflammation, leading to more harmonious, sustainable results that are rooted in good health—not just cosmetic change,' says Dr. Sarbaziha.
It's an approach that's generating buzz, but not everyone is sold—mostly because the science on some of these newer treatments isn't all that solid. 'It's easy for patients and providers to get swept up in claims about miracles,' says Steven Williams, MD, a board-certified plastic surgeon in Oakland, CA and the immediate past president of The American Society of Plastic Surgeons (ASPS). 'While some of these therapies are backed by rigorous science, others are just wishful thinking. It's important to be honest about the limitations."
The functional aesthetics toolkit.
Though every protocol is different, there are a few things that typically pop up in the repertoire of a functional aesthetics provider. These are a few of the most common, all focused on enhancing the health and appearance of the skin and hair.
Platelet-Rich Plasma (PRP) and Platelet-Rich Fibrin (PRF)
Two of the most popular treatments for enhancing the look of skin and improving hair loss are PRP and PRF. The former is so well-substantiated, it's become commonplace in the offices of traditional cosmetic dermatologists across the country—even Dr. Williams is a fan. Both PRP and PRF involve a simple blood draw, which is then spun down to extract the platelets that are injected into the scalp or face to do their job. While they can be done on their own, PRP and PRF are often used along with microneedling and laser tightening to help speed up the healing process.
PRF is considered a second-generation platelet concentrate technology, and research shows it can produce higher levels of tissue-regenerating growth factors that are released in a more prolonged way. While four PRP or PRF treatments are typically recommended to combat hair loss, 'results for thinning can be seen after the second treatment, with hair quality changes normally setting in around the three- to six-month mark,' says Dr. GolBerg.
When it comes to skin, both are known to stimulate collagen and elastin and can be used under the eyes to help brighten and in the cheeks, temples, and nasolabial folds for more fullness. 'PRP floods the tissue with growth factors that signal repair, boost collagen production, and improve skin texture,' says Dr. Williams. 'It's not magic; it's cellular logistics. If you want skin that glows, this is where to start.'
Exosomes
Think of these extracellular vesicles, which can be derived from human stem cells or biomimetic plant material, as tiny shuttles that travel deep into skin where they help cells communicate with one another to stimulate growth and healing. Rich in growth factors, exosomes can be used on the scalp to encourage thicker, healthier hair, or to improve skin quality. For the most part, they're injected (or used topically) alongside microneedling, PRP, or PRF. But note: Exosomes are not FDA-approved, so they remain a somewhat ambiguous area in the world of aesthetics.
NAD+
An abbreviation for nicotinamide adenine dinucleotide, NAD+ is often referred to the ultimate anti-aging IV cocktail remedy. It's a coenzyme that's present in all the cells in our body, and research shows it assists with energy production, DNA repair, and overall cellular health. It also naturally declines with age, which is why functional medicine doctors try to get more into the body in the form of IV drips, topical products, and supplements. The theory goes that 'by optimizing NAD+ levels, cellular health and function are restored, which is reflected by less collagen breakdown, fewer gray hairs, and reduced hair loss,' says Dr. Mussavir.
While many of these therapies are used on their own, another key tenet of the functional aesthetic philosophy is to stack or combine regenerative treatments to produce more dramatic results. Dr. GolBerg's Signature Lift, for example, relies upon a combination of Botox, collagen-stimulating PDO threads, and PRF to sculpt, lift, tighten, and rejuvenate. He insists the results are comparable to a surgical facelift—without the downtime.
The future is bright (and firm).
If any—or all—of this sounds appealing, it's important to find a vetted expert. 'A practitioner who doesn't know what to look for will just recommend the buzziest supplement or treatment and get limited results,' says Dr. Musavvir. That's why it's crucial to find someone qualified, experienced, and educated in functional and aesthetic medicine. Many functional aesthetic therapies are still in their infancy and not FDA approved, so it's important to grill your provider about the science to find someone who uses these treatments responsibly.
And while the crossroads of aesthetic and functional medicine are still being paved, the promise of natural-looking results by less invasive means is appealing—and is changing the way many people look at cosmetic tweaks. 'At the very least, it's clear to me that people want more than just filling, cutting, and freezing,' says Dr. Williams. But, he cautions, buyer beware: 'In a world that thrives on innovation, it's tempting to chase the new thing. But when it comes to your face, stick with what's been proven—people deserve results rooted in evidence, not alchemy."
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"I just felt on top of the world and just so happy that I decided to do it in the first place." Gordon is more than two decades younger than the average blepharoplasty patient, who's typically in their 50s and 60s, according to recent data from the American Society of Plastic Surgeons (ASPS). Still, she isn't an anomaly — Gordon is one of a growing number of women opting for the procedure before turning 30. "A lot of the patients were 30s, 40s, and older. Now, we are seeing more 20s, 30s," said Dr. Pradeep Mettu, a North Carolina-based oculofacial plastic surgeon who specializes in the procedure. "There's no doubt it's shifted to even younger than it was before." Blepharoplasty, or eyelid surgery, is one of the most popular cosmetic procedures in the United States, and it's only becoming more common. 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Filler can run you anywhere from $500 to $1,500 per syringe, and PRP can range from $500 to $2,000 per session of which providers recommend doing at least three. Meanwhile, the average cost of a lower blepharoplasty can be about $5,100 — and it's typically a one-time procedure. In total, Gordon paid $9,500 all-in for her lower blepharoplasty (nearly $900 was for the general anesthesia, under which most surgeons perform the procedure), which she paired with a CO2 laser to tighten and a fat transfer to plump the area — a number that, while high to some, made sense to her. "I was like, 'Oh my gosh, that's a lot of money,'" said Gordon. "But if I were to consider if I did under-eye filler and I would get it touched up once a year for the rest of my life, that, to me, sounded like way more money than doing a surgery." Plus, because the procedure is often done transconjunctivally (meaning the incision is made inside the eyelid), patients typically experience bruising and slight swelling, but no visible scarring, and pain that is often manageable with over-the-counter medications and ice. Immediately after her procedure, besides a haze from the anesthesia, Gordon said she felt "zero pain." "Even the next couple days, I had no pain on my face, which most people are shocked to hear." Most patients are back to work in a week, said Vrcek. "Oftentimes, it's impossible to tell that someone actually had the blepharoplasty," said Chicago-based oculofacial plastic surgeon Dr. Paul Phelps. Lower blepharoplasty's new demographic Vrcek said lower blepharoplasty's popularity has "exploded" in his practice within the past five years. Of the 12 lower blepharoplasties he averages each week, he estimates that half are done on women in their 20s and 30s. Spiegel, a top Boston plastic surgeon, added that he'd seen five patients under the age of 30 for blepharoplasty consultations recently. Mettu said he's seeing a lot more lower-blepharoplasty patients between the ages of 20 and 29 than he has in the past two years — and his youngest is a 20-year-old who traveled to him for this procedure in June. "It is kind of an old-school mindset of, 'This person is too young for surgery,'" said Mettu. "As long as someone's 18 and older, and is cognitively able to have an informed discussion … then I think if they're a good candidate, surgery is reasonable." Lower blepharoplasty's rising popularity is partially thanks to the social media content being posted about it. Gordon's videos on her surgery, for example, have over 7 million views. In 2024, then-28-year-old influencer Madeline White chronicled her experience in several videos, which have garnered almost 14 million views. And since being posted in January, 26-year-old content creator Jas Anahis 's videos about her lower blepharoplasty, done by Mettu, have been viewed over 11 million times. Mettu said he received over 10 consultation requests within 24 hours of Anahis's first video being posted, then more in the weeks that followed. "Many young people didn't realize that lower blepharoplasty was an option for them," he said. "When a popular video comes up, or a transformation video, people see that and they realize what's possible." One of those women was 27-year-old Sugelly Machado. In March, she drove from Connecticut to North Carolina for her lower blepharoplasty with Mettu after coming across Anahis's videos while researching the procedure. "I don't see it as plastic surgery. I just see it as an enhancement." Sugelly Machado, who got a lower blepharoplasty at 27 "I was like, 'I'm getting it,'" Machado said after seeing her video. "There was no doubt in my mind." Machado's eye bags were genetic, and given her age, she knew she didn't want to wait another 20 years to address them. Despite being confident, she said they were her only insecurity. Pre-surgery, she recalls rarely leaving the house without fake lashes or posting on social media without a filter to hide them. "My friends would always be like, 'Oh, your eyes are so puffy,' or 'You look so tired,'" Machado said. "And I'm like, 'I'm not tired. I got eight hours of sleep. I don't know what to tell you.'" Now, three months post-op, Machado has zero regrets. "I can leave the house without putting on makeup," she said. "I genuinely feel beautiful." Machado also shared her blepharoplasty experience on her TikTok account. A video of her before-and-after garnered more than 1.4 million views, and many commenters looked for the details of what she had done. And although she said her goal is never to convince any of her followers to get surgery, sharing the details of her lower blepharoplasty felt different. "I don't see it as plastic surgery," she said. "I just see it as an enhancement." Our eyes matter — a lot The amount of time spent looking at ourselves — in real life and online — is another motivator for these women, said Spiegel. This was the case for 30-year-old Kiana Robinson, who, despite first noticing her "puffy" eye bags back in 2017, hadn't considered surgery until she started working a remote job that required frequent video calls. "I was in a very high-demand job," she said, "and I feel like people were like, 'Are you OK?' 'Have you been crying all night?'" When eye creams and heavy hydration didn't minimize the appearance of her eye bags, Robinson went to Mettu to ask about filler. He suggested lower blepharoplasty instead. She had it done in April. Three months after her surgery, Robinson describes the mental and physical difference as "night and day." "When you see that change, you feel younger," she said. "Perception-wise, you feel healthier." It's no surprise Robinson feels this way — eyes are one of the first areas of the face to show signs of aging. Eye bags rarely shrink with age (or a daily-use serum), and this is especially true for congenital ones, which can worsen with age. "I'm not going to be miserable for 30 years and then determine, 'Maybe I'll look into it," Machado said about her decision to get the procedure in her 20s. "I feel like if the ladies in their 50s had all the resources that we had, they would have done it in their 20s as well." Although younger patients are increasingly showing up for consultations, surgeons note they aren't always agreeing to perform the procedure. "I spend a lot of time telling people, 'You look good, you look normal, you are healthy,'" said Spiegel. "'Ignore what you're seeing online.'" Given the sensitive nature of eyes and their functionality, lower blepharoplasty carries inherent risks — including dry eye and vision changes — which is why surgeons urge prospective patients to do their research. It's also important to rule out potential health issues, like sleep apnea or allergies, which can contribute to prominent eye bags. "People need to be aware that those underlying issues and self-confidence are things that should be worked on in conjunction, and not hanging their whole hat on surgery," Phelps said. Though the procedure has been known to promise long-term results, Phelps also cautions that, as with any surgery, people should be aware of how they're treating their body afterward. For the first two weeks, surgeons typically recommend avoiding strenuous physical activity, alcohol consumption, and makeup. "If you don't take care of your body, you may have a problem with longevity," Phelps said. "But for a person who's taking good care, as they should be, it should last basically forever." Now 29, Gordon is in the midst of planning her 2026 nuptials — an event she is happy to have gotten her surgery done before. "I'm not going to be nervous about my wedding pictures or how my bags look," she said. "Now I'm thinking about a boob job, but that's a different story."
