Aesthetic practitioners see patients at many stages of adult life, but one group of patients may come in with a shorter timeline and increased stress to address what they see as flaws. Brides-to-be have a laundry list of tasks to complete leading up to their wedding days, and while some may be more proactive than others, aesthetic treatments can contribute to boosting their confidence.
Modern Aesthetics spoke with Kay Durairaj, MD, FACS; Azza Halim, MD, MS; Anna Avaliani, MD; and Kim Nichols, MD, FAAD, to discuss their approaches when preparing brides for their special day.
What is the ideal timeline to attain maximum results when treating brides-to-be?
Dr. Halim: Most brides start preparing 12 months prior to their wedding day, but then I’ve had brides who have come in with only a month or 2 until the wedding.
I customize every single patient. I focus on skin health, because at the end of the day, we want a flawless foundation when they’re getting their makeup done. I do a proper skin analysis, skin imaging, and 3D imaging as well because that allows me to look at the pores, pigmentation, photo damage, hydration, and any kind of rosacea or vascularity. I start them off on a skincare routine that they’re going to live by through their wedding and after.
I take functional medicine into consideration with a general wellness review. Lifestyle and dietary habits play a vital role in overall wellness leading up to their wedding day. I go through the full gamut: I assess the hair, scalp, skin, diet/nutrition, lifestyle, and stress. We know the gut microbiome is going to affect your skin health. It’s also going to affect how healthy and glowing your skin is. This is where diet comes in. Sleep—or sleep deprivation—can affect cortisol levels. Cortisol is also very important because we need to get that under control.
What is the initial process when a bride comes in questioning what they need to do to prepare their skin for their wedding?
Dr. Nichols: The first thing I do is a customized, full-facial analysis. I take all their wants, needs, and information into consideration. The most important factor when it comes to a bride’s treatment plan is the timeline. How long do we have until the wedding? We have brides who book the venue and then call us, but we also have brides who book appointments 3 months before the wedding. We focus on what’s going to be safe during the timeline.
What’s your treatment approach for type B brides who come in with just a few months until the wedding?
Dr. Halim: We have a laser facial that combines certain chemical peels and biostimulators with a very mild laser to resurface, exfoliate, and provide somewhat of a glow. We call it red-carpet ready. The only thing I wouldn’t do, or recommend, is trying to do Botox the month of the wedding because a neuromodulator takes about 7 to 10 days to produce full results and if you want to tweak it, you need at least 2 weeks. Bruising is another risk, and I don’t want brides worrying about covering up bruising with makeup.
Dr. Durairaj: For my brides who are procrastinators, we want to go for a “soft glam” aesthetic. Treatments I recommend give some immediate “va-va-voom.” I’ll do a beautiful cheekbone contouring because that looks great in photos. Seventy percent of your beauty comes from your mid-face positioning. Brides are photographed from every angle, so we want to ensure every angle is their best. I often perform profile optimization procedures, like submental lipoplasty, to create a beautifully accentuated jawline, chin projection, and nasal profile for stunning photographs. I’ll do maximum beauty items like contouring cheeks and jawline, putting a focus on minimalistic effort. We want the filler and toxin to be fresh, done about 4-6 weeks prior to the wedding. I think everyone deserves a little skin polish and exfoliation—maybe a facial, microneedling, or chemical peel.
What recommendations do you have for practitioners when they have a patient come with just 3 months until the wedding?
Dr. Avaliani: Botox, 100%. Four musts for me to target with a neuromodulator treatment are the crow’s feet, the neck (with a Nefertiti lift), the trapezius muscle, and hyperhidrosis. With the trapezieus muscle, specifically, we can improve posture. The bride is not hunched over in her photos. I see an elongated neck, so the bride just looks better. If they’re wearing a low-cut dress, it allows them to show their neck and silhouette better.
What is your regimen for brides to optimize hydration and have a fresh, youthful-looking face on their wedding day?
Dr. Avaliani:I love for any bride to have beautiful, glowy, and healthy skin. When we do laser treatments, I ask them what style dress they are wearing because we want the face, neck, and chest to match. If it’s just a little bit of redness and the pigmentation, we use intense pulsed light (IPL) lasers. If it’s texture, then we perform some resurfacing with Fraxel, Pico, or UltraClear lasers. It really depends on the quality of the skin that they’re coming to me with, and usually it is 4 sessions, so 4 months. If we start at 6 months before the wedding, we have more than enough time to get a nice result.
Dr. Durairaj: I love doing our rose facial, where we microneedle in a low dose of toxin, hyaluronic acid, high-dose vitamin, and stem-cell growth factor. Once that is needled in, your skin looks so amazing the week of the wedding. It’s just flawless, poreless, smooth, and really pretty.
Dr. Halim: If a bride has 6 months, laser treatment is ideal. I would do an aggressive laser treatment to tighten, resurface, and remove any photodamage, pigmentation, redness, fine lines, and vascular issues. I would also address any issues from acne scarring or post-inflammatory hyperpigmentation because 6 months is plenty of time to get it under control.
Dr. Nichols: If they have moderate-to-severe sun damage, we like to use a Fraxel laser to get a lot of those layers off and improve the brown spots, collagen, and fine lines. For brides with mild sun damage, we can do a Clear and Brilliant, which is basically a baby laser or baby Fraxel to deal with some brown spots or redness without a lot of downtime. It’s a treatment brides can do in a series leading up to the wedding.
What treatment areas are less common that practitioners could suggest would enhance the bride’s appearance?
Dr. Durairaj: There are some creative things we can do. Brides’ hands get photographed a lot with their beautiful rings. Hand treatments with hyperdilute calcium hydroxylapatite (CaHA) are great to improve youthfulness. We can treat brown spots on the hands with light peels or laser treatments. Depending on where the honeymoon is, the bride might get Botox for hyperhidrosis to avoid sweating through garments. Drying up a sweaty scalp or hair also can be a fun treatment so that hairdos last longer, enhancing photographs and other things.
What can clinicians recommend outside of aesthetic treatments to improve wellness ahead of the wedding day?
Dr. Durairaj: When brides are feeling rundown, we follow some wellness protocols, like giving some IV infusions with NAD or IV hydration. With all the running around, they sometimes just hit the wall and need a little bit of internal pampering, too.
Do you have any advice for clinicians with interest in building their bridal clientele?
Dr. Halim: You must have your collection of before-and-after photo sets. As a provider, you need to be in alignment with what your patient’s goals are because, all too often, what the practitioner sees vs what the bride-to-be sees may not be aligned. If you try to push your aesthetic eye on them, that’s where things sometimes don’t align. I allow the bride-to-be to tell me what they are looking for, and some will show pictures. I explain to them what is practical, realistic, and doable vs what’s not. Once they understand and agree with my evaluation, we go from there. Sometimes, the features the patient desires are not suitable for their other features and are not going to look anything like the photo. At that point, I try to stimulate and show them that if we lift this or add volume here, this is the result you will get, and I ask if that is what they would like. It is a collaborative assessment and consultation first because you can’t just push something you like upon someone—even if you have the perfect aesthetic eye as a practitioner. I tell other providers who want to get those bridal patients that you need to be very open-minded and flexible. I think you must set realistic goals and expectations, and work with the bride.
Dr. Nichols: My No. 1 piece of advice is to have before-and-after photos—specifically, a little bridal section so they can see what to expect. No. 2, have a timeline and a bridal plan ready for them. A lot of them have so much on their mind that if you can just hand them something stating what they should do, they will feel so relieved—and, of course, you will customize each plan based on the bride’s needs.
Dr. Avaliani: Please do not take any brides who have less than 2 weeks before the wedding. One month should be your cutoff. You want to see them 2 weeks after any treatments, especially when they had a neurotoxin for adjustments. If they had filler, especially lip filler, you want to ensure there are not bumps or lumps. Do not try any new treatment areas because you cannot undo it.
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