How Functional Medicine Is Transforming Cosmetic Procedures

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.”