Aesthetic medicine is in the midst of a much-needed reset. For too long, cosmetic enhancements focused on adding volume including cheeks that became overly pronounced, overfilled lips that lost their natural shape, and facial expressions that disappeared under the weight of too much product. Now, patients and practitioners alike are stepping back and asking a different question: How can we help people look more like themselves and not less?
Dr. Olga Zilberstein, a physician based in New York City, built her career around that very idea. With over 18 years of experience in non-surgical aesthetics, her approach is rooted in facial structure, skin health, and the belief that subtle, intentional treatment planning leads to the most beautiful and believable results.
“We’re seeing people come in and say, ‘I don’t want to look done. I just want to feel better in my skin,’” says Dr. Zilberstein. “That shift is long overdue, and it’s changing how we practice.”
Understanding What Went Wrong
Part of the industry’s overcorrection came from a phenomenon known as perception drift. After an initial cosmetic improvement, patients can quickly adjust to the new look making them want more, even if they no longer need it. This cycle continues until features appear distorted, not enhanced.
Dr. Zilberstein points out that providers are also susceptible to this mindset. “When you see a patient regularly, it’s easy to lose track of where they started. What used to be subtle becomes the new baseline, and the goalposts keep moving.”
That’s how we ended up with filler fatigue: faces that no longer move naturally, lips that have migrated or ballooned, and skin that looks stretched rather than supported.
A Smarter, Healthier Approach
Rather than relying on volume alone, today’s most effective treatments focus on restoring what time has taken away like collagen, elasticity, and support. Bio-stimulators like Sculptra and Radiesse work gradually, encouraging the skin to rebuild itself from the inside out. Radiofrequency microneedling, ultrasound, and laser therapies help tighten and refine texture without overfilling or adding bulk.
Thread lifts, especially PDO and PCL threads, are another option. Dr. Zilberstein is an international trainer and speaker on advanced thread techniques and uses them to lift and reposition tissue while preserving natural contour and movement.
“It’s not about erasing every line,” she says. “It’s about strengthening what’s already there and aging with integrity.”
What to Watch For—and What to Ask
Patients seeking aesthetic treatments should take time to evaluate both the practitioner and the approach. Some questions Dr. Zilberstein encourages patients to ask include:
- Will this treatment improve the health and quality of my skin?
- How will this affect the natural shape of my face?
- What’s the long-term plan for maintaining balance as I age?
She also recommends being wary of overly aggressive treatment plans or providers who offer instant transformations. “Natural results come from understanding anatomy, respecting proportion, and knowing when to say no.” If the before-and-after photos all look the same, or if the provider isn’t explaining why they’re recommending a particular treatment, it may be worth seeking a second opinion.
Aging With Confidence—Not Disguise There’s growing recognition that more isn’t always better. The best aesthetic work today doesn’t chase youth—it supports it. It doesn’t flatten expressions or inflate features. It helps patients look more rested, more vibrant, and more like themselves.
“We’re not here to fix people,” she says. “We’re here to help them feel strong and beautiful in their own skin.”
Dr. Zilberstein’s philosophy is simple: You, only better. Her goal is to bring her patients back into alignment with how they feel on the inside, without losing what makes them unique.
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