Even in the earliest years of her life, Keren Bartov knew she was destined to sell good skin.
The Israeli aesthetician was four years old when she first saw her mother apply serums and moisturisers in her vanity mirror, prompting the younger Bartov to steal the products and peddle them around to her neighbours — telling them, in her toddler squeak, “This will be amazing for your skin.”
More than five decades later, her enterprise has grown considerably. When Bartov’s own line of skincare debuted in the US at Bergdorf Goodman, with two $170 creams and six $180 serums, it sold out in 24 hours.
But the nuclei of Bartov’s operation are her clinics in Tel Aviv and London, stocked with the latest and greatest devices the skincare industry has to offer. Her London clinic is stocked with around 50 professional-grade machines, which have to be wheeled into treatment rooms. Her newest toy is a “microwave” device, a form of radiofrequency. A Jan. 2025 Lasers in Medical Science article hailed microwave as a “promising alternative” to surgery for sagging skin. Bartov is the first aesthetician to bring it to the UK. “I really love to be first,” she said.
The world’s most in-demand clinicians, like the French facialist Sophie Carbonari, Thai dermatologist Dissapong Panithaporn and Bartov all stake their singularity on techniques and tools that no one else can offer. Part of this means accessing the latest and greatest in skincare technology, but more often involves stacking existing modalities into novel treatments, owing to the slow pace that medical devices make it to market.
But while some prefer machines, others say their hands are their best kept secret. And not all skin tech stands the test of time — even radiofrequency. Consumers demand newness, but hands can only move so fast.
Most experts agree that a combination of machine technology and human touch provide the best results, and offer a more natural alternative to a facelift, a procedure growing in popularity thanks to high-profile recipients like Kris Jenner. It also justifies a steep price tag, starting at $1,000 and scaling up from there.
“Technology is one thing, but you really need to know how to use it,” said the facialist Danuta Mieloch. “I say it’s like working out with a trainer instead of alone.”
Meet the Geek Squad
Zoom fatigue, “undetectable” aesthetic innovations and value-seeking shoppers who want more Botox for their buck are feeding demand for skincare treatments and the facialists and dermatologists who offer them.
At the same time, these professionals have become more entrepreneurial, likelier to start their own clinics or partner with brands and companies than toil in a name-brand spa for decades.
Before she founded Rescue Spa in Philadelphia in 2004, Mieloch was an aesthetician at Paul Labrecque, a spa in New York. “I felt like I needed to be different. I needed certain equipment, certain products,” she said. Mieloch’s Rescue Spa is famous among the skincare set for being one of the first US spas outside New York and LA to carry the once-obscure French skincare labels Valmont and Biologique Recherche.
She also offered microcurrent and LED therapy, two treatments that were novel two decades ago. “Now, they’re mainstream,” Mieloch said. Even products have become ubiquitous — Biologique Recherche opened a DTC storefront and launched in Bloomingdale’s this year — prompting pros to produce their own ranges, like Mieloch’s Danucera, Carbonari’s S Serum and Panithaporn’s Acca.
Where they distinguish themselves is in their innovative treatments, all of which are designed to offer ever impressive results. Dr. Panithaporn, or Dr. Joe to his 101,000 Instagram followers, is known for developing techniques like “N Glow”, a one-two punch of fractional laser followed by superficial filler. Repeated treatments appear to inflate craggy, acne-scarred skin into smooth Barbie-like perfection. Kim Kardashian posted a photo of her and Panithaporn in Oct. 2025, writing: “I love your work.”
“Technology is moving fast,” Panithaporn said later by phone, “and so are expectations from patients.”
In-clinic devices arrive slowly to market, being costly to manufacture and subject to uneven regulation, leaving practitioners to differentiate themselves by combining existing treatments in new ways. In lieu of a treatment menu, Bartov and her team offer an omakase approach. “We analyze your skin, and then we combine between four to six medical devices in one treatment,” Bartov said, sandwiching radiofrequency, LED therapy and laser sessions between cleanser and moisturiser.
The Facial Luddites
Even as skincare tools for microcurrent or LED therapy have migrated into consumers’ homes, these versions pale in comparison to the power of their in-clinic counterparts.
“If you used [my office’s microcurrent device] at home, your eyeballs would boil,” said Joanna Czech, who got her start as the go-to beautician to Anna Wintour and operates spas in New York, Dallas and Los Angeles. An hour with Czech starts at $1,450.
Czech is credited (by Czech herself) with bringing deep tissue massage to the US after immigrating from Poland. “When Instagram was born and they saw me massaging and slapping, they said, ‘Oh my god, this bitch is stretching the skin,” she said. “I am touching the skin, but [what] I’m really working on is fascia.”
Paris-based Carbonari has become renowned for her fascia focus, and her signature technique of “cracking” facial connective tissue in a series of audible pops. Carbonari charges $1,750 for an hour, and can only do up to four treatments a day before her fingers tire.
She has developed a slight aversion to skincare technology, discovered after she spent a year only using machines on her clients. “It was really frustrating for me, because I’m someone who likes to touch the skin and know what’s going on deeper inside.” Now she uses microcurrent, which is said to increase blood flow and which Carbonari feels is complementary to her handwork.
Many treatments that seem trendy, Czech said, are repackaged versions of older techniques. “I did not have gua sha in Poland,” she said. “But I had the handle of a knife.”
Not all of them age gracefully. In Oct. 2025, the FDA issued a warning about complications from some use of radiofrequency or RF microneedling devices, which tighten the skin using heat. Some patients reported burns, scarring and disfigurement; an anonymous fashion executive spoke to Goop in July 2025 about getting a corrective facelift after the procedure burned her facial fat away.
“Trends come and go,” Czech continued, but true innovations evolve much more slowly, she added.
“LED, microcurrent, cold laser, these techniques have been around for years,” she said. “It’s important not to jump on any wagons.”
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