Turning Back the Clock

From dermal fillers to chemical peels, an increasing array of non-surgical cosmetic procedures is available to patients that want to wipe away the years—without going under the knife.

Not everybody wants to spend up to £10,000 on a surgical facelift.  Not everybody has the time or opportunity to disappear like a recluse for two to three weeks as they recover from this surgery without anybody having to know.  And, not everybody is comfortable with the idea of someone they hardly know taking a scalpel to that part of their anatomy which defines them most.

Perhaps this is why there has been such an exponential rise in the popularity of non-invasive cosmetic procedures in the UK, which although not entirely risk-free, are at least—in the right hands—generally very safe and considerably cheaper. 

What kind of treatments are we talking about here?  Fundamentally the treatments involved are those that are trying to help you in your quest for perpetual youth.  We all want to live to 100, of course, but we also want to age gracefully with glowing skin which radiates beauty from a perfectly sculpted face. That may be an unrealistic expectation, but nevertheless, hundreds of thousands of women and men with a little disposable income are more than happy to invest in a course of dermal fillers, injectables, radio-frequency skin tighteners, chemical peels and laser treatments.  Sometimes these treatments may be combined into what may be described as ‘mini facelifts’ or ‘no-knife facelifts’ so that a course of different treatments are applied within a short space of time.

Surprisingly, a great many perceived facial imperfections can be addressed in this way. Age spots, unwanted hair, acne scarring, rosacea, loose jowelly skin, laughter lines, furrowed brows and crows feet can all be made to look dramatically better after treatment.  Dermal fillers can do much to restore the ravages of time, gravity, sunlight, smoking, alcohol and stress on even the most looked-after of faces. Fillers can make deep vertical nasolabial creases between nose and corner of the mouth all but disappear.  They can smooth out lip lines along which lipstick can infuriatingly bleed, and plump up thinned and sad-looking lips. In our 20s it is said our faces are heart-shaped—wide cheek bones with plenty of healthy tissue around our eyes and upper face. Later, that lovely youthful shape starts to invert as tissue is lost beneath the skin, and muscle drifts south giving us a thinner more bony upper face and a floppier, more jowelly lower face. The heart-shaped face of youth has become more of a pyramid shape with the apex at the top and its base hanging like a figurative noose around your neck.
Let’s just take Botox, for example. A purified protein derived from the anaerobic bacterium clostridium botulinum.  First used to treat blepharospasm—a condition in which the tiny muscles of the eyelid keep annoyingly flickering—in the 1980s, patients reported a coincidental improvement in their facial lines. Subsequently used for treatments for squint, hemifacial spasm and other clinical applications it was licensed for cosmetic use in 2002 by the FDA as Botox. These days Botox is also used for excessive sweating, focal spasticity associated with strokes and for migraines and incontinence. It works by preventing the release of the chemical from nerve endings that allows muscles to contract, so when injected it creates a paralysis of specific muscles for up to three or four months.
Good understanding of a client’s facial anatomy is important and so is the dose.  Too much can leave the client with a totally frozen look that others will notice, but for some is desirable. Others want a more subtle change so that people who know them compliment them on how well they look without knowing that they have had any procedure performed. Similar principles apply to other non-invasive procedures.

So How Safe Are Such Treatments?

Many thousands of these treatments are administered on a weekly basis, and so widespread is their use that even in clinically substandard beauty parlours the popular perception is that they are as much without risk as cosmetics themselves. Yet, there are always risks when you inject the skin or apply chemicals or laser treatments to it. Furthermore, there are many non-qualified people without training or experience (not to mention insurance) who may do you harm.

Ideally, to ensure safe non-invasive cosmetic treatment, do your research first. Find out what is involved, what the risks are, how much it will cost and what the qualifications and experience of the practitioner are. The treatment should only be carried out by an appropriately trained doctor, dentist or registered nurse in a properly approved clinical environment. Currently, people can obtain Botox or something like it from beauticians with a weekend’s training, practising from their garden shed. That is not ideal.

A reputable practitioner, although not bound to by law, should be registered with the Care Quality Commission (CQC) and be registered with either the General Medical Council, the General Dental Council or the Nurse and Midwifery Council. They should meet you face-to-face rather than prescribing the treatments remotely, they should be able to introduce you to other clients they have treated, and should spend time with you explaining the procedures and your choices, whilst telling you about any side-effects and risks at the same time. Balancing the client’s expectations is important too to avoid possible disappointment. It is always important to ask about aftercare too, just in case an unexpected problem arises.

As Professor Simon Kay, a consultant plastic surgeon and Member of the British Association of Plastic Reconstructive Aesthetic surgeons says, ‘Non-surgical procedures usually involve injections of either fillers or botulinum toxin type A, and carry less serious risks then surgery in general.  However, over-correction can be difficult to treat as can asymmetrical placement of the filler and allergic reactions.’

That said, the vast majority of clients who undergo such treatments are generally delighted by the comments they receive from others. In the clinic where I work we believe that less is more. Most women, although not all, will be hugely pleased when others compliment them on how healthy they look without being asked ‘have you had work done’?  Others love the frozen look and are only too happy make it the topic of social conversation.  That’s why managing a patient’s expectations is so important from the start.

Dr Hilary’s Aesthetic and Private General Practice clinic can be found at 64 Knightsbridge, London, SW1X 7JF.

FAST FACTS
As non-surgical cosmetic procedures are rarely available on the NHS it is most likely your cosmetic treatment will need to be done privately. Therefore, it’s vital that you do your research beforehand, as many of these treatments are not regulated in the same way as surgical cosmetic procedures.

INJECTABLES
Injectable cosmetics are a rapidly growing market. Botulinum toxin injections are one of the most popular forms of treatment, during which a small amount of the toxin is injected into the treatment area to help facial muscles relax and reduce the appearance of wrinkles. It can take up to two weeks for the full effects of the treatment to be seen, and bruising at the site of the injection is common. Dermal fillers are also used to fill out wrinkles in the skin, in addition to increasing the volume of the lips. The practitioner injects the dermal filler in to the specified area through a series of small injections, before gently massaging the area. Side effects may include rashes, swelling and itching.

THE CHEMICAL PEEL
Used to improve the overall appearance of the skin and alleviate the appearance of acne and pigmentation, chemical peels remove dead cells from the surface of the skin and promote new cell growth. Superficial, medium and deep peels offer varying effects, and with a superficial peel the effects are only temporary. Although medium peels remove skin cells from the top and middle layers of the skin, repeat treatments are usually needed every six to 12 months to maintain a similar effect. A deep peel, which penetrates down to the lower part of the dermis, is a one of treatment.

MICRODERMABRASION
Designed to reduce the appearance of blemishes and wrinkles, microdermabrasion is performed using a small handheld vacuum that contains small crystals to loosen dead skin cells before vacuuming them away. Side effects may include redness, swelling and dry, flaky skin.

Source: nhs.uk

See also: Nip, Tuck & Tweak

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