What are the facial issues that doctors are addressing most in 2015 and what are the best ways to deal with lines and imperfections?
Faces change with fashion. And hallelujah, subtlety is back. “We have moved away from the pillow face or trout pout that was in vogue ten years ago,” says Dr Tapan Patel, founder and medical director of Harley Street’s PHI Clinic. “New research shows people do not want to freeze their face in time, they simply want a better version of themselves.”
Although the days of cosmetic surgery are far from numbered – and the only option sometimes – less invasive procedures are proving to be viable options with technology in skincare upping the ante to compete with this new world of cosmetic dermatology. Here are ten treatments…
1. EYES: CROW’S FEET
Injectables: “I use Botox exactly below the lateral extension of the eyebrow – the crow’s feet are just below,” says consultant dermatologist Dr Susan Mayou of the Cadogan Clinic. “Filler can stretch out the loss of volume too.”
Topical skincare: Dr Dennis Gross Skincare Ferulic + Retinol Triple Correction Eye Serum is packed with glycolic and salicylic acid and retinol.
2. DROOPING EYELIDS
Under the knife: “I do a lot of upper eyelid skin and blepharoplasties [fat removals] to remove excess ‘hanging’ skin,” says Dr Maryam Zamani, consultant oculoplastic surgeon. “It takes an hour under local anaesthetic and sedation.”
Injectables: “A nip of Botox below the eyebrows will not only push them up, but prevent gravity pulling them down,” says Dr Mayou.
Topical skincare: Elizabeth Arden Ceramide Gold Ultra Lift and Strengthening Eye Capsules give a visible rise to brows.
Under the knife: “When people get older, the skin sags and also deflates,” says Mr Bryan Mayou, plastic surgeon and founder of the Cadogan Clinic. “Fat grafting from the tummy to the face brings back volume and lifts sagging in the area.”
Injectables: “I would inject a delicate filler such as Volbella under the eye to restore volume,” says Dr Patel.
Topical skincare: iS Clinical Youth Eye Complex has instant and accumulative effects even on notoriously hard-to-treat dark circles.
4. SKIN SAGGING
Under the knife: “A modern face-lift subtlety tightens skin at the sides of the face and on the jawline without looking taut,” says Dr Bryan Mayou.
Injectables: “The eight-point lift is ideal for a milder case of sagging,” says Dr Patel. “We identify the key strategic eight points in the face where sagging is evident – the cheeks, around the mouth and along the jaw line – and inject a variety of fillers to give delicate tightening in all these areas.”
Topical skincare: New Clinique Sculptwear Contouring Massage Cream Mask helps to define a clear jaw line.
5. HYPERPIGMENTATION (SUN DAMAGE)
Under the beam: “I use IPL – intense pulsed light - to remove red and brown spots, also known as liver spots, under the skin,” explains aesthetic doctor Darren McKeown founder of the Aesthetic Medicine Institute in Glasgow. “It gives the complexion a new lease of life.”
Topical skincare: “ZO Medical Brightenex Skin Brightening & Correcting Crème Non-Hydroquinone is a potent retinol-based skin brightener that is safe and effective with a sunscreen,” says international cosmetic surgery guru Wendy Lewis.
6. LINES AND DEEP FURROWS ON THE FOREHEAD
Under the knife: “Endoscopic brow lifts with tiny scars behind the hairline to lift sagging tissues were once the ‘go-to’ procedure for droopy brows,” says Ms Lewis. But less so now.
Injectables: “I would use Botox as well as fillers,” says Dr Sach Mohan, founder of Revere Clinics. “For someone like [footballer] Steven Gerrard, who has deep furrows in his forehead, I would inject Botox first, wait a week and then fillers or the dynamic movement of the forehead will cause the filler to migrate.”
Topical skincare: Perricone MD Acyl-Glutathione Deep Crease Serum deals with troughs.
7. BROKEN VEINS
Under the beam: “A vascular laser, such as the Norcel, will emit a wave of light to pick up the pink of haemoglobin, transfers it into thermal energy and disintegrates the blood vessel,” explains Dr Mayou.
Topical skincare: “Inflammation will exacerbate the redness, so use a topical anti-inflammatory, such as SkinCeuticals Redness Neutralizer,” she says. For sensitive skin, Pai Instant Calm Serum strengthens surface blood vessels helping to alleviate redness.
8. NOSE RESHAPING
Under the knife: “The mainstay of rhinoplasty remains surgical intervention, but it’s changed from reduction to rebalancing the nose for a more natural appearance,” says Dr McKeown.
Injectables: “Sometimes all the nose needs is a small amount of augmentation which can be done by injecting dermal fillers,” he continues. “The procedure is relatively simple with minimal down time, although only effective for specific defects.”
Topical skincare: Make friends with contouring make-up, such as Guerlain 4 Seasons Tailor-Made Bronzing Powder.
9. DULL SKIN
Minimally invasive: “The absolute ultimate treatment here is laser resurfacing,” says Dr Patel. “Wow with modern lasers, patients can have effective treatment with much less down time.” A ZO Obagi face peel is also very effective with a menu of different strengths.
Topical skincare: QMS Medi Cosmetics Exfoliant Fluid containing alpha hydroxyl acids and enzymes to remove dead skin and brighten the complexion.
10. WRINKLY NECK
Under the knife: “With my swan-neck procedures I remove the skin under the neck, pull it into a sharper angle and often combine it with liposuction to remove fat beneath the chin,” says Dr Bryan Mayou.
Under the beam: Ultherapy is the only non-invasive procedure US FDA-cleared to lift skin on the neck, under the chin, and smooth fine lines and wrinkles using heat. “Bar surgery this is the best treatment for tightening and lifting,” says Dr Zamani.
Topical skincare: NeoStrata Triple Firming Neck Cream intensely exfoliates dark spots, nourishes and increases the collagen turnover.
MEN MOVE FROM KNIFE TO NEEDLE
Where have all the men gone? It’s not only singletons asking – the question has cosmetic surgeons drumming their skilled fingers on their Harley Street desks as well. For it seems that men are eschewing cosmetic surgery with the British Association of Aesthetic Plastic Surgeons reporting that despite a boom over the last decade in men and women’s aesthetic operations, male surgery figures dropped by 15 per cent in 2014. Nose jobs are down 30 per cent, “moobs” – or male breast reduction – by 10 per cent and male eyelid surgery lowered 4 per cent.
Have men gone off the metrosexual boil? Not so much, but instead of surgery, it’s the less invasive treatments where they are putting their money. Ask cosmetic practitioners and men are queuing up for the needle over the knife. “Traditionally only five to ten per cent of my practice has been men,” says cosmetic dermatologist Rachael Eckel. “Now it’s more like 40 per cent.”
Bernadette Harte, training manager at the Harley Medical Group, adds: “In recent years we have seen an increase of around 30 per cent of male patients. They are looking for quick and effective treatments, such as Botox, fillers and laser hair removal.”
Who are they? “Typically they are in their mid-40s, on the corporate ladder, but looking tired because of volume loss in their faces,” says Dr Eckel. They may also be back in the relationship market according to Ms Harte. “We are seeing an increase in men post-divorce moving on to a second or third long-term relationship,” she says.
It is notable that men do not tend to share their cosmetic adventures with each other. Although compared to women, men’s skin is physiologically thicker, talk to those who treat them cosmetically and metaphorically speaking, it is considerably thinner.