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The Injectables

There are many options to rejuvenate ageing facial features and injectables have been the commonest type of treatments. All cosmetic surgery is on an increase, in part due to social media, ease of access and increasing disposable income. Between 2014 to 2015, there was an increase of 13% in the total number of cosmetic procecures (as reported by BAAPS, 2016). Botox is the most common non-surgical cosmetic procedure in the UK and USA, followed by dermal fillers. Their widespread availability, virtually nil downtime, relative low cost compared to surgery and its low risk profile lends itself to intense popularity. There are also individuals who are averse to surgery in general, despite it being their optimal option, and would only go for less invasive measures. Some clinics market injectables as a lunchtime treatment and trivialise them to the same level as having a massage. The Clinic strongly supports the tightening of regulations and having a registry of competent practitioners in the interest of patient safety, but this is out of the scope for this article.


The trend of celebrities openly tweeting their procedures or posting about their facial transformations has contributed to a powerful shift in the way injectables are thought of. It can seem to diminish the weight of procedures that fundamentally change your facial appearances. If procedures are done by doctors or aesthetic professionals with great experience, then results are good and consistent (celebrities will be going to these centres). However, the someone wanting to emulate their popular look, and having it done at the local beauty salon offering botox and filler, may very well likely be disappointed.


The Lumaesthetic Clinic always maintains that botox and fillers are not trivial nor inconsequential procedures that can be done by anyone. First of all, they change the way you look and this is important in its own right. Symmetry and finer details of what makes a face beautiful can only be achieved by study plus an appreciation of aesthetics from experience. Secondly, despite them having a medium-term, temporary action, uncommonly they can have adverse effects. The most serious of these can be permanent. Having them done by a surgeon with experience of facial anatomy can reduce complication risks.

Surgical Aesthetics

On the other side of the spectrum of facial cosmetic procedures we have the different types of surgical facelifts. These require a cut into the skin and the facial tissues rearranged or tightened. There is no facelift for all seasons and different faces will need different techniques. They all have aspects in common, however. They all require: a skin incision, lifting of skin at a certain depth, a design that pulls in a certain vector and fixing the skin to create the lift. Each of these areas have many nuances and decision factors requiring expert analysis.


Although botox and fillers can be effective in rejuvenating facial features, surgical procedures produce the most dramatic effects. By removing loose skin and surgically hitching up tissues, it will smooth out skin that has deeper, plentiful wrinkles with long-lasting results. There is no need for top-up procedures every 3-6 months to maintain your youthful look like for the injectables. Complications occur in the minority but there is a higher risk of serious adverse events compared to injectables. It comes, of course, with a higher price tag as well.

The Continuum

Every face ages differently and therefore require different procedures for rejuvenation. The skin quality, laxity, amount of wrinkles and degrees of volume loss will vary, not only between individuals, but also between different areas of the face. The surgeons at Lumaesthetic Clinic would always evaluate the entire face, assessing for each of these three elements. Rejuvenating all zones of the face creates a harmonious youthful look.


With such assessments and principles, we can then look at what procedures are best suited to each patient. It is worth noting that for the purpose of this article, we have mentioned mostly about the injectables and facelifts, but there are a multitude of other procedures that are along the continuum of complexity. These include thread-lifts, 'filler-lifts', laser treatments, fat-grafting, specific area (e.g. eyelid) surgeries and many more.


Working Together
Therefore, the best option for you is not as simple as the needle or the knife. They are both valid options, complementary to each other and not competing methods of rejuvenation. The best option for a patient may very well be a combination of surgical and non-surgical enhancement. At a general scale, prevention and treatment of early to moderate signs of ageing can be beautifully achieved with just injectables under skilled hands. These would naturally be the younger patients and in this group, a facelift is not required and surgical procedures should be delayed to a more appropriate time. There are ample options for this group to reduce and slow signs of ageing without surgery - botulinum toxin, dermal fillers, light peels and good skincare products.


For an older patient with more wrinkles, laxity and volume loss, a surgical facelift with a few specific non-surgical therapies may be recommended as first line. For those who are surgically averse (or just want a specific area of the face rejuvenated), then non-surgical treatments can be offered as an effective, but less than optimal alternative. There is a limit to the degree of rejuvenation offered by non-surgical therapies and it is important to appreciate that when surgery is the best option, they may function as an adjunct or a less effective alternative, but never a substitute for surgery.


Swiss-Army Approach
The choices are many and decisions can be tough. Like a Swiss-Army knife, there are tools for different applications, and for success you need to have all of them understood. The correct treatment option is one in which the patient is well informed, appropriate to symptoms and can be delivered by a well-trained and experienced surgeon. Whatever clinic you choose, be sure that all those aspects are offered.


At the Lumaesthetic Clinic, consultations with our surgeons will always analyse your facial features, take into account your initial aspirations, explain our clinical suggestions fully and counsel you adequately on any proposed treatments. Contact us for a free, no-rush and no-obligation appointment.


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