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In a world full of fillers, there are ways to continue looking like yourself ... only better
Long gone are the days when neuromodulators and soft-tissue fillers were treatments solely for the super-rich. These days, just about everyone has access to rejuvenation or pre-juvenation.
“Cosmetic treatments are increasing in popularity,” says Dr. Shannon Humphrey, dermatologist and medical director at Carruthers & Humphrey in Vancouver.
Humphrey says there are two main reasons that more and more people are embracing cosmetic procedures. And at younger ages, too.
“One, is that generational shifts are driving this. When we look at millennials and younger, just as they do with smartphones, treatments like Botox are perceived in a totally different, totally mainstream sort of way,” she says. “When I hear millennials talk about coming in for their Botox, it’s like they get their teeth cleaned, their hair cut and they get their Botox.”
Humphrey says this “paradigm shift” is prominent among patients ages 25 to 37 and has largely been driven by social media. Meanwhile, the other factor driving the increase in these types of treatments, predominately for the older, “positive-aging ” group is simply word of mouth.
“When we look at gen-Xers, even older boomers, just by a more conservative mode of communication — through friends and through positive experiences — I think that group is growing as well,” she says. “But it’s really fast on the more youthful end of the spectrum. That’s one of the biggest shifts.”
While the idea of a 20-something booking in for a Botox treatment may seem shocking to some, to Humphrey, it’s actually a positive, proactive move for those worried about how they ’ll look as they grow older.
“It’s actually a great thing,” she says. “They come in when they see the very earliest signs of aging — not to erase it, but really to just have a strategy and a plan to look their absolute best over time.”
The pre-emptive care not only potentially reduces signs of aging dramatically over time, it also allows for treatments to be administered with a concentrated outcome plan over a longer period, she explains. “Very conservative treatments done over time are a) safer and b) have much more natural-looking outcomes,” she says. “They allow me to harness a preventative effect rather than just an immediate-result delivery.”
But she’s quick to stress that fillers and other types of injections aren’t for children, nor should they be done on patients who are under the age of 18.
“I would say a reasonable time to talk about goals and evidencebased skin care on a very conservative, preventative regime for skin health in the mid- to late-20s is perfectly reasonable,” she says, answering the how-soon-is-toosoon-question.
“But, adults. These are treatments for adults.”
Whatever the final cause for the uptick in procedures, as treatments with neuromodulators like Botox and fillers such as Juvéderm and Restylane Skinboosters have become more accessible — and accepted — so too have concerns surrounding proper use and practice.
“People who have overly arched eyebrows or who have a very frozen face,” she says of common potential concerns. “Nicole Kidman circa two years ago. This is just poorly done neuromodulator treatments.
“The part that really strikes me about it is, both the patient and the provider in those situations don’t seem to reflect on the fact that it looks terribly unnatural.”
Humphrey says while patients in north of the border are less likely to ask for that over-filled, overfrozen look that celebrities such as Kidman, Kylie Jenner and even Sandra Bullock have been criticized for, “extreme modification” is not entirely unseen.
“Every patient who comes in, their first and foremost is, ‘I want to look natural’ and, ‘I don’t want to look dramatically different,” she says.
For patients who experience any “weird results” such as raised eyebrows or a funny expression from neuromodulators, Humphrey says an expert can usually correct or modify the results — to a certain extent.
“Unfortunately, the over-frozen look, you have to wait for that to wear off,” she says. “Typically, that’s within four months.”
For botched soft-tissue fillers, over-inflating or a lopsided application, for example, Humphrey says the solution is relatively simple.
“We’re quite lucky these days in that most of the fillers we use are hyaluronic acid fillers, which is a naturally occurring sugar and it is reversible,” she says.
Humphrey points to an enzyme called Hyaluronidase as the oftused remedy for injection errors.
“You can inject it into the filler and it dissolves it into water,” she explains. “And that happens almost instantly.”
But, quickly — and correctly — remedying concerns or failed outcomes is a key reason that Humphrey stresses to potential patients how important it is to find a provider who knows what they’re doing.
“That is not a skill that all filler providers have. And that is not an enzyme that all filler providers even stock in their office,” she says of the Hyaluronidase fix. “Cosmetic or not, this is real medicine. Thankfully, side-effects are typically mild, but serious complications have been reported. If one of these grave events happens ... you want (your provider) to be able to deal with it on the spot ...
“One of the things I usually tell patients when they’re struggling with where to go for a treatment and they often compare pricing between an esthetician and a dermatologist — you just can’t do this,” she says.
“What I say to them is you want someone who can do a good job, but what you want even more is someone who can, if something goes wrong, you want someone skilled that can deal with it. Not just reversing an unnatural result, but addressing an adverse event or even emergency that arises from the treatment. This is why you want someone who is highly skilled.”
Humphrey encourages patients to think of their “overarching strategy” for their appearance, acknowledging the “values around beauty and attitudes around aging ” they possess before committing to a treatment.
One source of assistance for this, she says, can be photos.
“With more positive-aging patients — so patients who are older and want to feel their best over time and maybe slow things down a little bit — if they have a photo from a time in their life when they felt most confident about their appearance, it can be helpful just to comment and discuss what changes have happened,” she explains.
“It doesn’t mean that we’re going to be trying to make them look like that photo — if it’s, for example, significant volume loss or sun damage — we can have that objective perspective to work toward addressing some of those changes that have happened.”
What Humphrey says should be a no-go, though, for when it comes to reference photos, is looking at a celebrity image.
“Bringing in a celebrity bodypart photo, these types of patients are more beautification patients. They tend to be younger patients and they ’re often social-media motivated,” she says.
While Humphrey says she’s “fully open” to seeing a photo of a celebrity, she says it’s important that the patient be ready to acknowledge that one’s unique face shape and features should be taken into consideration.
Basically, you want to go with someone who will ensure that, when you leave their office, you’ll look like the best version of yourself — but still yourself.
You want someone who can do a good job, but what you want even more is someone who can, if something goes wrong, you want someone skilled that can deal with it. Not just reversing an unnatural result, but addressing an adverse event or even emergency that arises from the treatment.