OVER THE KNIFE
Non-surgical breakthroughs in anti-ageing.
Sitting front row at the Paris couture shows is an extraordinary spectacle. firstly, the clothes: a fantasy of femininity crafted with an almost otherworldly precision, beyond price or reason . then, of course, the clients: again, a fantasy of femininity crafted … You get the picture. Nothing displays the changing face of beauty quite so literally as a roomful of the world’s richest women. Cosmetic surgery used to mean taking a scalpel to the sagging skin, cutting and pulling to make the face smaller, tighter.you see those women here, the so-called ‘social X-rays’ first identified by Tom Wolfe in the 1980s, for whom a facelift from the right surgeon is still an important signifier of status. But then, in the mid-2000s, doctors started to understand that what makes us look older is a loss of volume, and the way to reverse that is to actually make the face fatter. this is where fillers came in: the fullness of a youthful face, liberally injected into an ageing one. Those women who have enthusiastically embraced what the beauty industry calls ‘volumising’ are also on the front row, with their peachy, plumped-up cheeks and plush lips (not to mention pneumatic breasts) on otherwise slender frames. There’s a clear aesthetic shift visible between the different generations.
The couture shows are an extreme example, but what you see there closely correlates with what’s happening in the industry at large. “Surgery is ageing badly!” says Dr Jean-louis Sebagh, perhaps Europe’s best-known cosmetic doctor. “When I started my career as a facial plastic surgeon three decades ago, dealing with the ageing process was essentially limited to facelifts — as in using the knife — and mainly concerned patients over the age of 50. Advances since then have been amazing.”
Developments in science have resulted in a whole new arsenal of aesthetic weaponry: Botox, collagen injections, hyaluronic-acid fillers, fat-transfer treatments, plasma and growth-factor injections, plus laser for pigmentation, radio frequency for tightening, red light for brightening and ultrasound therapy to shorten facial muscles, all delaying any need for invasive work. Statistics back this up: the British Association of Aesthetic Plastic Surgeons recently reported a 40 per cent drop in cosmetic surgeries during 2016, the lowest level in almost a decade. according to Dr Michael Prager, widely regarded as one of the best in the business when it comes to non-surgical treatments, the reason for this “could really be the fact that a lot of patients started 15 to 20 years ago, possibly with Botox and fillers, and they have not progressed to surgery because these things prevent ageing more than is assumed. Before, it was about rather crude and bulky injections, but now the products are more refined and our understanding of facial ageing is much more advanced.” the rise of ‘no-knife surgery’ is a definite trend, says Dr Paul Charlson, the president of the British College of Aesthetic Medicine.“there’s a greater interest among plastic surgeons nowadays in non-surgical techniques — they don’t want to have to chop someone up. there are some things that you can’t achieve with aesthetic medicine — lifting jowls, for example, and fixing those lines around the side of the mouth — but it’s extraordinary what you can do for everything else.”
“Volume replacement is what has really changed in the last few years,” says Dr Frances Prenna Jones, whose discreet clinic is in the black book of most beauty editors. “People used to say, ‘I am not having filler, there’s no way.’ Now they understand what it really means — that you don’t have to have puffed-up lips or puffed-up cheekbones.” As new products are released onto the market, the best cosmetic doctors have developed a kind of bespoke facelift that uses injections of hyaluronic acid to restore symmetry and proportion, reshaping the jawline and ‘raising’ the cheekbones. this is usually combined with a little Botox, plus a cocktail of laser treatments that work to improve tone, texture and elasticity.you have to trust the doctor here, obviously: the most skilled will do the kind of subtle refinements that don’t make you look younger, exactly — the pursuit of youth is always doomed to dissatisfaction when it comes to beauty — but more like the version of yourself you see in the mirror after two weeks’ holiday and about 12 hours of sleep.
Of course, if you embrace these cosmetic procedures, it takes commitment. It takes time, money and energy. It takes what medical practitioners call ‘proactive maintenance’, which means regular upkeep, sometimes every few months. It also takes self-awareness to know when to stop. that can be the trouble with this stuff: it comes down to judgement and taste. we’ve all seen the overfilled celebrity face — not younger, just ‘done’. what looks flawless on Instagram doesn’t always translate to real life.who can recognise the point
The demand for conventional plastic surgery is falling as more of us opt for non-invasive procedures to achieve natural-looking results. By AVRIL MAIR
when enough is enough, when what constitutes ‘too much’ is an entirely subjective matter? “A lot of patients are paranoid that people will think they have had work [done],” Charlson says.“part of what I do now is avoiding that.the truth is that most women want to look fresher, rather than different; probably over 90 per cent don’t actually want to appear altered. We can make you look better, not odd.” As Prenna Jones says, “The biggest compliment for me is when patients say that their friends comment on how well they look — and yet they have no idea that they’ve had any treatments.”
There is still something that stops us being honest about the things we do to ourselves in the name of self-improvement — even though more of us are doing it than ever.actors and models like to keep it secret, to look an interviewer right in the eye and demur at the suggestion, confessing to having tried something or other once, but never again. Maybe when the time is right, they mutter, talking of their love for a certain cosmetic doctor’s skin cream but nothing else, oh no. For the sake of sisterhood, I’ll be more upfront: as a former beauty columnist, I’ve tried countless procedures, from the weird to the wonderful via the undignified and excruciating; from the truly life-changing to things that defy both common sense and medical credibility. Botox, Restylane, Perlane, Juvéderm, Sculptra, mesotherapy, platelet-rich plasma therapy, intense-pulsed-light treatment, chemical peels, laser liposuction, breast injections, lip implants … you name it, I’ve tried it. And what I learnt is this: perspective is everything. Going into any kind of aesthetic or cosmetic surgery thinking you will turn into someone else — someone younger — will only lead to disappointment.yes, you can find improvement. But at the end of the day, you’re only ever a new version of the old you.