VANITY FAIR
Women begged to be injected at an aesthetic-medicine meeting in Sandton, but it can all go horribly wrong, writes Shanthini Naidoo
IWe are going to have a fabulous-looking generation of 40-year-olds
N his immaculately cut suit and blue surgical gloves, Dr Tapan Patel is a tiny bit of handsomeness. Not tall, he has good teeth, great skin, a slick haircut and a posh English accent. But that is not why people are crowded around him, watching his every move, hanging on every word.
Patel, a respected aesthetic surgeon based in London, was in South Africa to teach local doctors, dentists and dermatologists how to make women, and some men, very happy. A guest of Cosmedica 2013, the fourth annual Aesthetic Medicine Conference held in Joburg last weekend, Patel was here to demonstrate the correct way to do botox, fillers and other medical beauty treatments.
Because let’s face the ugly truth, aesthetic medicine can go awfully wrong.
“There are serious longterm effects of botched procedures, the least of which are droopy eyelids or swelling. The worst cases see tissue necrosis, which is permanent tissue damage,” says the convener of the conference, Joburg aesthetician Dr Anushka Reddy.
The president of the SA Association of Cosmetic Doctors, Reddy is a vision with her flowing hair and glam gold nails. Like Patel, she is a walking billboard for beauty medicine.
She says the burgeoning business means that unqualified therapists and bogus doctors are a risk. “Every other doctor and dentist is offering aesthetics now, which is fine, but we are saying, ‘Do it properly.’ This form of medicine is not regulated by the Health Professions Council. It is a non-permanent, non-essential practice, but we need to teach techniques, like how to inject botox safely.”
Happily for the ladies who lift, nip and tuck, more than 200 GPs, dermatologists, plastic surgeons, somatologists and nurses came to learn from the guest doctors. The conference tackled challenges like dermal fillers; bunny lines (caused by squinching your nose when you smile); gummy smile (too much gum shows when you smile); marionette lines (around the corners of the mouth, which make you look sad even if you aren’t); and Nefertiti lifts (for the neck).
Several GPs attended Patel’s masterclass at the Sandton Sun. There are vials of botox, sterile syringes, bright lights and many, many eager women lining up to be guinea pigs for the day. One woman took a “sick day” so her crow’s feet could be injected for free. Some doctors have brought their wives, like Valerie Esterhuyse, who is lying on a bed waiting for her first-ever treatment.
Patel dashes for a mint, then starts the demonstration. He quizzes the doctors on where the procerus muscle and corrugators are. These are the frowned-upon line-makers at that troublesome glabella, the spot between the eyebrows. Patel draws dots and lines on Esterhuyse’s face with a white pencil, asking her to frown, demonstrating which bits will be temporarily frozen by botox to produce the smooth brow that women around the world are desperate for.
“Analyse the frown. We know the muscles of the face that are needed to frown. Start with the upper third [of the face], see what else they need done. Explain how the work on the lower face is more subtle because there is more muscle movement.”
He tells Esterhuyse: “Relax and frown again. Look at the muscles and where they are connecting. Some smiles go all through the face.”
He talks about losing eyebrow hair if the injection is misplaced. Then he moves on to the mix of botox in the syringe. “If you ask 10 barmen how to make a martini you’ll get 10 different answers. It is the same with botox. Presumably you don’t want to be frozen?” he asks Esterhuyse. “Respect botox. One unit makes the difference. You never want to drop these eyebrows,” he tells the doctors.
He talks about how people in hot countries have different wrinkles, and how to spot those caused by squinting at the sun. Then it is crunch time. “Who would like to inject?”
Esterhuyse’s brow is injected by her husband, an avuncular GP. The procedure is quick. Esterhuyse cannot stop beaming afterwards, even though the results will only be visible in a week. She says it was not painful. “I think it is a really thin needle. If it works, I will definitely do it again.”
Patel notices the next model has had some recent treatment and shows the doctors how to spot this. “Frown for me.” She can’t. Not really, anyway. Some muscles on the side of her face move slightly, but not her brow. People have botox addictions, after all. Reddy says aesthetic medicine is not cut-throat here, like in other countries. “We are top notch, on par with the rest of the world. But we are much more understanding of the aesthetics of face. Not like Americans, who really overdo it. South African doctors practise the ‘less is more’ rule.”
More doctors are practising this type of medicine, more often. There are obvious financial benefits for GPs who can add botox and fillers to their ’flu shots and ear-syringing services.
Reddy makes no bones about it. “Absolutely. You are talking about R1 500 to R3 500 cash payments per treatment. This is not covered by medical aid.”
But it isn’t all about vanity. One woman has come in for corrective botox after a car accident left her face asymmetrical. Reddy explains that another woman, lying on a bed with exposed armpits, is being treated for excessive sweating.
There is also a charitable side to the conference. At the Donald Gordon Medical Centre, guest doctor Matteo Clementoni from Italy did pro bono work with a special carbon-dioxide laser used to treat leathery skin which was found to have brilliant results for burn victims. “We have chosen people from the Baragwanath Hospital’s burns unit,” Reddy says. “The laser can break down scarring, meaning people can have mobility again.” Meanwhile, the beauty business is booming. “It is the media,” she says. “Every glossy magazine is talking about aesthetic medicine. Having minor flaws treated is part of the everyday beauty regimen. We are going to have ourselves a fabulous-looking generation of 40-year-olds, who will be very happy with the way they age.”
It does seem to make people happy. The guinea pigs leapt off their medical beds smiling — while they can — and without squinching their noses.