01.Non-surgical 'face lifts'
There are many non-surgical options offered to people who would like to look younger, but do they live up to their claims? CHOICE looks into what's on offer, including:
Lunch time lifts
The “lunch time face lift” promises a younger, better-looking you with no surgery, no general anaesthetic and no down time. While “lunch time” and “face lift” may be a bit of a stretch, these days it’s increasingly possible to take a few years off your face in a day clinic without the expense, pain and temporary disappearance from public life associated with surgery.
However, there are caveats:
- First and foremost, there’s no such thing as a "non-surgical face lift": there’s skin smoothing and tightening, volume replacement and wrinkle reduction. But no non-surgical treatment defies gravity, so no non-surgical treatment is going to give you the same lifting results as surgery. Tailor your expectations accordingly.
- You have to be a good candidate for the less-invasive procedures, and most are designed for people in their 30s to 50s with reasonably good skin who are prepared to protect it from the sun.
- Some procedures involve a lot of pain and some still entail a recovery period hiding out at home.
- The results won’t last as long as a surgical face lift, and the costs of repeating the procedure several times over 10 years (which is how long a face lift "lasts") may end up exceeding those of surgery.
- You get what you pay for - mostly. While salons and spas may offer radio frequency or ultrasound skin firming or facial peels for a tenth of the price of a cosmetic physician, it’s likely the treatments aren’t as strong. In addition, the staff may not have had the training and experience necessary for evaluating client suitability or delivering the procedure safely. That said, there are no guarantees with cosmetic physicians either – but the odds of a safe and effective procedure are better.
- The appearance of ageing takes a number of forms, including expression lines, loss of fat volume, loss of bone structure, gravity, and the big one – sun damage. Dr Phillip Artemi, spokesperson for the Australasian College of Dermatologists, says, “Seventy-five per cent of what you see in the mirror at 50 or 60 is due to sun damage”.
- There’s no one treatment that deals with all skin issues and works for all people, and a cosmetic physician may suggest you have more than one: for example muscle relaxers for forehead lines, dermal fillers for nasolabial folds and volume replacement, and IPL or a peel for fine lines and skin texture.
Finally, all procedures carry risks of temporary or even permanent damage, leading some to lament, “I wish I had my old skin back”.
So, if you're still willing to go ahead, what are your options?
The injection of filler materials under the skin can fill in deep folds, such as nasolabial folds (also called “bracket lines”, running from the corner of the nose to the corner of the mouth), create fuller lips and pad out hollow cheeks and eyes. Rather than just smoothing or tightening skin, they can change the facial profile to a more youthful one.
While collagen used to be the standard filler, hyaluronic acid, with brand names like Restylane and Juvederm, is now more popular. Hyaluronic acid lasts 6-12 months - although treating areas of the face that move less will last longer those that move more, such as the lips - and you tend to get better results with each treatment. There’s evidence that hyaluronic acid injections can also have a more permanent anti-ageing effect by stimulating collagen growth.
Synthetic fillers such as Radiesse are long-lasting (12-18 months). The main risk associated with these is lumps forming under the skin that have to be surgically removed, or changes to the skin structure that occur with age, leaving odd shapes where the filler is.
Finally, there are fat transfers, where your own body fat is extracted, processed and injected into your face. This can be expensive, and while it sometimes lasts five to 10 years, the fat may not survive long at all, and may be absorbed back into the body.
How much these procedures cost is difficult to say because treatments are usually priced by the type and volume of filler used, and that depends what you’re having done. Prices start from a few hundred dollars and can exceed $1000, with fat transfers at the higher end.
Botulinum toxin (brand names include Botox and Dysport) temporarily "paralyses" muscles when injected. This prevents the skin above from creasing up and causing wrinkles. It only works on so-called "expression lines", such as frown (vertical) lines and surprise (horizontal) lines on the forehead, smoothing them and preventing them from becoming more pronounced. It won’t do anything for sun-damaged skin or lines caused by skin sagging, such as nasolabial folds.
Though a prescription-only drug, it’s possible for non-medical professionals to obtain and inject Botox or its other variants, with potentially serious consequences if something goes wrong. It's best to leave these injections to an experienced medical professional - and definitely not to have them at a "Botox party".
The cost depends on how much is injected, and typically starts from around $100 to over $1000. The process itself is relatively painless, but you can’t lie down or rub the area for several hours afterwards - this is to prevent the toxin spreading to other areas.
The effects take a few days to kick in, and initially last a few months - longer after continued treatment. Possible side effects include a droopy upper eyelid if the drug's injected too low on the forehead, and this may last a couple of weeks. In the hands of a skilled administrator, you can avoid the notorious "frozen" look.
Liquid face lift
Combined use of muscle relaxers and dermal fillers is called a liquid face lift. It costs about $1000-4000, depending upon how much work is done, and lasts from one to two years.
Acid, such as glycolic acid, lactic acid or trichloracetic acid, is applied to the skin and exfoliates the top layer of skin, causing dead skin cells to peel off. At stronger concentrations, new, tighter skin forms as collagen production is stimulated in response to the wounding.
It can help reduce fine lines, small scars, discolouration and sun damaged skin. The stronger the peel, the more dramatic and longer-lasting the results - stronger peels (concentrations of more than 30%) are better left to medical professionals rather than beauticians. The acid stings, and for a strong peel a sedative may be helpful. After care for a strong peel may include bandaging and it could take weeks to heal. For milder acids some redness and peeling is expected in the first week, and there may be some crusting or scabbing.
The benefits can last for two years for stronger peels, although it depends on the strength of acid used (which determines how deep the peel is). These days a course of several milder peels, rather than one strong peel, is common. Milder peels may require top-up peels every few months.
Costs range from under $100 to several hundred dollars, depending on the type.
Not to be confused with dermabrasion, which is rarely used these days, microdermabrasion can be done at a salon or spa and uses fine crystals to sand the face, removing dead skin cells.
It may help fine lines and wrinkles, and improve skin texture, but don’t expect a major anti-ageing effect. There will probably be some redness and swelling for a few hours.