Devoted, interested or appalled: we all have our own response to the idea of opting for non-surgical aesthetic treatments (or ‘tweakments’ as they’re often called). To some, it’s no different to getting your highlights done; a little light refresh of what nature gave you. To others, it’s a capitulation to the patriarchy and its horror of female ageing.
Either way, they’re not going away: the industry is worth over £3bn, with the lockdown years (or, let’s be honest, Zoom face) fuelling an increasing interest in treatments.
At ELLE, some of us do it, regularly, while others never would. Some of us used to and now don’t; some of us are leaving it for the time being. But one thing we do have is information. The industry is huge, growing and ever-evolving: our inboxes are filled daily with news of novel treatments and innovations. We’ve seen the popularity of drastic face alterations diminish and witnessed a return in focus to improving the look and texture of the skin itself for more natural results. We’ve come to understand that the best of modern tweakments are subtle; the top practitioners have an intelligent and sensitive approach.
But how do you find them? The industry is not easy to navigate and it’s not tightly regulated, so it’s down to the prospective patient to do their research– which is where we come in.
The decision to tweak now, next year or never is entirely up to you. To help, here’s pretty much everything we know about what’s available, with some of our recommendations (and advice about what to avoid) thrown in.
Anti-Wrinkle Injections
Injected wrinkle-relaxers (Botox, a brand produced by Allergan Pharma, has become synonymous with the treatment) is often the first procedure people consider, perhaps due to its time-proven results (it has been around for over 30 years now). It’s also popular because, when used well and delicately, it can diminish wrinkles after a five minute session that even the most potent of face creams would struggle to iron out.
The injections contain the botulinum toxin and work by blocking chemical signals that cause muscles to contract. When injected into the forehead or around the eyes, movement is restricted, meaning your skin wrinkles less and fewer lines will form. They can also help to gently lift the eyebrows or around the mouth – including those vertical ‘marionette’ lines between your nose and mouth – by freezing lazy muscles that have started to succumb to gravity. But they can’t get rid of deep, static grooves that have bedded in, hence the popularity of ‘preventative Botox', starting at a younger age (usually late twenties) than would generally be appropriate for other cosmetic procedures.
The treatment can only be administered by a medical practitioner and it takes a practised hand to give the best results. Because it relaxes muscles, injections just millimetres out of place can cause drooping instead of lifting or, worse, paralysis in the area. Among our go-tos are Dr Suha Kersh and Dr Costas Papageorgiou, who are famed for a steady hand, light touch and a natural-looking outcome.
BOTOX FROM £350 WITH DR DAVID JACK
Recommended Frequency:
Every three to six months.
Pain Rating:
Apart from a tiny scratch from each injection, low. It can sting a bit in more sensitive areas. There is no downtime at all, but it takes around a fortnight to see final results, so don’t be worried if you see too much lift or even some drooping while it settles in.
A two-week follow-up is always advised (and should be offered by your practitioner), in case an adjustment is required.
Results:
Once settled, wrinkles should appear relaxed after a couple of weeks and remain so for three to four months.
Incoming Aesthetics
Hairline Botox
Increasingly popular in America, as (predominantly) Black women turn to the injectable to help prevent forehead sweat that can turn sleek edges frizzy.
Stem-Cell Transfers
Instead of using filler, fat is taken from elsewhere in the body (usually the legs or bum) and injected into the face. The results are thought to be more natural looking and last longer.
Exosomes
These microscopic ‘messengers’ run between cells to boost tissue repair and regeneration, essentially encouraging them to start acting young again. It’s sort of like an injectable retinol, but more potent
Fillers
If you’re tempted to skip this section, we don’t blame you. Dermal fillers have a bad rep, and for good reason. When done incorrectly or overused, the effects are at best unnatural, at worst comedic. But you’d be surprised by how subtle they can be when applied correctly.
Composed of varying viscosities of hyaluronic acid – a popular ingredient in serums and moisturisers – dermal filler is injected under the skin to replace lost volume (like in the cheeks or temples) or lift sagging skin (around the jaw). Practitioners usually use a cannula to insert it then manipulate it with their fingers into a natural position under the skin. The results are instant and can make an immediate difference to the balance and perkiness of skin. Designed to replicate lost volume, not increase it, you don’t ‘need’ to start young.
Brands trusted by doctors include Teoxane and Juvederm. There’s also HArmonyCA, a new kid on the block that marries traditional hyaluronic acid with calcium hydroxyapatite, a complex that stimulates fibroblasts and growth factors – meaning plumping and lifting effects continue for up to two years.
DERMAL FILLER (TEOXANE), FROM £595 AT THE TAKTOUK CLINIC
Recommended Frequency:
An appointment every 12 to 18 months.
Pain Rating:
With a little numbing cream, fillers shouldn’t be painful at all, bar a tiny scratch at the injection point. However, the feeling of the cannula moving under the skin and the filler being pushed around is pretty icky.
Results:
Immediate.
HARMONYCA HYBRID FILLER,FROM £550 WITH DR SOPHIE SHOTTER
Recommended Frequency:
An appointment (plus a follow up),every 18 to 24 months.
Pain Rating:
Expect a tiny bit of soreness to the touch for a few days after and possibly some light bruising.
Results:
Immediate and ongoing.
The Specialists
Dija Ayodele
Her Westroom Aesthetics Clinic champions accessible skincare for all, with women seeking out the founder of the Black Skin Directory for her bespoke solutions to scarring and hyperpigmentation in particular.
Dr Barbara Sturm
The home of the cult darker skin tones range, the clinic boasts a menu of products developed for melanin-rich skin including anti-pigmentation treatments.
Dr Tijion Esho
Known as the ‘king of lips’, the founder of the Esho Clinic has amassed a nationwide following for his clinic’s innovative range of non-surgical treatments.
Lasers
Needle-phobes needn’t miss out. Lasers– which fire a targeted beam of light at the skin – are non-invasive, have options for all skin types, and can be very effective for resolving skin issues like redness, pigmentation and acne scarring. They stimulate collagen production, which helps skin look smoother and fresher, with different wavelengths targeting different layers of the skin. There maybe discomfort after, but the effects are long-lasting – up to several years.
For women with darker skin tones who may have been afraid to dabble (it was a no-no decades ago, due to risk of scarring and burning), fear not – lasers are now safe to use on Black and brown skin. Nd:YAG lasers are the best bet for melanated skin, which also may require treatments at a lower setting over a longer period of time.
FOTONA SP DYNAMIS WITH DEBBIE THOMAS, FROM £455
Recommended Frequency:
Three to six treatments spaced closely.
Pain Rating:
Mild, but intermittent.
Results:
Fotona can stimulate collagen, shrink pores, reduce hair growth, resurface scarring, and reduce rosacea, acne and veins.
COOLPEEL FROM £995 WITH DR WASSIM TAKTOUK
Recommended Frequency:
A short course of treatments (three is typical), four to six weeks apart.
Pain Rating:
Low. Numbing cream is applied and the laser feels like a scratch. Skin will be red and feel hot and rough.
Results:
More even and radiant skin.
FOREVER YOUNG BROADBAND LIGHT, £1,350 FOR A COURSE OF THREE, WITH LEE GARRETT AT THE COSMETIC SKIN CLINIC
Recommended Frequency:
Every two weeks for the course, then every three to six months as maintenance.
Pain Rating:
The laser can feel hot.
Results:
Skin quality should be visibly better in a week, with pigmentation and damaged blood vessels dispersing a week or so after that.
Dos And Don'ts
Do...
...your research into your clinic and medical practitioner and ensure they’re qualified for what they are offering. People of colour should check their practitioner has experience of working with brown or Black skin types, where relevant.
Don't...
...take painkillers before an appointment without checking with the clinic. Some procedures won’t be allowed if you have (due to blood-thinning pain medication can cause).
Do...
...consider what your practitioner looks like. It sounds harsh, but if you think they’ve had ‘too much’ work done, would you want them giving you the same results?
Don't...
...assume it’s reversible. Filler dissolving is complicated and often painful. Botox can’t be undone. If you don’t like the results, you might be stuck with them for months, or longer.
Do...
...accept the numbing cream. If it’s being offered, it’s probably worth the extra waiting time.
Don't...
...make rash decisions. Many doctors will encourage a two-week consideration period after an initial consultation. Be wary of those who are eager to get you on the bed quickly.
Skin Boosters
If you’re looking for a skin improvement without freezing bits of your face or changing its shape, this raft of treatments, with plumping, smoothing and glow-inducing benefits, is for you. Like dermal fillers, they’re made from a hyaluronic acid (HA) base, but in a liquid form. They don’t add volume but instead bed into the skin (via multiple, quick injections around the face) and boost it from within. The effects are impressive, but subtle: more ‘slept like a baby’ than ‘had some work done’.
Profhilo is perhaps the best known, and is a concentrated form of pure HA for collagen stimulation, hydration and elasticity, which can be used across the lower face, neck and even the body. Others, like Redensity 1, are souped up with amino acids, antioxidants and vitamins to further improve complexion concerns such as sun damage and skin tone, almost like injecting your favourite super serum into your skin.
PRP (platelet rich plasma) injections(known as ‘the vampire facial’) and mesotherapy are two other tried and tested, good-skin-from-within treatments. For the former, your blood platelets (for heal-ing and rejuvenating) are injected to release growth factors and stimulate repair, giving a more youthful, bright appearance over time. Mesotherapy gives similar results, but without the fun Dracula element. Instead, a multitude of mini and shallow injections contains a cocktail of celebrated skin ingredients (vitamins, peptides, HA and more).
PROFHILO FROM £500 WITH DR ALEXIS GRANITE AT SKINESIS
Recommended Frequency:
Two sessions within six weeks, every six to nine months.
Pain Rating:
Many people find the injections painful and pinching, especially around the mouth. Numbing cream helps and, in the hands of a skilled doctor, it should take less than five minutes. You’ll be left with little bee-sting-like bumps for up to 24 hours, but otherwise, apart from the possibility of light bruising, there is no downtime.
Results:
Plumper skin can be visible within a few days, but the famous Profhilo glow will take
a few weeks to appear.
TEOXANE REDENSITY 1FROM £400 PER SESSION WITH DR PARIS ACHARYA AT WATERHOUSE YOUNG CLINIC
Recommended Frequency:
Three sessions within six weeks, every six to nine months.
Pain Rating:
There might be a little discomfort at injection points, but there is an ingredient (lidocaine) in the booster to minimise this.
Results:
You should see a plumper reflection within days, but things will get smoother and glowier
a few weeks later.
PLATELET RICH PLASMA (PRP) £550 FOR ONE SESSION, £1,405 FOR THREE AT DR BARBARA STURM
Recommended Frequency:
Three sessions, annually.
Pain Rating:
Minimal, but anyone who finds having their blood taken uncomfortable might want to avoid, as you have to give blood first. There might be some redness after.
Results:
You should see an improved complexion within a few weeks.
MESOTHERAPY £200 PER SESSION WITH DR DRAY
Recommended Frequency:
Three to four sessions, with two weeks apart.
Pain Rating:
Not for the needle-averse, as this is a (quick) series of (tiny) jabs. The needles are micro, though, and combined with the numbing cream, the pain factor is minimal to non-existent. Short term, sensitive skin may redden for a few hours, so keep make-up to a minimum and sunblock on.
Results:
A cocktail of skin-improving ingredients – brightening vitamins, quenching hydration and nourishing minerals – are delivered directly into the dermis and epidermis. Over the next few weeks, you’ll start to see the benefits – namely a more luminous and happier complexion – emerge.
Skin Sculpting
Another route to go down that offers serious benefits without any tell-tale signs are sculpting treatments using microcurrents or ultrasound energy to lift and hone the face.
Ultherapy, which has stood the test of time in the ever-changing world of aesthetics, is widely regarded as one of the best MFU (micro-focused ultra-sound) treatments available. It sends energy in the form of ultrasound waves deep into the skin layers to stimulate collagen production and provide skin scaffolding from within. The procedure was famously painful, but modernisation has taken it to merely mildly uncomfortable levels. The beauty with ultherapy is how long lasting the results can be – up to two years – from a single 60-minute session, and how natural they look: no over-inflated cheeks or Maleficent-esque sharp edges here.
Other treatments, such as EmFace, use electronic currents delivered via pads that are attached to your face to contract your muscles at a high speed and strength, making them denser and sturdier, which in turn provides lift and structure to the face. You’d work your glutes to perk your bottom – this is the same idea, but with more science and less sweat involved.
Finally, ultrasound microneedling machines are fast gaining popularity thanks to their long-term and foolproof results. Best for tightening and lifting, they combine micro-needling and powerful radio frequency (RF) to promote collagen and elastin growth. Delivered by a small stamp of 24 needles, they not only create micro-trauma that encourages new healthy cells but open pathways for the RF waves to be ‘injected’ really deep, meaning that your face is given a renewed foundation. Morpheus8 is perhaps the best known, and doctors love the ability to adjust the depth of the delivery depending on the patient’s requirements.
A similar device is Focus Dual, which uses RF and HIFU(high-intensity focused ultrasound). Darker skin tones will require lower set-tings and several weeks of pre- and post-treatment with hydroquinone to prevent hyperpigmentation.
ULTHERAPY FROM £800 WITH DR MARYAM ZAMANI
Recommended Frequency:
One treatment, with results lasting for up to 18 months.
Pain Rating:
We can’t say it’s not uncomfortable, but it doesn’t linger.
Results:
Some immediate lifting, but true change happens after a month.
EMFACE £3,600 FOR A COURSE OF FOUR TREATMENTS, WITH DR COSTAS AT THE HARRODS WELLNESS CLINIC
Recommended Frequency:
Four sessions, five to 10 days apart.
Pain Rating:
Zero pain, but the muscle pull can feel quite extreme.
Results:
Instant and ongoing for six to 12 weeks, but top-up treatments would be required fairly regularly to maintain results.
MORPHEUS8 FROM £550 AT MONTROSE CLINIC
Recommended Frequency:
Three treatments every four to six weeks. Results last for 18 to 24 months.
Pain Rating:
There are multiple injections stamped around the face, which can be quite painful, but numbing cream helps a lot.
Results:
There’ll be some downtime, redness and possibly a little scabbing. You should see change after a month, with big results three to six months in.
Eyes And Lips
In these delicate areas (the skin around the eye is thinner than anywhere else on the face, and we’ve all seen how easily lip fillers can go wrong), a thoughtful and less-is-more touch is required. For the eyes, under-eye filler is perhaps the most well-known procedure, as it promises to eradicate hollows and tired-looking eyes, but it’s bottom of the list for many doctors as not only can it look totally unnatural but most patients aren’t good candidates.
This is a good area for non-invasive options, such as Sofwave, which encourages collagen and elastin renewal (both key for volume and plumpness). Mesotherapy treatments (such as Light Eyes) can help fix and prevent dark circles, with a high dose of antioxidants delivered to the area.
Meanwhile, Dr Dray’s Lip Refresh is a micro-needling treatment that combines hyaluronic acid and vitamin E to rehydrate and restore that healthy pink colour, which can fade with age. For a soft boost of volume, Dr Sophie Shotter’s lip ‘menu’ offers options from Volite hyaluronic injection, to hydrate and add bounce, to a sturdier filler (Volbella) combined with Botox to define and lift your pout, but with a natural-looking finish.
SOFWAVE FROM £2400 WITH DR GALYNA SELEZNEVA AT THE RITA RAKUS CLINIC
Recommended Frequency:
One 45-minute treatment every 12 to 18 months.
Pain Rating:
You’ll let out a few ‘ows’ when it’s happening, but nothing lingers. There’s zero downtime, too.
Results:
True smoothing effects can take up to eight weeks to reveal themselves. In many cases, there is a pleasing immediate lifting.
LIGHT EYES £295 A SESSION OR £1,035 FOR FOUR WITH DR EUAN AT THE LOVELY CLINIC
Recommended Frequency:
A course of four (two weeks apart) is recommended, with results lasting around six to nine months.
Pain Rating:
Very minimal – you just need to get over injections being so close to your eyes.
Results:
Pretty instant. You should see brightening and diminished dark circles within 24 hours.
