The fast paced world of non-surgical aesthetic procedures becomes ever more magical with every month that passes bye. From a BACD meeting in Nice, to an IMCAS meeting in Paris and even all the way to the Anti-Aging show in Las Vegas, new procedures and techniques are being developed and invented and the non-surgical world is becoming ever more the leader in the anti-aging field. With brand new refined fillers, great botox techniques, and lasers which can do everything from rejuvenating the face, to removing even the most stubborn areas of cellulite.
But as brand new developments in our field come and go, in the last 3 or 4 years I have been preoccupied with 3 fantastic procedures which have become a true speciality o mine. These are 3 procedures which were never thought possible until recetnly, and all 3 can now replicate , in a much more natural way, results which were before thought only possible with 3 very well known surgical procedures: rhinoplasty, lower blepharoplasty, and a lower face lift.
The non-surgical rhinoplasty is a real favourite of mine. A procedure which takes only 5 minutes to perform , with no pain or side-effects and great results. With this procedure we can do many things. We can correct imperfections after a surgical rhinoplasty, we can straighten injured noses and we can even build up and shape noses in asian and afro-caribbean patients who want to have bigger, more european looking noses. All of these 3 applications are performed by a careful injection of hyaluronic acid fillers such as restylane, and I favour the fillers with bigger particles such as Perlane. The results are better and longer lasting, up to 12 months. The most wonderful application of these non-surgical nose shaping techniques however, is definietly that in many cases we can replicate the surgical procedure alternative, by straightening the nose, evening out the dorsal hump, lifting the tip of the nose, changing the shape of the nostrils, and optically we can even make the nose look smaller. Of course, not all patients are suitable, but this modern cutting edge technique now provides a great alternative to all those who would never consider an operation.
Great expertise is needed with this procedure, but by carefully injecting dermal filler above and below the “bump” on the nose, we can very easily make the most “hooked” of noses, look completely straight. Additionally by applying filler around the tip of the nose, we can make it look thinner and more refined, and can further lift the tip of the nose by injecting botox into the depresor nasalis, the muscle which continuously pulls the nose down. After many thousand cases which I have performed I am still amazed each time with the possibilities of this procedure.
The second of my favourite procedures is the non-surgical eyebag removal, very commonly known as the tear trough procedure. With over 3000 performed cases, I can honestly say that this is my favourite procedure with a real wow factor. It is my opinion that in 95% of patients presenting with a lower eyebag, dark circle or a loss of volume in the area below the eye, we can now very successfully correct the problem with a careful and intricate application of hyaluronic acid fillers. In my experience even the older patient with a significant lower eyebag swelling and skin laxity, can benefit from this procedure greatly.
This procedure is best performed using needles, as the ever trendy cannulas in my opinion are too inaccurate for this procedure, not to mention that patients do not like having fillers injected through a cannula, it just feels too much like a big procedure with a cannula!
In the case of the tear trough procedure, I use a very careful multiple puncture tehnique, injecting the filler deep just above the orbital bone. I inject many times, depositing small boluses, and massaging them and moulding them carefully along the way. Like a patchwork, I slowly bulid up the filler, and because of my special technique, I have never yet had to use hyalase to melt the product away. The procedure takes only 10 minutes and the results are truly amazing. This procedure rejuvenates the tired aging face like no other and the results can last as long as 12-36 months.
Last but not least, I have to mention the Nefertiti neck lift. A very simple procedure, with a very apt name, using botox and dermal fillers to tighten the skin around the jawline and to get rid of that most tell tell of signs of aging, jowling. Injecting carefully calculated doses of botox into the platysma (the thin sheet of muscle around the neck which is constantly pulling the aging skin downwards), the strength of this muscle is weakened, and the muscles on the upper face perform a natural “face lift”. By filling the areas of fat atrophy around the jawline, just like reinflating a balloon, we straighten up the jawline, and we magically erase thosy pesky jowls. A true lower facelift.